A large randomized individual and group intervention conducted by registered dietitians increased adherence to Mediterranean-type diets: the PREDIMED study.
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.
Zazpe
Itziar
I
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
Sanchez-Tainta
Ana
A
Estruch
Ramon
R
Lamuela-Raventos
Rosa María
RM
Schröder
Helmut
H
Salas-Salvado
Jordi
J
Corella
Dolores
D
Fiol
Miquel
M
Gomez-Gracia
Enrique
E
Aros
Fernando
F
Ros
Emilio
E
Ruíz-Gutierrez
Valentina
V
Iglesias
Pablo
P
Conde-Herrera
Manuel
M
Martinez-Gonzalez
Miguel Angel
MA
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
D015415:Biomarkers; D000069463:Olive Oil; D010938:Plant Oils