Intensive Counseling Leads to Improved Adherence to a Calorie-Reduced Mediterranean Diet

Following a Mediterranean diet is associated with lower risk for cardiovascular and metabolic diseases, but adherence often is poor. In this randomized trial, researchers assessed the effect on diet adherence of an intensive behavioral and lifestyle counseling program among 6874 community-dwelling Spanish patients with metabolic syndrome (mean age, 65; mean body-mass index, 33 kg/m²). Diet and lifestyle behaviors were assessed at baseline. Intervention participants received 36 educational encounters during the 12-month study (i.e., group and individual counseling sessions and telephone calls), and control patients received 6 such encounters. All participants received free extra-virgin olive oil and nuts.

At 12-month follow-up, validated meas…