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A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study.
Am J Clin Nutr. 2014 Jul; 100 Suppl 1:320S-8S.AJ

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.

DESIGN

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.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Martínez-González MA
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).
Sánchez-Tainta A
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).
Corella D
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).
Salas-Salvadó J
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).
Ros E
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).
Arós F
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).
Gómez-Gracia E
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).
Fiol M
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).
Lamuela-Raventós RM
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).
Schröder H
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).
Lapetra J
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).
Serra-Majem L
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).
Pinto X
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).
Ruiz-Gutierrez V
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).
Estruch R
No affiliation info available
PREDIMED Group
No affiliation info available

MeSH

AgedCardiovascular DiseasesCause of DeathDiet, MediterraneanDiet, VegetarianFeeding BehaviorFemaleHumansMaleMiddle AgedNeoplasmsSurveys and Questionnaires

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24871477

Citation

Martínez-González, Miguel A., et al. "A Provegetarian Food Pattern and Reduction in Total Mortality in the Prevención Con Dieta Mediterránea (PREDIMED) Study." The American Journal of Clinical Nutrition, vol. 100 Suppl 1, 2014, 320S-8S.
Martínez-González MA, Sánchez-Tainta A, Corella D, et al. A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study. Am J Clin Nutr. 2014;100 Suppl 1:320S-8S.
Martínez-González, M. A., Sánchez-Tainta, A., Corella, D., Salas-Salvadó, J., Ros, E., Arós, F., Gómez-Gracia, E., Fiol, M., Lamuela-Raventós, R. M., Schröder, H., Lapetra, J., Serra-Majem, L., Pinto, X., Ruiz-Gutierrez, V., & Estruch, R. (2014). A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study. The American Journal of Clinical Nutrition, 100 Suppl 1, 320S-8S. https://doi.org/10.3945/ajcn.113.071431
Martínez-González MA, et al. A Provegetarian Food Pattern and Reduction in Total Mortality in the Prevención Con Dieta Mediterránea (PREDIMED) Study. Am J Clin Nutr. 2014;100 Suppl 1:320S-8S. PubMed PMID: 24871477.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study. AU - Martínez-González,Miguel A, AU - Sánchez-Tainta,Ana, AU - Corella,Dolores, AU - Salas-Salvadó,Jordi, AU - Ros,Emilio, AU - Arós,Fernando, AU - Gómez-Gracia,Enrique, AU - Fiol,Miquel, AU - Lamuela-Raventós,Rosa M, AU - Schröder,Helmut, AU - Lapetra,Jose, AU - Serra-Majem,Lluis, AU - Pinto,Xavier, AU - Ruiz-Gutierrez,Valentina, AU - Estruch,Ramon, AU - ,, Y1 - 2014/05/28/ PY - 2014/5/30/entrez PY - 2014/5/30/pubmed PY - 2015/5/2/medline SP - 320S EP - 8S JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 100 Suppl 1 N2 - 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. DESIGN: 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. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/24871477/A_provegetarian_food_pattern_and_reduction_in_total_mortality_in_the_Prevenci��n_con_Dieta_Mediterr��nea__PREDIMED__study_ DB - PRIME DP - Unbound Medicine ER -