Abstract P098: The Association Between Obesity Status and Long-Term Adherence to Mediterranean Diet in the PREDIMED Trial
Background: The aim of this study was to determine if long-term adherence to a prescribed diet, in the context of the PREDIMED trial, a multi-year, randomized, controlled trial, was different among obese and non-obese participants after an average follow-up of three years. Previous studies only examined short term compliance or were not sufficiently powered to compare obese with nonobese participants.
Methods: This randomized clinical trial included 6,463 subjects. All subjects were asymptomatic; females aged 55-80 years and males 55-80 years and were at high-risk for cardiovascular disease at baseline. Participants’ characteristics were measured at baseline and every 12 months. Obesity was defined as having a BMI of 30kg/m2 or more. The main outcome measure was achieving an average score of 10 points or more on a validated 14-point Mediterranean diet adherence scale over follow-up.
Results: In all three dietary intervention groups, obesity status was significantly inversely associated with adherence to the Mediterranean diet; In the olive oil group, the odds ratio of obtaining a score of 10 or more was 23.4% (95% CI: 6.3, 37.5%) lower for obese subjects than for non-obese subjects after an average follow-up of three years. A similar pattern was also seen in the nuts group; the odds of obtaining a score of 10 or more was 24.3% (95% CI: 5.1,39.6%) lower for obese subjects than for non-obese subjects. In the low fat group, subjects who were obese at baseline had 25.7% (95% CI:5.7, 40.8%) lower odds of obtaining a score of 10 or more on the adherence score. All models were adjusted for relevant covariates.
Conclusion: In this long-term trial of the Mediterranean Diet, adherence was high across all intervention groups. However, adherence was appreciably lower among obese participants after three years. Additional intervention efforts may be necessary to achieve the same adherence among high-risk obese individuals.
- © 2013 by American Heart Association, Inc.