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A Large Randomized Individual and Group Intervention Conducted by Registered Dietitians Increased Adherence to Mediterranean-Type Diets: The PREDIMED Study

AuthorsZazpe, Itzíar; Sánchez-Tainta, Ana; Estruch, Ramón; Lamuela-Raventós, Rosa M.; Schröder, Helmut; Salas-Salvadó, Jordi; Corella, Dolores; Fiol, Miquel; Gómez-Gracia, Enrique; Arós, Fernando; Ros, Emilio; Ruiz-Gutiérrez, Valentina ; Iglesias, Pablo; Conde-Herrera, Manuel; Martínez-González, Miguel A.
KeywordsCardiovascular diseases
Plant oils
Food habits
Olive oil
Issue DateJul-2008
PublisherAmerican Dietetic Association
CitationJournal of the American Dietetic Association 108(7): 1134-1144 (2012)
AbstractOBJECTIVE: To assess the effectiveness of an intervention aimed to increase adherence to a Mediterranean diet. DESIGN: A 12-month assessment of a randomized primary prevention trial. SUBJECTS/SETTINGS: One thousand five hundred fifty-one asymptomatic persons aged 55 to 80 years, with diabetes or > or =3 cardiovascular risk factors. INTERVENTION: 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. MAIN OUTCOME MEASURES: Changes in food and nutrient intake after 12 months. STATISTICAL ANALYSES: 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.
Publisher version (URL)http://dx.doi.org/10.1016/j.jada.2008.04.011
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