Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study
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 be...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | info:eu-repo/semantics/article |
| Language: | eng |
| Published: |
Elsevier
2014
|
| Subjects: | |
| Online Access: | https://hdl.handle.net/10171/37086 |
| _version_ | 1793400058402570240 |
|---|---|
| author | Martinez-Gonzalez, M.A. (Miguel Ángel) Zazpe, I. (Itziar) Razquin, C. (Cristina) Sanchez-Tainta, A. (Ana) Corella, D. (Dolores) Salas-Salvado, J. (Jordi) Toledo, E. (Estefanía) Ros, E. (Emilio) Muñoz, M.A. (Miguel Angel) Recondo, J. (Javier) Gomez-Gracia, E. (Enrique) Fiol, M. (Miquel) Lapetra, J. (José) Buil-Cosiales, P. (Pilar) Serra-Majem, L. (Luis) Pinto, X. (Xavier) Schröder, H. (Helmut) Tur, J.A. (Josep A.) Sorli, J.V. (Jose V.) Lamuela-Raventos, R.M. (Rosa Maria) Estruch, R. (Ramón) |
| author_facet | Martinez-Gonzalez, M.A. (Miguel Ángel) Zazpe, I. (Itziar) Razquin, C. (Cristina) Sanchez-Tainta, A. (Ana) Corella, D. (Dolores) Salas-Salvado, J. (Jordi) Toledo, E. (Estefanía) Ros, E. (Emilio) Muñoz, M.A. (Miguel Angel) Recondo, J. (Javier) Gomez-Gracia, E. (Enrique) Fiol, M. (Miquel) Lapetra, J. (José) Buil-Cosiales, P. (Pilar) Serra-Majem, L. (Luis) Pinto, X. (Xavier) Schröder, H. (Helmut) Tur, J.A. (Josep A.) Sorli, J.V. (Jose V.) Lamuela-Raventos, R.M. (Rosa Maria) Estruch, R. (Ramón) |
| author_sort | Martinez-Gonzalez, M.A. (Miguel Ángel) |
| collection | DSpace |
| description | 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. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-37086 |
| institution | Universidad de Navarra |
| language | eng |
| publishDate | 2014 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-370862023-03-13T11:03:58Z Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study Martinez-Gonzalez, M.A. (Miguel Ángel) Zazpe, I. (Itziar) Razquin, C. (Cristina) Sanchez-Tainta, A. (Ana) Corella, D. (Dolores) Salas-Salvado, J. (Jordi) Toledo, E. (Estefanía) Ros, E. (Emilio) Muñoz, M.A. (Miguel Angel) Recondo, J. (Javier) Gomez-Gracia, E. (Enrique) Fiol, M. (Miquel) Lapetra, J. (José) Buil-Cosiales, P. (Pilar) Serra-Majem, L. (Luis) Pinto, X. (Xavier) Schröder, H. (Helmut) Tur, J.A. (Josep A.) Sorli, J.V. (Jose V.) Lamuela-Raventos, R.M. (Rosa Maria) Estruch, R. (Ramón) Cardiovascular risk Dietary pattern Mediterranean diet Mortality Predimed 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. 2014-11-24T11:24:12Z 2014-11-24T11:24:12Z 2014 info:eu-repo/semantics/article https://hdl.handle.net/10171/37086 eng info:eu-repo/semantics/openAccess application/pdf Elsevier |
| spellingShingle | Cardiovascular risk Dietary pattern Mediterranean diet Mortality Predimed Martinez-Gonzalez, M.A. (Miguel Ángel) Zazpe, I. (Itziar) Razquin, C. (Cristina) Sanchez-Tainta, A. (Ana) Corella, D. (Dolores) Salas-Salvado, J. (Jordi) Toledo, E. (Estefanía) Ros, E. (Emilio) Muñoz, M.A. (Miguel Angel) Recondo, J. (Javier) Gomez-Gracia, E. (Enrique) Fiol, M. (Miquel) Lapetra, J. (José) Buil-Cosiales, P. (Pilar) Serra-Majem, L. (Luis) Pinto, X. (Xavier) Schröder, H. (Helmut) Tur, J.A. (Josep A.) Sorli, J.V. (Jose V.) Lamuela-Raventos, R.M. (Rosa Maria) Estruch, R. (Ramón) Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title | Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title_full | Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title_fullStr | Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title_full_unstemmed | Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title_short | Empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| title_sort | empirically derived food patterns and the risk of total mortality and cardiovascular events in the predimed study |
| topic | Cardiovascular risk Dietary pattern Mediterranean diet Mortality Predimed |
| url | https://hdl.handle.net/10171/37086 |
| work_keys_str_mv | AT martinezgonzalezmamiguelangel empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT zazpeiitziar empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT razquinccristina empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT sancheztaintaaana empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT corelladdolores empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT salassalvadojjordi empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT toledoeestefania empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT roseemilio empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT munozmamiguelangel empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT recondojjavier empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT gomezgraciaeenrique empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT fiolmmiquel empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT lapetrajjose empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT builcosialesppilar empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT serramajemlluis empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT pintoxxavier empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT schroderhhelmut empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT turjajosepa empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT sorlijvjosev empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT lamuelaraventosrmrosamaria empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy AT estruchrramon empiricallyderivedfoodpatternsandtheriskoftotalmortalityandcardiovasculareventsinthepredimedstudy |