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Primary prevention of cardiovascular disease with a Mediterranean diet.

BACKGROUNDObservational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. METHODSIn a multice... Full description

Journal Title: The New England journal of medicine April 4, 2013, Vol.368(14), pp.1279-1290
Main Author: Estruch, Ramón
Other Authors: Ros, Emilio , Salas-Salvadó, Jordi , Covas, Maria-Isabel , Corella, Dolores , Arós, Fernando , Gómez-Gracia, Enrique , Ruiz-Gutiérrez, Valentina , Fiol, Miquel , Lapetra, José , Lamuela-Raventos, Rosa Maria , Serra-Majem, Lluís , Pintó, Xavier , Basora, Josep , Muñoz, Miguel Angel , Sorlí, José V , Martínez, José Alfredo , Martínez-González, Miguel Angel , Estruch, Ramón
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1533-4406 ; DOI: 1533-4406 ; DOI: 10.1056/NEJMoa1200303
Link: http://search.proquest.com/docview/1324385148/?pq-origsite=primo
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title: Primary prevention of cardiovascular disease with a Mediterranean diet.
format: Article
creator:
  • Estruch, Ramón
  • Ros, Emilio
  • Salas-Salvadó, Jordi
  • Covas, Maria-Isabel
  • Corella, Dolores
  • Arós, Fernando
  • Gómez-Gracia, Enrique
  • Ruiz-Gutiérrez, Valentina
  • Fiol, Miquel
  • Lapetra, José
  • Lamuela-Raventos, Rosa Maria
  • Serra-Majem, Lluís
  • Pintó, Xavier
  • Basora, Josep
  • Muñoz, Miguel Angel
  • Sorlí, José V
  • Martínez, José Alfredo
  • Martínez-González, Miguel Angel
  • Estruch, Ramón
subjects:
  • Aged–Mortality
  • Aged, 80 and Over–Prevention & Control
  • Cardiovascular Diseases–Epidemiology
  • Diet, Fat-Restricted–Epidemiology
  • Diet, Mediterranean–Epidemiology
  • Dietary Supplements–Epidemiology
  • Female–Epidemiology
  • Humans–Epidemiology
  • Kaplan-Meier Estimate–Epidemiology
  • Male–Epidemiology
  • Middle Aged–Epidemiology
  • Multivariate Analysis–Epidemiology
  • Myocardial Infarction–Epidemiology
  • Nuts–Epidemiology
  • Olive Oil–Epidemiology
  • Plant Oils–Epidemiology
  • Primary Prevention–Epidemiology
  • Risk Factors–Epidemiology
  • Stroke–Epidemiology
  • Abridged
  • Olive Oil
  • Plant Oils
ispartof: The New England journal of medicine, April 4, 2013, Vol.368(14), pp.1279-1290
description: BACKGROUNDObservational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. METHODSIn a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years. RESULTSA total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported. CONCLUSIONSAmong persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. (Funded by the Spanish government's Instituto de Salud Carlos III and others; Controlled-Trials.com number, ISRCTN35739639.).
language: eng
source:
identifier: E-ISSN: 1533-4406 ; DOI: 1533-4406 ; DOI: 10.1056/NEJMoa1200303
fulltext: fulltext
issn:
  • 15334406
  • 1533-4406
url: Link


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titlePrimary prevention of cardiovascular disease with a Mediterranean diet.
creatorEstruch, Ramón ; Ros, Emilio ; Salas-Salvadó, Jordi ; Covas, Maria-Isabel ; Corella, Dolores ; Arós, Fernando ; Gómez-Gracia, Enrique ; Ruiz-Gutiérrez, Valentina ; Fiol, Miquel ; Lapetra, José ; Lamuela-Raventos, Rosa Maria ; Serra-Majem, Lluís ; Pintó, Xavier ; Basora, Josep ; Muñoz, Miguel Angel ; Sorlí, José V ; Martínez, José Alfredo ; Martínez-González, Miguel Angel ; Estruch, Ramón
contributorEstruch, R (correspondence author) ; Corella, D (record owner) ; Covas, M I ; Martínez-González, M A ; Ros, E ; Salas-Salvadó, J ; Arós, F ; Aldamiz, M ; Alonso, A ; Berjón, J ; Forga, L ; Gállego, J ; García Layana, M ; Larrauri, A ; Portu, J ; Timiraus, J ; Serrano-Martínez, M ; Ros, E ; Covas, M I ; Martínez-González, M A ; Pérez-Heras, A ; Salas-Salvadó, J ; Serra, M ; Pi-Sunyer, X ; González, C A ; Hu, F B ; Sabaté, J ; Serra, M ; Pérez-Heras, A ; Viñas, C ; Casas, R ; de Santamaría, L ; Romero, S ; Sacanella, E ; Chiva, G ; Valderas, P ; Baena, S Arranz J M ; García, M ; Oller, M ; Amat, J ; Duaso, I ; García, Y ; Iglesias, C ; Simón, C ; Quinzavos, Ll ; Parra, Ll ; Liroz, M ; Benavent, J ; Clos, J ; Pla, I ; Amorós, M ; Bonet, M T ; Martin, M T ; Sánchez, M S ; Altirriba, J ; Manzano, E ; Altés, A ; Cofán, M ; Valls-Pedret, C ; Sala-Vila, A ; Doménech, M ; Gilabert, R ; Bargalló, N ; Sánchez-Tainta, A ; Sanjulián, B ; Toledo, E ; Bes-Rastrollo, M ; Martí, A ; Razquin, C ; Buil-Cosiales, P ; Serrano-Martínez, M ; Díez-Espino, J ; García-Arellano, A ; Zazpe, I ; Basterra-Gortari, F J ; Martínez-Lapiscina, E H ; Gea, A ; Garcia-Lopez, M ; Nuñez-Córdoba, J M ; Ortuño, N ; Berrade, N ; Extremera-Urabayen, V ; Arroyo-Azpa, C ; García-Pérez, L ; Tellería, J Villanueva ; Ugalde, F Cortés ; Arce, T Sagredo ; Montoy, Ma D García de La Noceda ; López, Ma D Vigata ; Campo, Ma T Arceiz ; Samper, A Urtasun ; Rubio, Ma V Gueto ; Beraza, B Churio ; Bulló, M ; González, R ; Molina, C ; Márquez, F ; Babio, N ; Sorli, M ; Roselló, J García ; Martin, F ; Tort, R ; Isach, A ; Costa, B ; Cabré, J J ; Fernández-Ballart, J ; Ibarrola, N ; Alegret, C ; Martínez, P ; Millán, S ; Piñol, J L ; Basora, T ; Hernández, J M ; Tello, S ; Vila, J ; Fitó, M ; Schröder, H ; De La Torre, R ; Muñoz-Aguayo, D ; Elosúa, R ; Marrugat, J ; Ferrer, M ; Carrasco, P ; Osma, R ; Guillén, M ; Guillem-Saiz, P ; Portolés, O ; Pascual, V ; Riera, C ; Valderrama, J ; Serrano, A ; Lázaro, E ; Sanmartín, A ; Girbés, A ; Santamaría, V ; Sánchez, C ; Plá, Z ; Sánchez, E ; Ortega-Azorín, C ; González, J I ; Saiz, C ; Coltell, O ; Asensio, E M ; Salaverría, I ; Del Hierro, T ; Algorta, J ; Francisco, S ; Alonso, A ; San Vicente, J ; Sanz, E ; Felipe, I ; Gómez, A Alonso ; Loma-Osorio, A ; Pont, R Benítez ; Alba, M Bianchi ; Navajas, J Fernández-Crehuet ; Wärnberg, J ; Gómez-Huelgas, R ; Martínez-González, J ; García, V Velasco ; Salas, J de Diego ; Osorio, A Baca ; Zarzosa, J Gil ; Luque, J J Sánchez ; López, E Vargas ; Perona, J Sánchez ; Romero, E Montero ; García, M García ; Ruiz, E Jurado ; García-Valdueza, M ; Moñino, M ; Proenza, A ; Prieto, R ; Frontera, G ; Ginard, M ; Fiol, F ; Jover, A ; García, J ; Leal, M ; Martínez, E ; Santos, J M ; Ortega-Calvo, M ; Román, P ; García, F José ; Iglesias, P ; Corchado, Y ; Mayoral, E ; Lama, C ; López-Sabater, M C ; Castellote-Bargallo, A I ; Medina-Remón, A ; Tresserra-Rimbau, A ; Álvarez-Pérez, J ; Benítez, E Díez ; Castaño, I Bautista ; Díaz, I Maldonado ; Sánchez-Villegas, A ; de La Fe, F Sarmiendo ; García, C Simón ; Sanabria, I Falcón ; Gutiérrez, B Macías ; Santana, A J Santana ; de La Cruz, E ; Galera, A ; Soler, Y ; Trias, F ; Sarasa, I ; Padres, E ; Figueras, R ; Solanich, X ; Pujol, R ; Corbella, E ; Cabezas, C ; Vinyoles, E ; Rovira, M A ; García, L ; Flores, G ; Verdú, J M ; Baby, P ; Ramos, A ; Mengual, L ; Roura, P ; Yuste, M C ; Guarner, A ; Rovira, A ; Santamaría, M I ; Mata, M ; de Juan, C ; Brau, A ; Mitjavila, M T ; Portillo, M P
ispartofThe New England journal of medicine, April 4, 2013, Vol.368(14), pp.1279-1290
identifier
subjectAged–Mortality ; Aged, 80 and Over–Prevention & Control ; Cardiovascular Diseases–Epidemiology ; Diet, Fat-Restricted–Epidemiology ; Diet, Mediterranean–Epidemiology ; Dietary Supplements–Epidemiology ; Female–Epidemiology ; Humans–Epidemiology ; Kaplan-Meier Estimate–Epidemiology ; Male–Epidemiology ; Middle Aged–Epidemiology ; Multivariate Analysis–Epidemiology ; Myocardial Infarction–Epidemiology ; Nuts–Epidemiology ; Olive Oil–Epidemiology ; Plant Oils–Epidemiology ; Primary Prevention–Epidemiology ; Risk Factors–Epidemiology ; Stroke–Epidemiology ; Abridged ; Olive Oil ; Plant Oils
descriptionBACKGROUNDObservational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. METHODSIn a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years. RESULTSA total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported. CONCLUSIONSAmong persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. (Funded by the Spanish government's Instituto de Salud Carlos III and others; Controlled-Trials.com number, ISRCTN35739639.).
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0Estruch, Ramón
1Ros, Emilio
2Salas-Salvadó, Jordi
3Covas, Maria-Isabel
4Corella, Dolores
5Arós, Fernando
6Gómez-Gracia, Enrique
7Ruiz-Gutiérrez, Valentina
8Fiol, Miquel
9Lapetra, José
10Lamuela-Raventos, Rosa Maria
11Serra-Majem, Lluís
12Pintó, Xavier
13Basora, Josep
14Muñoz, Miguel Angel
15Sorlí, José V
16Martínez, José Alfredo
17Martínez-González, Miguel Angel
titlePrimary prevention of cardiovascular disease with a Mediterranean diet.
descriptionBACKGROUNDObservational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. METHODSIn a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years. RESULTSA total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported. CONCLUSIONSAmong persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. (Funded by the Spanish government's Instituto de Salud Carlos III and others; Controlled-Trials.com number, ISRCTN35739639.).
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0Aged–Mortality
1Aged, 80 and Over–Prevention & Control
2Cardiovascular Diseases–Epidemiology
3Diet, Fat-Restricted–Epidemiology
4Diet, Mediterranean–Epidemiology
5Dietary Supplements–Epidemiology
6Female–Epidemiology
7Humans–Epidemiology
8Kaplan-Meier Estimate–Epidemiology
9Male–Epidemiology
10Middle Aged–Epidemiology
11Multivariate Analysis–Epidemiology
12Myocardial Infarction–Epidemiology
13Nuts–Epidemiology
14Olive Oil–Epidemiology
15Plant Oils–Epidemiology
16Primary Prevention–Epidemiology
17Risk Factors–Epidemiology
18Stroke–Epidemiology
19Abridged
20Olive Oil
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0Estruch, R
1Corella, D
2Covas, M I
3Martínez-González, M A
4Ros, E
5Salas-Salvadó, J
6Arós, F
7Aldamiz, M
8Alonso, A
9Berjón, J
10Forga, L
11Gállego, J
12García Layana, M
13Larrauri, A
14Portu, J
15Timiraus, J
16Serrano-Martínez, M
17Pérez-Heras, A
18Serra, M
19Pi-Sunyer, X
20González, C A
21Hu, F B
22Sabaté, J
23Viñas, C
24Casas, R
25de Santamaría, L
26Romero, S
27Sacanella, E
28Chiva, G
29Valderas, P
30Baena, S Arranz J M
31García, M
32Oller, M
33Amat, J
34Duaso, I
35García, Y
36Iglesias, C
37Simón, C
38Quinzavos, Ll
39Parra, Ll
40Liroz, M
41Benavent, J
42Clos, J
43Pla, I
44Amorós, M
45Bonet, M T
46Martin, M T
47Sánchez, M S
48Altirriba, J
49Manzano, E
50Altés, A
51Cofán, M
52Valls-Pedret, C
53Sala-Vila, A
54Doménech, M
55Gilabert, R
56Bargalló, N
57Sánchez-Tainta, A
58Sanjulián, B
59Toledo, E
60Bes-Rastrollo, M
61Martí, A
62Razquin, C
63Buil-Cosiales, P
64Díez-Espino, J
65García-Arellano, A
66Zazpe, I
67Basterra-Gortari, F J
68Martínez-Lapiscina, E H
69Gea, A
70Garcia-Lopez, M
71Nuñez-Córdoba, J M
72Ortuño, N
73Berrade, N
74Extremera-Urabayen, V
75Arroyo-Azpa, C
76García-Pérez, L
77Tellería, J Villanueva
78Ugalde, F Cortés
79Arce, T Sagredo
80Montoy, Ma D García de La Noceda
81López, Ma D Vigata
82Campo, Ma T Arceiz
83Samper, A Urtasun
84Rubio, Ma V Gueto
85Beraza, B Churio
86Bulló, M
87González, R
88Molina, C
89Márquez, F
90Babio, N
91Sorli, M
92Roselló, J García
93Martin, F
94Tort, R
95Isach, A
96Costa, B
97Cabré, J J
98Fernández-Ballart, J
99Ibarrola, N
100...
startdate20130404
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titlePrimary prevention of cardiovascular disease with a Mediterranean diet.
authorEstruch, Ramón ; Ros, Emilio ; Salas-Salvadó, Jordi ; Covas, Maria-Isabel ; Corella, Dolores ; Arós, Fernando ; Gómez-Gracia, Enrique ; Ruiz-Gutiérrez, Valentina ; Fiol, Miquel ; Lapetra, José ; Lamuela-Raventos, Rosa Maria ; Serra-Majem, Lluís ; Pintó, Xavier ; Basora, Josep ; Muñoz, Miguel Angel ; Sorlí, José V ; Martínez, José Alfredo ; Martínez-González, Miguel Angel ; Estruch, Ramón
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5Dietary Supplements–Epidemiology
6Female–Epidemiology
7Humans–Epidemiology
8Kaplan-Meier Estimate–Epidemiology
9Male–Epidemiology
10Middle Aged–Epidemiology
11Multivariate Analysis–Epidemiology
12Myocardial Infarction–Epidemiology
13Nuts–Epidemiology
14Olive Oil–Epidemiology
15Plant Oils–Epidemiology
16Primary Prevention–Epidemiology
17Risk Factors–Epidemiology
18Stroke–Epidemiology
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20Olive Oil
21Plant Oils
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2Covas, M I
3Martínez-González, M A
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atitlePrimary prevention of cardiovascular disease with a Mediterranean diet.
jtitleThe New England journal of medicine
risdate20130404
volume368
issue14
spage1279
epage1290
pages1279-1290
eissn1533-4406
formatjournal
genrearticle
ristypeJOUR
abstractBACKGROUNDObservational cohort studies and a secondary prevention trial have shown an inverse association between adherence to the Mediterranean diet and cardiovascular risk. We conducted a randomized trial of this diet pattern for the primary prevention of cardiovascular events. METHODSIn a multicenter trial in Spain, we randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra-virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow-up of 4.8 years. RESULTSA total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported. CONCLUSIONSAmong persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. (Funded by the Spanish government's Instituto de Salud Carlos III and others; Controlled-Trials.com number, ISRCTN35739639.).
doi10.1056/NEJMoa1200303
urlhttp://search.proquest.com/docview/1324385148/
issn00284793
date2013-04-04