Change to a healthy diet in people over 70 years old: the PREDIMED experience

PURPOSE: It is difficult to change dietary habits and maintain them in the long run, particularly in elderly people. We aimed to assess whether adherence to the Mediterranean diet (MedDiet) and cardiovascular risk factor were similar in the middle-aged and oldest participants in the PREDIMED study. METHODS: We analyzed participants belonging to the first and fourth quartiles of age (Q1 and Q4, respectively) to compare between-group differences in adherence to the nutritional intervention and cardiovascular risk factor (CRF) control during a 3-year follow-up. All participants underwent yearly clinical, nutritional, and laboratory assessments during the following. RESULTS: A total of 2278 patients were included (1091 and 1187 in Q1 and Q4, respectively). At baseline, mean ages were 59.6 ± 2.1 years in Q1 and 74.2 ± 2.6 years in Q4. In Q4, there were more women, greater prevalence of hypertension and diabetes, and lower obesity and smoking rates than the younger cohort (P ≤ 0.001, all). Adherence to the MedDiet was similar in Q1 and Q4 at baseline (mean 8.7 of 14 points for both) and improved significantly (P < 0.01) and to a similar extent (mean 10.2 and 10.0 points, respectively) during follow-up. Systolic blood pressure, low density–lipoprotein cholesterol, and body weight were similarly reduced at 3 years in Q1 and Q4 participants. CONCLUSION: The youngest and oldest participants showed improved dietary habits and CRFs to a similar extent after 3 years’ intervention. Therefore, it is never too late to improve dietary habits and ameliorate CRF in high-risk individuals, even those of advanced age. REGISTRATION: The trial is registered in the London-based Current Controlled Trials Registry (ISRCTN number 35739639). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00394-021-02741-7.