RT Journal Article T1 Factors associated with successful dietary changes in an energy-reduced Mediterranean diet intervention: a longitudinal analysis in the PREDIMED-Plus trial A1 Fernandez-Lazaro, Cesar, I A1 Toledo, Estefania A1 Buil-Cosiales, Pilar A1 Salas-Salvado, Jordi A1 Corella, Dolores A1 Fito, Montserrat A1 Alfredo Martinez, J. A1 Alonso-Gomez, Angel M. A1 Warnberg, Julia A1 Vioque, Jesus A1 Romaguera, Dora A1 Lopez-Miranda, Jose A1 Estruch, Ramon A1 Tinahones, Francisco J. A1 Lapetra, Jose A1 Serra-Majem, Luis A1 Bueno-Cavanillas, Aurora A1 Tur, Josep A. A1 Martin Sanchez, Vicente A1 Pinto, Xavier A1 Delgado-Rodriguez, Miguel A1 Matia-Martin, Pilar A1 Vidal, Josep A1 Ros, Emilio A1 Vazquez, Clotilde A1 Daimiel, Lidia A1 SanJulian, Beatriz A1 Garcia-Gavilan, Jesus F. A1 Sorli, Jose, V A1 Castaner, Olga A1 Angeles Zulet, M. A1 Tojal-Sierra, Lucas A1 Perez-Farinos, Napoleon A1 Oncina-Canovas, Alejandro A1 Monino, Manuel A1 Garcia-Rios, Antonio A1 Sacanella, Emilio A1 Bernal-Lopez, Rosa M. A1 Manuel Santos-Lozano, Jose A1 Vazquez-Ruiz, Zenaida A1 Muralidharan, Jananee A1 Ortega-Azorin, Carolina A1 Goday, Alberto A1 Razquin, Cristina A1 Goicolea-Guemez, Leire A1 Ruiz-Canela, Miguel A1 Becerra-Tomas, Nerea A1 Schroder, Helmut A1 Martinez Gonzalez, Miguel A. A1 PREDIMED-Plus Investigators, K1 PREDIMED-Plus K1 Dietary change K1 Factors K1 Dietary adherence K1 Mediterranean diet K1 Randomized controlled trials K1 Weight-loss K1 Cardiovascular-disease K1 Breast-cancer K1 Adherence K1 Health K1 Pattern K1 Risk K1 Fat K1 Questionnaire K1 Population AB Purpose Long-term nutrition trials may fail to respond to their original hypotheses if participants do not comply with the intended dietary intervention. We aimed to identify baseline factors associated with successful dietary changes towards an energy-reduced Mediterranean diet (MedDiet) in the PREDIMED-Plus randomized trial.Methods Longitudinal analysis of 2985 participants (Spanish overweight/obese older adults with metabolic syndrome) randomized to the active intervention arm of the PREDIMED-Plus trial. Dietary changes were assessed with a 17-item energy-reduced MedDiet questionnaire after 6 and 12 months of follow-up. Successful compliance was defined as dietary changes from baseline of >= 5 points for participants with baseline scores = 5 points for participants with baseline scores = 13 points. We conducted crude and adjusted multivariable logistic regression models to identify baseline factors related to compliance.Results Consistent factors independently associated with successful dietary change at both 6 and 12 months were high baseline perceived self-efficacy in modifying diet (OR6-month: 1.51, 95% CI 1.25-1.83; OR12-month: 1.66, 95% CI 1.37-2.01), higher baseline fiber intake (OR6-month: 1.62, 95% CI 1.07-2.46; OR12-month: 1.62, 95% CI 1.07-2.45), having > 3 chronic conditions (OR6-month: 0.65, 95% CI 0.53-0.79; OR12-month: 0.76, 95% CI 0.62-0.93), and suffering depression (OR6-month: 0.80, 95% CI 0.64-0.99; OR12-month: 0.71, 95% CI 0.57-0.88).Conclusion Our results suggested that recruitment of individuals with high perceived self-efficacy to dietary change, and those who initially follow diets relatively richer in fiber may lead to greater changes in nutritional recommendations. Participants with multiple chronic conditions, specifically depression, should receive specific tailored interventions. PB Springer heidelberg SN 1436-6207 YR 2021 FD 2021-11-30 LK https://hdl.handle.net/10668/25708 UL https://hdl.handle.net/10668/25708 LA en DS RISalud RD Apr 7, 2025