Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study.

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Salas-Salvado JAuthorPalau-Galindo AAuthorBecerra Tomás, NereaAuthorBarrubés Piñol, LauraAuthor

September 18, 2019

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Article

Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study.

Publicated to:European Journal Of Nutrition. 59 (6): 2395-2409 - 2020-09-01 59(6), DOI: 10.1007/s00394-019-02087-1

Authors: Cano-Ibanez, Naomi; Bueno-Cavanillas, Aurora; Martinez-Gonzalez, Miguel Angel; Salas-Salvado, Jordi; Corella, Dolores; Freixer, Gal-la; Romaguera, Dora; Vioque, Jesus; Alonso-Gomez, Angel M; Warnberg, Julia; Martinez, J Alfredo; Serra-Majem, Lluis; Estruch, Ramon; Tinahones, Francisco J; Lapetra, Jose; Pinto, Xavier; Tur, Josep A; Garcia-Rios, Antonio; Garcia-Molina, Laura; Delgado-Rodriguez, Miguel; Matia-Martin, Pilar; Daimiel, Lidia; Martin-Sanchez, Vicente; Vidal, Josep; Vazquez, Clotilde; Ros, Emilio; Bartolome-Resano, Javier; Palau-Galindo, Antoni; Portoles, Olga; Torres, Laura; Miquel-Fiol; Sanchez, Maria Teresa Cano; Sorto-Sanchez, Carolina; Moreno-Morales, Noelia; Abete, Itziar; alvarez-Perez, Jacqueline; Sacanella, Emilio; Bernal-Lopez, Maria Rosa; Santos-Lozano, Jose Manuel; Fanlo-Maresma, Marta; Bouzas, Cristina; Razquin, Cristina; Becerra-Tomas, Nerea; Ortega-Azorin, Carolina; LLimona, Regina; Morey, Marga; Roman-Macia, Josefa; Goicolea-Guemez, Leire; Vazquez-Ruiz, Zenaida; Barrubes, Laura; Fito, Montse; Gea, Alfredo

Affiliations

ABS Reus V. Centre d’Assistència Primària Marià Fortuny, SAGESSA, Reus, Spain - Author

Carlos III Inst Hlth, CIBER Physiopathol Obes & Nutr CIBEROBN, Madrid, Spain - Author

CEI UAM CSIC, IMDEA Food, Nutr Genom & Epigenom Grp, Madrid, Spain - Author

Centro de Salud Santa Pola, Alicante, Spain - Author

CIBER Diabetes y enfermedades metabólicas (CIBERdem), Instituto de Salud Carlos III (ISCIII), Madrid, Spain - Author

CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain - Author

CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain - Author

Ctr Salud Santa Pola, Alicante, Spain - Author

Department of Cardiology, OSI ARABA, University Hospital Araba, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain - Author

Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain - Author

Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain - Author

Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain - Author

Department of Endocrinology, Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain - Author

Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain - Author

Department of Health Sciences, University of Jaen, Jaen, Spain - Author

Department of Internal Medicine, Institut d’Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain - Author

Department of Internal Medicine, Regional University Hospital of Malaga, Instituto de Investigación Biomédica de Malaga (IBIMA), Malaga, Spain - Author

Department of Medicine, Facultad de Medicina, University of Sevilla, Seville, Spain - Author

Department of Nursing, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain - Author

Department of Nutrition, Food Sciences and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain - Author

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States - Author

Department of Physiotherapy, School of Health Sciences, University of Malaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain - Author

Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain - Author

Department of Preventive Medicine and Public Health, University of Granada, Avda. De la Investigación 11, Granada, 18016, Spain - Author

Department of Preventive Medicine, University of Valencia, Valencia, 46010, Spain - Author

Dist Sanitario Atenc Primaria Sevilla, Dept Family Med, Res Unit, Seville, Spain - Author

Fdn Jimenez Diaz, Dept Endocrinol, Madrid, Spain - Author

Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA - Author

Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, 07120, Spain - Author

Hlth Res Inst Balear Isl IdISBa, Palma de Mallorca 07120, Spain - Author

Hosp Clin Barcelona, Dept Endocrinol & Nutr, IDIBAPS, Lipid Clin, Barcelona, Spain - Author

Hosp del Mar, Unit Cardiovasc Risk & Nutr, Inst Municipal Invest Med IMIM, Barcelona, Spain - Author

Hosp Univ Bellvitge, Lipids & Vasc Risk Unit, Internal Med, IDIBELL, Barcelona, Spain - Author

Human Nutrition Unit, Biochemistry and Biotechnology Department, IISPV, Universitat Rovira i Virgili, Reus, Spain - Author

Inst Invest Biosanitaria Granada Ibs GRANADA, Granada, Spain - Author

Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Dept Endocrinol & Nutr, Madrid, Spain - Author

Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain - Author

Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metabol CIBERdem, Madrid, Spain - Author

Inst Salud Carlos III ISCIII, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain - Author

Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain - Author

Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain - Author

Institute of Biomedicine (IBIOMED), University of León, León, Spain - Author

Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain - Author

Lipid Clinic Department of Endocrinology and Nutrition, IDIBAPS, Hospital Clinic, Barcelona, Spain - Author

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain - Author

Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain - Author

Miguel Hernandez Univ, Nutr Epidemiol Unit, ISABIAL FISABIO, Alicante, Spain - Author

Navarra Health Service-Osasunbidea, Pamplona, Spain - Author

Navarra Hlth Serv Osasunbidea, Pamplona, Spain - Author

Navarra Inst Hlth Res IdiSNA, Pamplona, Spain - Author

Navarra Institute for Health Research (IdiSNA), Pamplona, Spain - Author

Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain - Author

Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain - Author

Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain - Author

Reg Univ Hosp Malaga, Dept Internal Med, Inst Invest Biomed Malaga IBIMA, Malaga, Spain - Author

Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain - Author

SAGESSA, ABS Reus V Ctr Assistencia Primaria Maria Fortuny, Reus, Spain - Author

Traslational Medicine. Cardiovascular, Respiratory and Systemic Diseases and cellular aging Program. Cardiovascular Diseases - Author

Unit of Cardiovascular Risk and Nutrition, Hospital del Mar, Institut Municipal d’Investigació Médica (IMIM), Barcelona, Spain - Author

Univ Balear Isl, Res Grp Community Nutr & Oxidat Stress, Palma De Mallorca, Spain - Author

Univ Barcelona, Hosp Clin, IDIBAPS, Dept Endocrinol, Barcelona, Spain - Author

Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Internal Med, Barcelona, Spain - Author

Univ Basque Country UPV EHU, Univ Hosp Araba, OSI ARABA, Dept Cardiol, Vitoria, Spain - Author

Univ Cordoba, Reina Sofia Univ Hosp, Dept Internal Med,Lipids & Atherosclerosis Unit, Maimonides Biomed Res Inst Cordoba IMIBIC, Cordoba, Spain - Author

Univ Granada, Dept Prevent Med & Publ Hlth, Avda Invest 11, Granada 18016, Spain - Author

Univ Hosp St Joan de Reus, Nutr Unit, Reus, Spain - Author

Univ Jaen, Dept Hlth Sci, Jaen, Spain - Author

Univ Las Palmas Gran Canaria, Inst Biomed Res, Las Palmas Gran Canaria, Spain - Author

Univ Leon, Inst Biomed IBIOMED, Leon, Spain - Author

Univ Malaga, Inst Invest Biomed Malaga IBIMA, Sch Hlth Sci, Dept Nursing, Malaga, Spain - Author

Univ Malaga, Inst Invest Biomed Malaga IBIMA, Sch Hlth Sci, Dept Physiotherapy, Malaga, Spain - Author

Univ Malaga, Virgen Victoria Hosp, Dept Endocrinol, Malaga, Spain - Author

Univ Navarra, Ctr Nutr Res, Dept Nutr Food Sci & Physiol, Pamplona, Spain - Author

Univ Navarra, Sch Med, Dept Prevent Med & Publ Hlth, Pamplona, Spain - Author

Univ Rovira & Virgili, Dept Biochem & Biotechnol, Human Nutr Unit, IISPV, Reus, Spain - Author

Univ Seville, Fac Med, Dept Med, Seville, Spain - Author

Univ Valencia, Dept Prevent Med, Valencia 46010, Spain - Author

Abstract

The prevalence of overweight/obesity and related manifestations such as metabolic syndrome (MetS) is increasing worldwide. High energy density diets, usually with low nutrient density, are among the main causes. Some high-quality dietary patterns like the Mediterranean diet (MedDiet) have been linked to the prevention and better control of MetS. However, it is needed to show that nutritional interventions promoting the MedDiet are able to improve nutrient intake.To assess the effect of improving MedDiet adherence on nutrient density after 1 year of follow-up at the PREDIMED-Plus trial.We assessed 5777 men (55-75 years) and women (60-75 years) with overweight or obesity and MetS at baseline from the PREDIMED-Plus trial. Dietary changes and MedDiet adherence were evaluated at baseline and after 1 year. The primary outcome was the change in nutrient density (measured as nutrient intake per 1000 kcal). Multivariable-adjusted linear regression models were fitted to analyse longitudinal changes in adherence to the MedDiet and concurrent changes in nutrient density.During 1-year follow-up, participants showed improvements in nutrient density for all micronutrients assessed. The density of carbohydrates (- 9.0%), saturated fatty acids (- 10.4%) and total energy intake (- 6.3%) decreased. These changes were more pronounced in the subset of participants with higher improvements in MedDiet adherence.The PREDIMED-Plus dietary intervention, based on MedDiet recommendations for older adults, maybe a feasible strategy to improve nutrient density in Spanish population at high risk of cardiovascular disease with overweight or obesity.

Keywords

AdultsAgedCardiovascular diseasesDiet, mediterraneanFemaleFollow-up studiesHealthHumansMaleMediterranean dietMenMetabolic syndromeMiddle agedNutrient densityNutritional adequacyNutritional statusObesityOutcomesOverweightPrevalenceRisk factorsSpainTime factors

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal European Journal Of Nutrition due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position 18/88, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.86, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-12, the following number of citations:

WoS: 10
Scopus: 12
Europe PMC: 7

Impact and social visibility

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Granada; United States of America.

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Effect of changes in adherence to Mediterranean diet on nutrient density after 1-year of follow-up: results from the PREDIMED-Plus Study.

Affiliations

Abstract

Keywords

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

Impact and social visibility

Leadership analysis of institutional authors