title: A large randomized individual and group intervention conducted by registered dietitians increased adherence to Mediterranean-type diets: the PREDIMED study.
abstract: OBJECTIVE
  To assess the effectiveness of an intervention aimed to increase adherence to a Mediterranean diet.
  
  
  METHODS
  A 12-month assessment of a randomized primary prevention trial.
  
  
  METHODS
  One thousand five hundred fifty-one asymptomatic persons aged 55 to 80 years, with diabetes or > or =3 cardiovascular risk factors.
  
  
  METHODS
  Participants were randomly assigned to a control group or two Mediterranean diet groups. Those allocated to the two Mediterranean diet groups received individual motivational interviews every 3 months to negotiate nutrition goals, and group educational sessions on a quarterly basis. One Mediterranean diet group received free virgin olive oil (1 L/week), the other received free mixed nuts (30 g/day). Participants in the control group received verbal instructions and a leaflet recommending the National Cholesterol Education Program Adult Treatment Panel III dietary guidelines.
  
  
  METHODS
  Changes in food and nutrient intake after 12 months.
  
  
  METHODS
  Paired t tests (for within-group changes) and analysis of variance (for between-group changes) were conducted.
  
  
  RESULTS
  Participants allocated to both Mediterranean diets increased their intake of virgin olive oil, nuts, vegetables, legumes, and fruits (P<0.05 for all within- and between-group differences). Participants in all three groups decreased their intake of meat and pastries, cakes, and sweets (P<0.05 for all). Fiber, monounsaturated fatty acid, and polyunsaturated fatty acid intake increased in the Mediterranean diet groups (P<0.005 for all). Favorable, although nonsignificant, changes in intake of other nutrients occurred only in the Mediterranean diet groups.
  
  
  CONCLUSIONS
  A 12-month behavioral intervention promoting the Mediterranean diet can favorably modify an individual's overall food pattern. The individual motivational interventions together with the group sessions and the free provision of high-fat and palatable key foods customary to the Mediterranean diet were effective in improving the dietary habits of participants in this trial.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Zazpe
authors.forename: Ana
authors.initials: A
authors.lastname: Sanchez-Tainta
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
authors.forename: Rosa María
authors.initials: RM
authors.lastname: Lamuela-Raventos
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröder
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvado
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.forename: Enrique
authors.initials: E
authors.lastname: Gomez-Gracia
authors.forename: Fernando
authors.initials: F
authors.lastname: Aros
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruíz-Gutierrez
authors.forename: Pablo
authors.initials: P
authors.lastname: Iglesias
authors.forename: Manuel
authors.initials: M
authors.lastname: Conde-Herrera
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Martinez-Gonzalez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D038441:Diet, Mediterranean; D004046:Dietetics / Q000379:methods*; D007887:Fabaceae; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009754:Nuts; D000069463:Olive Oil; D010349:Patient Compliance; D010938:Plant Oils / Q000008:administration & dosage; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014675:Vegetables
chemical_list: D015415:Biomarkers; D000069463:Olive Oil; D010938:Plant Oils