title: A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study.
abstract: BACKGROUND
  Vegetarian diets have been associated with reduced mortality. Because a pure vegetarian diet might not easily be embraced by many individuals, consuming preferentially plant-derived foods would be a more easily understood message. A provegetarian food pattern (FP) emphasizing preference for plant-derived foods might reduce all-cause mortality.
  
  
  OBJECTIVE
  The objective was to identify the association between an a priori-defined provegetarian FP and all-cause mortality.
  
  
  METHODS
  We followed 7216 participants (57% women; mean age: 67 y) at high cardiovascular risk for a median of 4.8 y. A validated 137-item semiquantitative food-frequency questionnaire was administered at baseline and yearly thereafter. Fruit, vegetables, nuts, cereals, legumes, olive oil, and potatoes were positively weighted. Added animal fats, eggs, fish, dairy products, and meats or meat products were negatively weighted. Energy-adjusted quintiles were used to assign points to build the provegetarian FP (range: 12-60 points). Deaths were confirmed by review of medical records and the National Death Index.
  
  
  RESULTS
  There were 323 deaths during the follow-up period (76 from cardiovascular causes, 130 from cancer, 117 for noncancer, noncardiovascular causes). Higher baseline conformity with the provegetarian FP was associated with lower mortality (multivariable-adjusted HR for ≥ 40 compared with <30 points: 0.59; 95% CI: 0.40, 0.88). Similar results were found with the use of updated information on diet (RR: 0.59; 95% CI: 0.39, 0.89).
  
  
  CONCLUSIONS
  Among omnivorous subjects at high cardiovascular risk, better conformity with an FP that emphasized plant-derived foods was associated with a reduced risk of all-cause mortality. This trial was registered at www.controlled-trials.com as ISRCTN35739639.
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Tainta
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Dolores
authors.initials: D
authors.lastname: Corella
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Jordi
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Emilio
authors.initials: E
authors.lastname: Ros
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Fernando
authors.initials: F
authors.lastname: Arós
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Enrique
authors.initials: E
authors.lastname: Gómez-Gracia
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Miquel
authors.initials: M
authors.lastname: Fiol
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Lamuela-Raventós
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Helmut
authors.initials: H
authors.lastname: Schröder
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Jose
authors.initials: J
authors.lastname: Lapetra
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Lluis
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Xavier
authors.initials: X
authors.lastname: Pinto
authors.affiliation: From the Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (MAM-G and AS-T); the CIBER Fisiopatologia de la Obesidad y Nutricion (DC, JS-S, ER, MF, RML-R, HS, JL, and RE), CIBER Epidemiologia y Salud Pública (HS), and the PREDIMED Network, Instituto de Salud Carlos III) (RE, JS-S, FA, EG-G, VR-G, RML-R, LS-M, XP, and MAM-G), Spain; the Department of Internal Medicine (RE) and the Lipid Clinic, Department of Endocrinology and Nutrition (ER), Institut d'Investigacions Biomediques August Pi Sunyer, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain; the Human Nutrition Department, Institut d'Investigacions Sanitaries Pere i Virgili, Universitat Rovira i Virgili, Reus (JS-S); the Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain (HS); the Department of Preventive Medicine, University of Valencia, Valencia, Spain (DC); the Department of Cardiology, University Hospital of Alava, Vitoria, Spain (FA); the Department of Preventive Medicine, University of Malaga, Malaga, Spain (EG-G); the Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Seville, Spain (VR-G); the Institute of Health Sciences IUNICS, University of Balearic Islands, and Hospital Son Espases, Palma de Mallorca, Spain (MF); the Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Seville, Spain (JL); the Department of Nutrition and Food Science, School of Pharmacy, Xarxa de Referència en Tecnologia d'Aliments, University of Barcelona, Barcelona, Spain (RML-R); the Research Institute of Biomedical and Health Sciences University of Las Palmas de Gran Canaria, Las Palmas, Spain (LS-M.); and the Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (XP).
authors.forename: Valentina
authors.initials: V
authors.lastname: Ruiz-Gutierrez
authors.forename: Ramon
authors.initials: R
authors.lastname: Estruch
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D038441:Diet, Mediterranean; D014676:Diet, Vegetarian; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011795:Surveys and Questionnaires