Primary prevention of cardiovascular disease with a Mediterranean diet
Authors: Ll Quinzavos
A Medina-Rem√≥n
O Portol√©s
E Padres
M T Bonet
V  Velasco Garc√≠a
Jordi Salas-Salvad√≥
J M Hern√°ndez
J Tur
M C Yuste
R G√≥mez-Huelgas
A Isach
C S√°nchez
M S S√°nchez
I Felipe
P Buil-Cosiales
F  Cort√©s Ugalde
J  S√°nchez Perona
C  Sim√≥n Garc√≠a
F Fiol
C Lama
F  Jos√© Garc√≠a
M Mo√±ino
J G√°llego
M Cof√°n
A Garc√≠a-Arellano
R Osma
E Mart√≠nez
F B Hu
J J Cabr√©
Miguel Angel Mart√≠nez-Gonz√°lez
J  Garc√≠a Rosell√≥
B Costa
A Jover
PREDIMED Study Investigators
Y Garc√≠a
M Garc√≠a-Valdueza
G Chiva
J Vila
C Vi√±as
Rosa Maria Lamuela-Raventos
C Razquin
C Sim√≥n
X Solanich
M I Santamar√≠a
J Amat
M Garc√≠a Layana
A I Castellote-Bargallo
A  Baca Osorio
A Rovira
L Garc√≠a
N Babio
I Salaverr√≠a
M  Bianchi Alba
J Algorta
J de Diego Salas
M Oller
A  Urtasun Samper
Josep Basora
D Mu√±oz-Aguayo
J Portu
A Ramos
E H Mart√≠nez-Lapiscina
P Iglesias
E Corbella
A Gea
E Sacanella
E  Vargas L√≥pez
M Fit√≥
J Marrugat
P Baby
F Sarmiendo de la Fe
I  Falc√≥n Sanabria
S Romero
R De la Torre
R Prieto
L Garc√≠a-P√©rez
E Sanz
R  Ben√≠tez Pont
J Benavent
S  Arranz J M Baena
J Garc√≠a
E  D√≠ez Ben√≠tez
M Bull√≥
J Mart√≠nez-Gonz√°lez
E Mayoral
E L√°zaro
R Figueras
B  Churio Beraza
A Alonso
T del Hierro
J Sabat√©
C Iglesias
A Proenza
G Flores
A Alt√©s
L Mengual
J San Vicente
P Rom√°n
M Bes-Rastrollo
A Girb√©s
E M Asensio
J  Gil Zarzosa
J √Ålvarez-P√©rez
M Ortega-Calvo
A Tresserra-Rimbau
F Trias
A Serrano
O Coltell
C Alegret
Jos√© V Sorl√≠
C de Juan
X Pi-Sunyer
I Duaso
A Sanmart√≠n
M Serrano-Mart√≠nez
M Dom√©nech
Llu√≠s Serra-Majem
J L Pi√±ol
C Valls-Pedret
N Bargall√≥
T Basora
E de la Cruz
J Timiraus
V Pascual
B Sanjuli√°n
Ma T  Arceiz Campo
Ma D  Garc√≠a de la Noceda Montoy
J Salas-Salvad√≥
Y Corchado
Maria-Isabel Covas
P Carrasco
C Riera
T  Sagredo Arce
J Altirriba
C Cabezas
R Elos√∫a
Fernando Ar√≥s
J Clos
M Aldamiz
A Brau
M Mata
I  Maldonado D√≠az
Dolores Corella
R Tort
J M Santos
A  Alonso G√≥mez
A Sala-Vila
E Ros
D Corella
L de Santamar√≠a
P Guillem-Saiz
J Valderrama
R Pujol
Z Pl√°
Emilio Ros
M T Mitjavila
R Gilabert
M Liroz
Ram√≥n Estruch
C Molina
N Ortu√±o
C Saiz
E  Jurado Ruiz
F Ar√≥s
Xavier Pint√≥
L Forga
R Casas
Valentina Ruiz-Guti√©rrez
J Fern√°ndez-Crehuet Navajas
R Gonz√°lez
P Roura
M Serra
S Mill√°n
R Estruch
V Santamar√≠a
M I Covas
M Guill√©n
S Tello
G Frontera
A Guarner
N Berrade
A S√°nchez-Tainta
A Larrauri
N Ibarrola
C A Gonz√°lez
Ma V  Gueto Rubio
F M√°rquez
A S√°nchez-Villegas
E  Montero Romero
M Garc√≠a
I  Bautista Casta√±o
M Ferrer
M Garcia-Lopez
G S√°ez
I Pla
F J Basterra-Gortari
M Ginard
J D√≠ez-Espino
Miquel Fiol
J Fern√°ndez-Ballart
Jos√© Alfredo Mart√≠nez
A Loma-Osorio
S Francisco
A J  Santana Santana
Enrique G√≥mez-Gracia
J W√§rnberg
M C L√≥pez-Sabater
I Sarasa
A Mart√≠
Ll Parra
A Galera
M P Portillo
E Vinyoles
J Berj√≥n
A P√©rez-Heras
E Toledo
I Zazpe
C Ortega-Azor√≠n
H Schr√∂der
Ma D  Vigata L√≥pez
J  Villanueva Teller√≠a
J M Nu√±ez-C√≥rdoba
P Valderas
V Extremera-Urabayen
M A Mart√≠nez-Gonz√°lez
M Amor√≥s
Jos√© Lapetra
P Mart√≠nez
J I Gonz√°lez
B  Mac√≠as Guti√©rrez
C Arroyo-Azpa
Miguel Angel Mu√±oz
M  Garc√≠a Garc√≠a
M Sorli
M T Martin
M Leal
J M Verd√∫
F Martin
M A Rovira
Y Soler
E Manzano
J J  S√°nchez Luque
E S√°nchez
Journal: New England Journal of Medicine (2013)
Discipline: CLINICAL MEDICINE
Keywords: Mediterranean diet; cardiovascular risk; primary prevention; randomized trial; cardiovascular events
Affiliations: Centro de Investigaci√≥n Biom√©dica en Red de Fisiopatolog√≠a de la Obesidad y Nutrici√≥n, Instituto de Salud Carlos III, Madrid, Spain. , The authors' affiliations are listed in the Appendix.

Abstract:  Background: Observational 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. Methods: In 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. Results: A 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. Conclusions: Among 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.). 

Retracted: No

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 This article has been **retracted**. For more information please see this thread: https: pubpeer.com publications BB15507E0782661445E816FEEDE7FC#6 or https: www.npr.org sections health-shots 2018 06 13 619619302 researchers-soften-claim-that-mediterranean-diet-prevents-heart-attacks?live=1 ,