Bulló, M., M. Garcia-Aloy, M.A. Martínez-González, D. Corella, J.D. Fernández-Ballart, M. Fiol, E. Gómez-Gracia, R. Estruch, M. Ortega-Calvo, S. Francisco, G. Flores-Mateo, L. Serra-Majem, X. Pintó, M.–I. Covas, E. Ros, R. Lamuela-Raventós, J. Salas-Salvadó, 2011. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Preventive Medicine. 53:155–161.
Background: Diet, smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation. We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study, a randomized dietary primary prevention trial conducted in Spain. Methods: 7000 subjects at high cardiovascular risk were assessed cross-sectionally. A healthy lifestyle pattern (HLP) was determined using a score including: adherence to the Mediterranean diet, moderate alcohol consumption, expending ≥ 200 kcal/day in leisure-time physical activity, and non-smoking. Results: Inverse linear trends were observed between the HLP-score and body-mass-index (BMI) or waist circumference (p<0.001). The BMI and waist circumference of participants with a HLP-score = 4 were, respectively, 1.3 kg/m2 (95% CI: 0.9 to 1.7) and 4.3 cm (3.1 to 5.4) lower than those of subjects with an HLP ≤ 1. The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score ≤ 1were 0.50 (0.42 to 0.60) and 0.51 (0.41 to 0.62), respectively. Conclusion: A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk.