Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial

Purpose: Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PR...

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Detalhes bibliográficos
Autores: Fernandez-Lazaro, Cesar I, Toledo, Estefanía, Buil-Cosiales, Pilar, Salas-Salvadó, Jordi, Corella, Dolores, Fitó, Montserrat, Martínez, J Alfredo, Alonso-Gómez, Ángel M, Wärnberg, Julia, Vioque, Jesús, Romaguera, Dora, López-Miranda, José, Estruch, Ramon, Tinahones, Francisco J, Lapetra, José, Serra-Majem, Luís, Bueno-Cavanillas, Aurora, Tur, Josep A, Martín Sánchez, Vicente, Pintó, Xavier, Delgado-Rodríguez, Miguel, Matía-Martín, Pilar, Vidal, Josep, Ros, Emilio, Vázquez, Clotilde, Daimiel, Lidia, SanJulián, Beatriz, García-Gavilán, Jesús F, Sorlí, Jose V, Castañer, Olga, Zulet, M Ángeles, Tojal-Sierra, Lucas, Pérez-Farinós, Napoleón, Oncina-Canovas, Alejandro, Moñino, Manuel, Garcia-Rios, Antonio, Sacanella, Emilio, Bernal-Lopez, Rosa M, Santos-Lozano, José Manuel, Vázquez-Ruiz, Zenaida, Muralidharan, Jananee, Ortega-Azorín, Carolina, Goday, Alberto, Razquin, Cristina, Goicolea-Güemez, Leire, Ruiz-Canela, Miguel, Becerra-Tomás, Nerea, Schröder, Helmut, Martínez González, Miguel A, PREDIMED-Plus investigators
Formato: artículo
Fecha de publicación:2021
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/18511
Acesso em linha:http://hdl.handle.net/20.500.12105/18511
Access Level:acceso abierto
Palavra-chave:Dietary adherence
Dietary change
Factors
Mediterranean diet
PREDIMED-Plus
Randomized controlled trials
Dieta Mediterránea
Factores de Riesgo
Humanos
Obesidad
Síndrome Metabólico
Anciano
Enfermedades Cardiovasculares
Estado Nutricional
Sobrepeso
Aged
Cardiovascular Diseases
Diet, Mediterranean
Humans
Metabolic Syndrome
Nutritional Status
Obesity
Overweight
Risk Factors
Descrição
Resumo:Purpose: Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial. Methods: Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of ≥ 5 points for participants with baseline scores < 13 points or any increase if baseline score was ≥ 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance. Results: Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25-1.83; OR12-month: 1.66, 95% CI 1.37-2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07-2.46; OR12-month: 1.62, 95% CI 1.07-2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53-0.79; OR12-month: 0.76, 95% CI 0.62-0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64-0.99; OR12-month: 0.71, 95% CI 0.57-0.88). Conclusion: Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. Trial registration: ISRCTN registry 89898870, 24th July 2014 retrospectively registered http://www.isrctn.com/ISRCTN89898870 .

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