Follow-up of a web-based tailored intervention promoting the Mediterranean diet in Scotland

2008 ◽  
Vol 73 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Angeliki Papadaki ◽  
Jane A. Scott
BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040959
Author(s):  
Saman Khalatbari-Soltani ◽  
Pedro Marques-Vidal ◽  
Fumiaki Imamura ◽  
Nita G. Forouhi

ObjectiveThe Mediterranean diet has been promoted as a healthy dietary pattern, but whether the Mediterranean diet may help to prevent hepatic steatosis is not clear. This study aimed to evaluate the prospective association between adherence to the Mediterranean diet and risk of hepatic steatosis.DesignPopulation-based prospective cohort study.SettingThe Swiss CoLaus Study.ParticipantsWe evaluated 2288 adults (65.4% women, aged 55.8±10.0 years) without hepatic steatosis at first follow-up in 2009–2012. Adherence to the Mediterranean diet was scaled as the Mediterranean diet score (MDS) based on the Mediterranean diet pyramid ascertained with responses to Food Frequency Questionnaires.Outcome measuresNew onset of hepatic steatosis was ascertained by two indices separately: the Fatty Liver Index (FLI, ≥60 points) and the non-alcoholic fatty liver disease (NAFLD) score (≥−0.640 points). Prospective associations between adherence to the Mediterranean diet and risk of hepatic steatosis were quantified using Poisson regression.ResultsDuring a mean 5.3 years of follow-up, hepatic steatosis was ascertained in 153 (6.7%) participants by FLI criteria and in 208 (9.1%) by NAFLD score. After multivariable adjustment, higher adherence to MDS was associated with lower risk of hepatic steatosis based on FLI: risk ratio 0.84 (95% CI 0.73 to 0.96) per 1 SD of MDS; 0.85 (0.73 to 0.99) adjusted for BMI; and 0.85 (0.71 to 1.02) adjusted for both BMI and waist circumference. When using NAFLD score, no significant association was found between MDS and risk of hepatic steatosis (0.95 (0.83 to 1.09)).ConclusionA potential role of the Mediterranean diet in the prevention of hepatic steatosis is suggested by the inverse association observed between adherence to the Mediterranean diet and incidence of hepatic steatosis based on the FLI. The inconsistency of this association when hepatic steatosis was assessed by NAFLD score points to the need for accurate population-level assessment of fatty liver and its physiological markers.


2016 ◽  
Vol 77 (3) ◽  
pp. 125-132 ◽  
Author(s):  
Alexandra Bédard ◽  
Louise Corneau ◽  
Sylvie Dodin ◽  
Simone Lemieux

Purpose: To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. Methods: Thirty-eight males and 32 premenopausal females (all aged 24–53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. Results: Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. Conclusions: Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.


2017 ◽  
Vol 117 (10) ◽  
pp. 1478-1485 ◽  
Author(s):  
Sonia Eguaras ◽  
Maira Bes-Rastrollo ◽  
Miguel Ruiz-Canela ◽  
Silvia Carlos ◽  
Pedro de la Rosa ◽  
...  

AbstractIt is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.


10.2196/21436 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e21436
Author(s):  
Leticia Goni ◽  
Víctor de la O ◽  
M Teresa Barrio-López ◽  
Pablo Ramos ◽  
Luis Tercedor ◽  
...  

Background The Prevention With Mediterranean Diet (PREDIMED) trial supported the effectiveness of a nutritional intervention conducted by a dietitian to prevent cardiovascular disease. However, the effect of a remote intervention to follow the Mediterranean diet has been less explored. Objective This study aims to assess the effectiveness of a remotely provided Mediterranean diet–based nutritional intervention in obtaining favorable dietary changes in the context of a secondary prevention trial of atrial fibrillation (AF). Methods The PREvention of recurrent arrhythmias with Mediterranean diet (PREDIMAR) study is a 2-year multicenter, randomized, controlled, single-blinded trial to assess the effect of the Mediterranean diet enriched with extra virgin olive oil (EVOO) on the prevention of atrial tachyarrhythmia recurrence after catheter ablation. Participants in sinus rhythm after ablation were randomly assigned to an intervention group (Mediterranean diet enriched with EVOO) or a control group (usual clinical care). The remote nutritional intervention included phone contacts (1 per 3 months) and web-based interventions with provision of dietary recommendations, and participants had access to a web page, a mobile app, and printed resources. The information is divided into 6 areas: Recommended foods, Menus, News and Online resources, Practical tips, Mediterranean diet classroom, and Your personal experience. At baseline and at 1-year and 2-year follow-up, the 14-item Mediterranean Diet Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire were collected by a dietitian by phone. Results A total of 720 subjects were randomized (365 to the intervention group, 355 to the control group). Up to September 2020, 560 subjects completed the first year (560/574, retention rate 95.6%) and 304 completed the second year (304/322, retention rate 94.4%) of the intervention. After 24 months of follow-up, increased adherence to the Mediterranean diet was observed in both groups, but the improvement was significantly higher in the intervention group than in the control group (net between-group difference: 1.8 points in the MEDAS questionnaire (95% CI 1.4-2.2; P<.001). Compared with the control group, the Mediterranean diet intervention group showed a significant increase in the consumption of fruits (P<.001), olive oil (P<.001), whole grain cereals (P=.002), pulses (P<.001), nuts (P<.001), white fish (P<.001), fatty fish (P<.001), and white meat (P=.007), and a significant reduction in refined cereals (P<.001), red and processed meat (P<.001), and sweets (P<.001) at 2 years of intervention. In terms of nutrients, the intervention group significantly increased their intake of omega-3 (P<.001) and fiber (P<.001), and they decreased their intake of carbohydrates (P=.02) and saturated fatty acids (P<.001) compared with the control group. Conclusions The remote nutritional intervention using a website and phone calls seems to be effective in increasing adherence to the Mediterranean diet pattern among AF patients treated with catheter ablation. Trial Registration ClinicalTrials.gov NCT03053843; https://www.clinicaltrials.gov/ct2/show/NCT03053843


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 162 ◽  
Author(s):  
Rosario Alonso-Domínguez ◽  
Luis García-Ortiz ◽  
Maria Patino-Alonso ◽  
Natalia Sánchez-Aguadero ◽  
Manuel Gómez-Marcos ◽  
...  

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to the MD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25–70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.


2020 ◽  
pp. 1-12
Author(s):  
Elena Critselis ◽  
Meropi D Kontogianni ◽  
Ekavi Georgousopoulou ◽  
Christina Chrysohoou ◽  
Dimitrios Tousoulis ◽  
...  

Abstract Objective: To compare the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets in deterring 10-year CVD. Design: Prospective cohort (n 2020) with a 10-year follow-up period for the occurrence of combined (fatal or non-fatal) CVD incidence (International Classification of Diseases (ICD)-10). Baseline adherence to the Mediterranean and DASH diets was assessed via a semi-quantitative FFQ according to the MedDietScore and DASH scores, respectively. Setting: Attica, Greece. Participants: Two thousand twenty individuals (mean age at baseline 45·2 (sd 14·0) years). Results: One-third of individuals in the lowest quartile of Mediterranean diet consumption, as compared with 3·1 % of those in the highest quartile, developed 10-year CVD (P < 0·0001). In contrast, individuals in the lowest and highest DASH diet quartiles exhibited similar 10-year CVD rates (n (%) of 10-year CVD in DASH diet quartiles 1 v. 4: 79 (14·7 %) v. 75 (15·3 %); P = 0·842). Following adjustment for demographic, lifestyle and clinical confounding factors, those in the highest Mediterranean diet quartile had a 4-fold reduced 10-year CVD risk (adjusted hazard ratio (HR) 4·52, 95 % CI 1·76, 11·63). However, individuals with highest DASH diet quartile scores did not differ from their lowest quartile counterparts in developing such events (adjusted HR 1·05, 95 % CI 0·69, 1·60). Conclusions High adherence to the Mediterranean diet, and not to the DASH diet, was associated with a lower risk of 10-year fatal and non-fatal CVD. Therefore, public health interventions aimed at enhancing adherence to the Mediterranean diet, rather than the DASH diet, may most effectively deter long-term CVD outcomes particularly in Mediterranean populations.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Jessica Cohen ◽  
Eric B Rimm ◽  
Miguel A Martínez-González ◽  
Jordi Salas-Salvadó ◽  
María I Covas ◽  
...  

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.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 562-562
Author(s):  
Helena Sandoval-Insausti ◽  
Ana Bayan-Bravo ◽  
Carolina Donat-Vargas ◽  
Jimena Rey-Garcia ◽  
Jose Ramon Banegas ◽  
...  

Abstract Objectives It is not clear if the adherence to a Mediterranean diet is associated with changes in kidney function. The aim of this study is to assess the prospective association between the adherence to the Mediterranean diet and renal function decline. Methods Prospective cohort study of 975 community-dwelling individuals aged 60 and older who were recruited during 2008–10 in Spain, and followed up to December, 2015. At baseline, food consumption was obtained with a validated, computerized face-to-face diet history. The “a priori” adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS score: low adherence 0–5 points, moderate adherence 6–8 points, high adherence 9–14 points). To identify “a posteriori” dietary patterns, 880 foods were categorized into 36 different groups according to similarities in their nutritional profile. Factor analysis (principal components analysis) was applied to generate independent dietary patterns. At baseline and at the end of follow-up, serum creatinine (SC) and glomerular filtration rate (GFR) levels were ascertained and changes were calculated. Two end-points were considered: SC increase and GFR decrease beyond that expected for age. Logistic regression models were built and adjusted for prevalent and incident cardiovascular risk factors. Results At the end of follow-up 150 cases of SC increase and 146 cases of GFR decrease occurred. The fully adjusted ORs (95% CI) of SC increase were 0.75 (0.49–1.15) for participants with a moderate adherence to the MEDAS score, and 0.58 (0.36–0.95) for those with a high adherence, when comparing to participants with a low adherence; (p-trend: 0.026). Results for GFR decrease had the same direction (p-trend: 0.049). The fully adjusted ORs (95% CI) of SC increase according to increasing quartiles of adherence to an “a posteriori” Mediterranean-like dietary pattern were 1.00, 0.62 (0.37–1.03), 0.57 (0.33–0.99), and 0.46 (0.24–0.86); (p-trend: 0.017). Results for GFR decrease were similar (p-trend: 0.007). Conclusions A higher adherence to a Mediterranean dietary pattern was associated with a lower risk of kidney function decline. Funding Sources State Secretary of R + D and FEDER/FSE, the ATHLOS project (EU H2020), and the CIBERESP, Instituto de Salud Carlos III. Madrid, Spain.


2016 ◽  
Vol 20 (5) ◽  
pp. 938-947 ◽  
Author(s):  
Ralf Schwarzer ◽  
Lena Fleig ◽  
Lisa M Warner ◽  
Maryam Gholami ◽  
Lluis Serra-Majem ◽  
...  

AbstractObjectiveThe traditional Mediterranean diet includes high consumption of fruits, vegetables, olive oil, legumes, cereals and nuts, moderate to high intake of fish and dairy products, and low consumption of meat products. Intervention effects to improve adoption of this diet may vary in terms of individuals’ motivational or volitional prerequisites. In the context of a three-country research collaboration, intervention effects on these psychological constructs for increasing adoption of the Mediterranean diet were examined.DesignAn intervention was conducted to improve Mediterranean diet consumption with a two-month follow-up. Linear multiple-level models examined which psychological constructs (outcome expectancies, planning, action control and stage of change) were associated with changes in diet scores.SettingWeb-based intervention in Italy, Spain and Greece.SubjectsAdults (n454; mean age 42·2 (sd10·4) years, range 18–65 years;n112 at follow-up).ResultsAnalyses yielded an overall increase in the Mediterranean diet scores. Moreover, there were interactions between time and all four psychological constructs on these changes. Participants with lower levels of baseline outcome expectancies, planning, action control and stage of change were found to show steeper slopes, thus greater behavioural adoption, than those who started out with higher levels.ConclusionsThe intervention produced overall improvements in Mediterranean diet consumption, with outcome expectancies, planning, action control and stage of change operating as moderators, indicating that those with lower motivational or volitional prerequisites gained more from the online intervention. Individual differences in participants’ readiness for change need to be taken into account to gauge who would benefit most from the given treatment.


Sign in / Sign up

Export Citation Format

Share Document