Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/10681
Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study
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ISSN: 0261-5614
eISSN: 1532-1983
WOS ID: 000360949800010
Scopus EID: 2-s2.0-84939259701
PMID: 25304294
Embase PUI: L602650370
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Martinez-Gonzalez, Miguel A.; Zazpe, Itziar; Razquin, Cristina; Sanchez-Tainta, Ana; Corella, Dolores; Salas-Salvado, Jordi; Toledo, Estefanía; Ros, Emilio; Angel Munoz, Miguel; Recondo, Javier; Gomez-Gracia, Enrique; Fiol Sala, Miquel



Publication date
2015-10Document type
research articleCitation
Martinez-Gonzalez Miguel A., Zazpe Itziar, Razquin Cristina, Sanchez-Tainta Ana, Corella Dolores, Salas-Salvado Jordi, et al. Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clin Nutr. 2015 Oct;34(5):859-867. Epub 2014 Sep 16.Abstract
Background & aims: There is little evidence on post hoc-derived dietary patterns (DP) and all-cause mortality in Southern-European populations. Furthermore, the potential effect modification of a DP by a nutritional intervention has not been sufficiently assessed. We assessed the association between a posteriori defined baseline major DP and total mortality or cardiovascular events within each of the three arms of a large primary prevention trial (PREDIMED) where participants were randomized to two active interventions with Mediterranean-type diets or to a control group (allocated to a low-fat diet). Design: We followed-up 7216 participants for a median of 4.3 years. A validated 137-item food-frequency questionnaire was administered. Baseline DP were ascertained through factor analysis based on 34 predefined groups. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) for cardiovascular disease (CVD) or mortality across quartiles of DP within each of the-three arms of the trial. Results: We identified two major baseline DP: the first DP was rich in red and processed meats, alcohol, refined grains and whole dairy products and was labeled Western dietary pattern (WDP). The second DP corresponded to a Mediterranean-type dietary pattern (MDP). During follow-up, 328 participants died. After controlling for potential confounders, higher baseline adherence to the MDP was associated with lower risk of CVD (adjusted HR for fourth vs. first quartile: 0.52; 95% Cl (Confidence Interval): 0.36, 0.74; p-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 038, 0.75; p-trend <0.001), regardless of the allocated arm of the trial. An increasing mortality rate was found across increasing quartiles of the WDP in the control group (allocated to a low-fat diet), though the linear trend was not statistically significant (p = 0.098). Conclusions: Higher adherence to an empirically-derived MDP at baseline was associated with a reduced risk of CVD and mortality in the PREDIMED trial regardless of the allocated arm. The WDP was not associated with higher risk of mortality or cardiovascular events.
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https://dx.doi.org/10.1016/j.clnu.2014.09.006MeSH
Cardiovascular DiseasesAged, 80 and over
Aged
Energy Intake
Empirical Research
Feeding Behavior
Follow-Up Studies
Humans
Middle Aged
Male
Europe
Patient Compliance
Motor Activity
Female
Risk Factors
Proportional Hazards Models
Body Mass Index
Diet, Mediterranean
Nutrition Assessment
Diet, Fat-Restricted
Surveys and Questionnaires
DeCS
Índice de Masa CorporalEvaluación Nutricional
Dieta Mediterránea
Dieta con Restricción de Grasas
Modelos de Riesgos Proporcionales
Investigación Empírica
Femenino
Europa (Continente)
Actividad Motora
Masculino
Conducta Alimentaria
Estudios de Seguimiento
Cooperación del Paciente
Factores de Riesgo
Humanos
Persona de Mediana Edad
Ingestión de Energía
Anciano
Anciano de 80 o más Años
Encuestas y Cuestionarios
Enfermedades Cardiovasculares
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Hospital Universitario Son Espases - HUSE > Comunicación científicaInstituto de Investigación Sanitaria Islas Baleares - IDISBA > Comunicación científica