Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study. Issue 5 (October 2015)

• Record Type: Journal Article
• Authors: Martínez-González, Miguel A.; Zazpe, Itziar; Razquin, Cristina; Sánchez-Tainta, Ana; Corella, Dolores; Salas-Salvadó, Jordi; Toledo, Estefanía; Ros, Emilio; Muñoz, Miguel Ángel; Recondo, Javier; Gómez-Gracia, Enrique; Fiol, Miquel; Lapetra, José; Buil-Cosiales, Pilar; Serra-Majem, Lluis; Pinto, Xavier; Schröder, Helmut; Tur, Josep A.; Sorli, José V.; Lamuela-Raventós, Rosa M.; Estruch, Ramón; for the PREDIMED GROUP
• Is Part Of: Clinical nutrition. Volume 34:Issue 5(2015:Oct.)
• Page Start: 859
• Page End: 867
• Publication Date: 2015-10
• Subjects: Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2014.09.006
• Languages: English
• ISSNs: 0261-5614

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background & aims</title> <p id="abspara0010">There is little evidence on <italic>post hoc</italic>-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 <italic>a posteriori</italic> 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).</p> </sec> <sec> <title id="sectitle0020">Design</title> <p id="abspara0015">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.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">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; <italic>p</italic>-trend <0.001) and all-cause mortality (adjusted HR: 0.53; 95% CI: 0.38, 0.75; <italic>p</italic>-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 (<italic>p</italic> = 0.098).</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">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.</p> </sec> </abstract>