847 - MORTALITY IN THE LONG-TERM FOLLOW-UP OF THE PREDIMED TRIAL
Department of Preventive Medicine and Public Health, University of Navarra; Department of Preventive Medicine and Public Health, University of Granada; CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII); IdiSNA (Instituto de Investigación Sanitaria de Navarra); Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM); Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM); CIBERESP, Instituto de Salud Carlos III; Department of Nutrition, Harvard T.H. Chan School of Public Health.
Background/Objectives: PREDIMED was the largest trial demonstrating effective primary prevention of myocardial infarction, stroke, and cardiovascular death through a Mediterranean diet (MedDiet). However, the long-term effects on mortality remain unknown.
Methods: We conducted an extended follow-up of all 7,447 PREDIMED participants, originally randomized 1:1:1 to a MedDiet supplemented with extra-virgin olive oil, a MedDiet supplemented with nuts, or a control diet. All-cause mortality was tracked from 2003 to 2022. MedDiet adherence was assessed annually during the intervention (2003-2010) using a validated 14-item MEDAS score (range 0-14), and cumulative average adherence was calculated for each participant based on repeated yearly measures.
Results: Over the follow-up period, 2,731 deaths occurred. Randomized assignment to either MedDiet intervention did not significantly reduce long-term mortality compared with the control diet. However, participants with higher cumulative MedDiet adherence (≥ 12 of 14 points) during the trial had lower long-term mortality than those with lower adherence (≤ 7 points) (multivariable-adjusted HR 0.72; 95%CI 0.60-0.87).
Conclusions/Recommendations: Greater adherence to the Mediterranean diet during the PREDIMED trial was associated with reduced mortality more than a decade later, suggesting a potential “legacy effect” of sustained dietary quality.
Funding: This study did not receive dedicated funding. It uses data from the PREDIMED trial, for which funding details are reported in DOI: 10.1056/NEJMoa1800389.
