Tags

Type your tag names separated by a space and hit enter

Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study.
Clin Nutr. 2015 Oct; 34(5):859-67.CN

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% CI (Confidence Interval): 0.36, 0.74; p-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 0.38, 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.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Martínez-González MA
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain. Electronic address: mamartinez@unav.es.
Zazpe I
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Nutrition and Food Sciences and Physiology, University of Navarra, Pamplona, Spain.
Razquin C
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
Sánchez-Tainta A
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain.
Corella D
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.
Salas-Salvadó J
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Human Nutrition Department, IISPV, Universitat Rovira i Virgili, Reus, Spain.
Toledo E
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain.
Ros E
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.
Muñoz MÁ
Unitat de Suport a la Recerca, División de Atención Primaria de Salud, Institut Català de la Salut e IDIAP-Jordi Gol, Barcelona, Spain; Departamento de Pediatría, Obstetricia, Ginecología y Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, Spain.
Recondo J
Department of Cardiology, University Hospital of Alava, Vitoria, Spain.
Gómez-Gracia E
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain.
Fiol M
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Son Espases, Palma de Mallorca, Spain.
Lapetra J
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Family Medicine, Primary Care Division of Sevilla, San Pablo Health Center, Sevilla, Spain.
Buil-Cosiales P
Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
Serra-Majem L
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.
Pinto X
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
Schröder H
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar-IMIM, Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Spain.
Tur JA
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Fundamental Biology & Health Sciences, University of Balearic Islands, Spain.
Sorli JV
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.
Lamuela-Raventós RM
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Department of Nutrition and Food Science, School of Pharmacy, XaRTA, INSA, University of Barcelona, Barcelona, Spain.
Estruch R
CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn) and PREDIMED Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII) Spanish Government, Spain; Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain.
PREDIMED GROUP
No affiliation info available

MeSH

AgedAged, 80 and overBody Mass IndexCardiovascular DiseasesDiet, Fat-RestrictedDiet, MediterraneanEmpirical ResearchEnergy IntakeEuropeFeeding BehaviorFemaleFollow-Up StudiesHumansMaleMiddle AgedMotor ActivityNutrition AssessmentPatient ComplianceProportional Hazards ModelsRisk FactorsSurveys and Questionnaires

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25304294

Citation

Martínez-González, Miguel A., et al. "Empirically-derived Food Patterns and the Risk of Total Mortality and Cardiovascular Events in the PREDIMED Study." Clinical Nutrition (Edinburgh, Scotland), vol. 34, no. 5, 2015, pp. 859-67.
Martínez-González MA, Zazpe I, Razquin C, et al. Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clin Nutr. 2015;34(5):859-67.
Martínez-González, M. A., Zazpe, I., Razquin, C., Sánchez-Tainta, A., Corella, D., Salas-Salvadó, J., Toledo, E., Ros, E., Muñoz, M. Á., Recondo, J., Gómez-Gracia, E., Fiol, M., Lapetra, J., Buil-Cosiales, P., Serra-Majem, L., Pinto, X., Schröder, H., Tur, J. A., Sorli, J. V., ... Estruch, R. (2015). Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Clinical Nutrition (Edinburgh, Scotland), 34(5), 859-67. https://doi.org/10.1016/j.clnu.2014.09.006
Martínez-González MA, et al. Empirically-derived Food Patterns and the Risk of Total Mortality and Cardiovascular Events in the PREDIMED Study. Clin Nutr. 2015;34(5):859-67. PubMed PMID: 25304294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. AU - Martínez-González,Miguel A, AU - Zazpe,Itziar, AU - Razquin,Cristina, AU - Sánchez-Tainta,Ana, AU - Corella,Dolores, AU - Salas-Salvadó,Jordi, AU - Toledo,Estefanía, AU - Ros,Emilio, AU - Muñoz,Miguel Ángel, AU - Recondo,Javier, AU - Gómez-Gracia,Enrique, AU - Fiol,Miquel, AU - Lapetra,José, AU - Buil-Cosiales,Pilar, AU - Serra-Majem,Lluis, AU - Pinto,Xavier, AU - Schröder,Helmut, AU - Tur,Josep A, AU - Sorli,José V, AU - Lamuela-Raventós,Rosa M, AU - Estruch,Ramón, AU - ,, Y1 - 2014/09/16/ PY - 2014/06/02/received PY - 2014/08/29/revised PY - 2014/09/03/accepted PY - 2014/10/12/entrez PY - 2014/10/12/pubmed PY - 2016/6/4/medline KW - Cardiovascular risk KW - Dietary pattern KW - Mediterranean diet KW - Mortality KW - PREDIMED SP - 859 EP - 67 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 34 IS - 5 N2 - 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% CI (Confidence Interval): 0.36, 0.74; p-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 0.38, 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. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/25304294/Empirically_derived_food_patterns_and_the_risk_of_total_mortality_and_cardiovascular_events_in_the_PREDIMED_study_ DB - PRIME DP - Unbound Medicine ER -