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Association between coffee consumption and total dietary caffeine intake with cognitive functioning: cross-sectional assessment in an elderly Mediterranean population

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Coffee is rich in compounds such as polyphenols, caffeine, diterpenes, melanoidins and trigonelline, which can stimulate brain activity. Therefore, the possible association of coffee consumption with cognition is of considerable research interest. In this paper, we assess the association of coffee consumption and total dietary caffeine intake with the risk of poor cognitive functioning in a population of elderly overweight/obese adults with metabolic syndrome (MetS).

Methods

PREDIMED-plus study participants who completed the Mini-Mental State Examination test (MMSE) (n = 6427; mean age = 65 ± 5 years) or a battery of neuropsychological tests were included in this cross-sectional analysis. Coffee consumption and total dietary caffeine intake were assessed at baseline using a food frequency questionnaire. Logistic regression models were fitted to evaluate the association between total, caffeinated and decaffeinated coffee consumption or total dietary caffeine intake and cognitive impairment.

Results

Total coffee consumers and caffeinated coffee consumers had better cognitive functioning than non-consumers when measured by the MMSE and after adjusting for potential confounders (OR 0.63; 95% CI 0.44–0.90 and OR 0.56; 95% CI 0.38–0.83, respectively). Results were similar when cognitive performance was measured using the Clock Drawing Test (CDT) and Trail Making Test B (TMT-B). These associations were not observed for decaffeinated coffee consumption. Participants in the highest tertile of total dietary caffeine intake had lower odds of poor cognitive functioning than those in the reference tertile when screened by the MMSE (OR 0.64; 95% CI 0.47–0.87) or other neurophysiological tests evaluating a variety of cognitive domains (i.e., CDT and TMT-A).

Conclusions

Coffee consumption and total dietary caffeine intake were associated with better cognitive functioning as measured by various neuropsychological tests in a Mediterranean cohort of elderly individuals with MetS.

Trial registration

ISRCTN89898870. Registration date: July 24, 2014.

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Availability of data and materials

There are restrictions on the availability of data for the PREDIMED-Plus trial, due to the signed consent agreements around data sharing, which only allow access to external researchers for studies following the project purposes. Requestors wishing to access the PREDIMED-Plus trial data used in this study can make a request to the PREDIMED-Plus trial Steering Committee chair: jordi.salas@urv.cat. The request will then be passed to members of the PREDIMED-Plus Steering Committee for deliberation.

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Acknowledgements

The authors would especially like to thank the PREDIMED-Plus participants for their enthusiastic collaboration, the PREDIMED-Plus personnel for their outstanding support and staff of all associated primary care centers for their exceptional work. CIBEROBN, CIBERESP and CIBERDEM are initiatives of the Carlos III Health Institute, Spain. We also thank the PREDIMED-Plus Biobank Network, which is part of the National Biobank Platform of the Carlos III Health Institute for storing and managing the biological samples. List of PREDIMED-Plus study investigators: Steering Committee: J. Salas-Salvadó (Coordinator), M.A. Martínez-González, M. Fitó. E. Ros, FJ. Tinahones, D. Corella and R. Estruch. Executive Committee: J. Salas-Salvadó, M.A. Martínez-González, D. Corella, M. Fitó, J. Vioque, D. Romaguera, J.A Martínez, J. Wärnberg, J. Lopez-Miranda, R. Estruch, A. Bueno-Cavanillas, Á.M. Alonso-Gómez, J.A. Tur, FJ. Tinahones, L. Serra-Majem, V. Martin, J. Lapetra, C. Vázquez, X. Pinto, J. Vidal, L. Daimiel, M. Delgado-Rodríguez, M.A. Rubio and E. Ros. Dietary and Lifestyle Intervention Committee: J. Salas-Salvadó (chair), M.A. Martínez-González, M. Fitó and R. Estruch; Dietary Intervention: J. Salas-Salvadó (chair), N. Babio, E. Ros, A. Sánchez-Tainta; Physical Exercise: M. Fitó (chair), H. Schröder, A. Marcos, D. Corella, J. Warnberg; Behavioral support: R. Estruch (chair), F. Fernández-Aranda, C. Botella and J. Salas-Salvadó. Clinical Event Ascertainment Committee: F. Arós (Chair), M. Aldamiz, A. Alonso-Gómez, L. Forga, A. García-Layana, J. Portu, J. Timiraos, A. González-Pinto, I. Zorrilla, M. Martínez-Kareaga, P. Seoane. Chair: Dr. Fernando Arós. Cardiology: Dr. Angel Alonso-Gómez; Dr. Fernando Arós. Neurology: Dr. Juan Timiraos. Internal Medicine: Dr. Mikel Aldamiz; Dr. Joseba Portu. Endocrinology: Dr. Lluis Forga. Ophthalmology: Dr. Alfredo García-Layana. Psychiatry: Dr. Ana González Pinto; Dr. Iñaki Zorrilla. Oncology: Dr. Mireia Martínez; Dr. Patricia Seoane. Independent Data and Safety Monitoring Board: M.J. Stampfer (Harvard School of Public Health), J. Sabate (Loma Linda University), A. Astrup (Copenhagen University), F. Fernandez-Aviles (Universidad Complutense of Madrid), X. Pi-Sunyer (Columbia University). Rovira i Virgili University, Department of Biochemistry and Biotechnology, Human Nutrition Unit, University Hospital of Sant Joan de Reus, Pere Virgili Institute for Health Research, Reus, Spain: R. Pedret Llaberia, R. Gonzalez, R. Sagarra Álamo, F. París Palleja, J. Balsells, J.M. Roca, T. Basora Gallisa, J. Vizcaino, P. Llobet Alpizarte, C. Anguera Perpiñá, M. Llauradó Vernet, C. Caballero, M. Garcia Barco, M.D. Morán Martínez, J. García Rosselló, A. Del Pozo, C. PobletCalaf, P. Arcelin Zabal, X. Floresví, M. Ciutat Benet, A. Palau Galindo, J.J. Cabré Vila, F. Dolz Andrés, M. Soler, M. Gracia Vidal, J. Vilalta J. Boj Casajuana, M. Ricard, F. Saiz, A. Isach, M. Sanchez Marin Martinez, E. Granado Font, C, Lucena Luque, C. 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Galilea-Zabalza, H. Lancova, R. Ramallal, M.L. Garcia-Perez, V. Estremera-Urabayen, M.J. Ariz-Arnedo, C. Hijos-Larraz, C. Fernandez-Alfaro, B. Iñigo-Martinez, R. Villanueva Moreno, S. Martin-Almendros, L. Barandiaran-Bengoetxea, C. Fuertes-Goñi, A. Lezaun-Indurain, M.J. Guruchaga-Arcelus, O. Olmedo-Cruz, L. Escriche-Erviti, R. Ansorena-Ros, R. Sanmatin-Zabaleta, J. Apalategi-Lasa, J. Villanueva-Telleria, M.M. Hernández-Espinosa, L. Herrera-Valdez, L. Dorronsoro-Dorronsoro, Lourdes Echeverria-Lizarraga (†), J.A. Cabeza-Beunza, P. Fernández-Urretavizcaya, P. Gascó-García, C. Royo-Jimenez, J. Moran-Pí, F. Salazar-Fernández, F.J. Chasco-Ros, F. Cortés-Ugalde, J.J. Jurio-Burgui, P. Pascual-Pascual, A.I. Rodríguez-Ezpeleta, M. Esparza-Cáceres, C. Arroyo-Azpa, M. Rodríguez-Sanz de Galdeano, T.Forcen-Alonso, M. Armendariz-Marcotegui, A. Brugos-Larumbe, A. Arillo, B. López-Aisa. Department of Preventive Medicine, University of Valencia, University Jaume I, Conselleria de Sanitat de la Generalitat Valenciana, Valencia, Spain: J.I. González, J.V. Sorlí, O. Portolés, R. Fernández-Carrión, C. Ortega-Azorín, R. Barragán, E.M. Asensio, O. Coltell, R. Martínez-Lacruz, I. Giménez‐Alba, C. Sáiz, R. Osma, E. Férriz, I. González-Monje, P. Guillém-Sáiz, F. Giménez-Fernández, L. Quiles, P. Carrasco, A. Carratalá-Calvo, C. Valero-Barceló, C. Mir, S. Sánchez-Navarro, J. Navas, I. González-Gallego, L. Bort-Llorca, L. Pérez-Ollero, M. Giner-Valero, R. Monfort-Sáez, J. Nadal-Sayol, V. Pascual-Fuster, M. Martínez-Pérez, C. Riera, M.V. Belda, A. Medina, E. Miralles, M.J. Ramírez-Esplugues, M. Rojo-Furió, G. Mattingley, M.A. Delgado, M.A. Pages, Y Riofrío, L. Abuomar, N. Blasco-Lafarga, R. Tosca, L. Lizán, A.M Valcarce, M.D. Medina, S. de Valcárcel, N. Tormo, O. Felipe-Román, S. Lafuente, E.I. Navío, G. Aldana, J.V. Crespo, J.L. Llosa, L. González-García, R. Raga-Marí. Cardiovascular Risk and Nutrition Research Group, Endocrinology Service, Neurosciences Programme, Clinical Research Unit at the Hospital del Mar Medical Research Institute (IMIM), Barcelona. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain: M. Fitó, O. Castañer, M.A. Muñoz, M.D. Zomeño, A. Hernaéz, L. Torres, M. Quifer, R. Llimona, G Freixer, KA. Pérez-Vega, M. Farràs, R. Elosua, J. Vila, I. Subirana, S. Pérez, A. Goday, J.J. Chillaron Jordan, J.A. Flores Lerroux, D. Benaiges Boix, G. Llauradó, M. Farré, E. Menoyo, A. Aldea-Perona, M. Pérez-Otero, D. Muñoz-Aguayo, S. Gaixas, G. Blanchart, A. Sanllorente, M. Soria, J. Valussi, A. Cuenca, L. Forcano, A. Pastor, A. Boronat, S. Tello, M. Cabañero, L. Franco, H. Schröder, R. De la Torre, C. Medrano, J. Bayó, M.T. García, V. Robledo, P. Babi, E. Canals, N. Soldevila, L. Carrés, C. Roca, M.S. Comas, G. Gasulla, X. Herraiz, A. Martínez, E. Vinyoles, J.M. Verdú, M. Masague Aguade, E. Baltasar Massip, M. López Grau, M. Mengual, V. Moldon, M. Vila Vergaz, R. Cabanes Gómez, Ciurana, M. Gili Riu, A. Palomeras Vidal, F Peñas F, A Raya, M.A. Sebastian, M. Valls, J. Guerrero, M. Marne, E. Minguella, M. Montenegro, A. Sala, M.R. Senan, N. Talens, N. Vera. Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain: J. Vioque, M. García-de-la-Hera, E.M. Navarrete-Muñoz, S. Gonzalez-Palacios, L. Torres-Collado, L. Compañ-Gabucio, A. Oncina-Canovas, L. Notario-Barandiaran, D. Orozco-Beltran, S. Pertusa Martínez, A. Asensio, I. Candela-García, J.M. Zazo, C. Gisbert Sellés, N.Fernándis-Brufal, J. Román Maciá, C. Sánchez Botella, M. García Muñoz, C. Barceló, M.C. Altozano-Rodado, N.Iranzo García, M.C. Martínez Vergara, M.A.Sempere Pascual, S.J. Miralles Gisbert, A. González Botella, C.M. López García, R. Valls Enguix, N. Gómez Bellvert, I. López Aguilera, R.LloretMacián, A. Pastor Morell, E. Alonso Bartolomé, J.J. Ballester Baixauli, M.T. Cano Sánchez, B.E.Ayús Rojo, E.P. Cases Pérez, C. Tercero Maciá, L.A. Mira Castejón, I.A. García García, M. Jordá Ballesta, C. Pastor Polo, E. Puig Agulló. Hospital Son Espases (HUSE) and Institute for Health Research Illes Balears (IdISBa), Palma de Mallorca, Spain: M. Fiol, M. Moñino, A. Colom, J. Konieczna, M. Morey, R. Zamanillo, A.M. Galmés-Panadés, V. Pereira, M.A. Martín, A. Yáñez, J. Llobera, J. Ripoll, R. Prieto, F. Grases, A. Costa, C. Fernández-Palomeque, E. Fortuny, M. Noris, S. Munuera, F. Tomás, F. Fiol, A. Jover, J.M. Janer, C. Vallespir, I. Mattei, N. Feuerbach, M. del Mar Sureda, S. Vega, L. Quintana, A. Fiol, M. Amador, S. González, J. Coll, A. Moyá, T. Piqué Sistac, M.D. Sanmartín Fernández, M.C. Piña Valls, M.A. Llorente San Martín, J. PouBordoy. Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain: I. Abete, I. Cantero, C. Cristobo, I. Ibero-Baraibar, M. Zulet, J. Ágreda-Peiró, M.D. Lezáun-Burgui, N. Goñi-Ruiz, R. Bartolomé-Resano, E. Cano-Cáceres, T. Elcarte-López, E. Echarte-Osacain, B. Pérez-Sanz, I. Blanco-Platero, A. Andueza- Azcárate, A. Gimeno-Aznar, E. Ursúa-Sesma, B. Ojeda-Bilbao, J. Martinez-Jarauta, L. Ugalde-Sarasa, B. Rípodas-Echarte, M.V. Güeto-Rubio, C. Napal-Lecumberri, MD Martínez-Mazo, E Arina-Vergara, A. Parra-Osés, F. Artal-Moneva, F. Bárcena-Amigo, F. Calle-Irastoza, J. Abad-Vicente, J.I. Armendáriz-Artola, P. Iñigo-Cibrian, J. Escribano-Jarauta, J. Ulibarri-delportillo, B. Churio-Beraza, Y. Monzón-Martínez, E. Madoz-Zubillaga, C. Arroniz. University of Málaga and Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain: F.J. Barón-López, J.C. Fernández García, N. Pérez-Farinós, N. Moreno-Morales, M. del C. Rodríguez-Martínez, J. Pérez-López, J.C. Benavente-Marín, E. Crespo Oliva, E. Contreras Fernández, F.J. Carmona González, R. Carabaño Moral, S. Torres Moreno, M.V. Martín Ruíz, M. Alcalá Cornide, V. Fuentes Gómez. Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain: J. López-Miranda, A. Garcia-Rios, J. Criado García, A.I. Jiménez Morales, A. Ortiz Morales, J.D. Torres Peña, F.J. Gómez Delgado, J.F. Alcalá, A. León Acuña, A.P. Arenas Larriva, F. Rodríguez Cantalejo, J. Caballero Villaraso, I. Nieto Eugenio, P. Coronado Carvajal, M.C del Campo Molina, P.J. Peña Orihuela, I. Perez Corral, G. Quintana Navarro. Department of Internal Medicine, Institutd’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain: R. Casas, M. Domenech, C. Viñas, S. Castro-Barquero, A.M. Ruiz-León, R. Losno, L. Tarés, A. Jordán, R. Soriano, M. Camafort, C. Sierra, E. Sacanella, A. Sala-Vila, J. M. Cots, I. Sarroca, M. García, N. Bermúdez, A. Pérez, I. Duaso, A. de la Arada, R. Hernández, C. Simón, M.A. de la Poza, I. Gil, M. Vila, C. Iglesias, N. Assens, M. Amatller, LL. Rams, T. Benet, G. Fernández, J. Teruel, A. Azorin, M. Cubells, D. López, J.M. Llovet, M.L. Gómez, P. Climente, L. de Paula, J. Soto, C. Carbonell, C. Llor, X. Abat, A. Cama, M. Fortuny, C. Domingo, A. I. Liberal, T. Martínez, E. Yañez, M. J. Nieto, A. Pérez, E. Lloret, C. Carrazoni, A. M. Belles, C. Olmos, M. Ramentol, M. J. Capell, R. Casas, I. Giner, A. Muñoz, R. Martín, E. Moron, A. Bonillo, G. Sánchez, C. Calbó, J. Pous, M. Massip, Y. García, M.C. Massagué, R. Ibañez, J. Llaona, T. Vidal, N. Vizcay, E. Segura, C. Galindo, M. Moreno, M. Caubet, J. Altirriba, G. Fluxà, P. Toribio, E. Torrent, J. J. Anton, A. Viaplana, G. Vieytes, N. Duch, A. Pereira, M. A. Moreno, A. Pérez, E. Sant, J. Gené, H. Calvillo, F. Pont, M. Puig, M. Casasayas, A. Garrich, E. Senar, A. Martínez, I. Boix, E. Sequeira, V. Aragunde, S. Riera, M. Salgado, M. Fuentes, E. Martín, A. Ubieto, F. Pallarés, C. Sala, A. Abilla, S. Moreno, E. Mayor, T. Colom, A. Gaspar, A. Gómez, L. Palacios, R. Garrigosa. Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain: L. García Molina, B. Riquelme Gallego, N. Cano Ibañez, A. Maldonado Calvo, A. López Maldonado, E.M. Garrido, A. Baena Dominguez, F. García Jiménez, E. Thomas Carazo, A. Jesús Turnes González, F. González Jiménez, F. Padilla Ruiz, J. Machado Santiago, M.D. Martínez Bellón, A. Pueyos Sánchez, L. Arribas Mir, R. Rodríguez Tapioles, F. Dorador Atienza, L. Baena Camus, C. Osorio Martos, D. Rueda Lozano, M. López Alcázar, F. Ramos Díaz, M. Cruz Rosales Sierra, P. Alguacil Cubero, A. López Rodriguez, F. Guerrero García, J. Tormo Molina, F. Ruiz Rodríguez. Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain: I. Salaverria, A. Alonso-Gómez, M.C. Belló, L. Tojal, L. Goicolea, C. Sorto, A Goikoetxea, A. Casi Casanellas, M.L. Arnal Otero, J. Ortueta Martínez De Arbulo, J. Vinagre Morgado, J. Romeo Ollora, J. Urraca, M.I. Sarriegui Carrera, F.J. Toribio, E. Magán, A. Rodríguez, S. Castro Madrid, M.T. Gómez Merino, M. Rodríguez Jiménez, M. Gutiérrez Jodra, B. López Alonso, J. Iturralde Iriso, C. Pascual Romero, A. Izquierdo De La Guerra. Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain: M. Abbate, E. Angullo, E. Argelich, M.M. Bibiloni, C. Bouzas, X. Capó, S. Carreres, L. Gallardo, J.M. Gámez, B. García, C. García, A. Julibert, C. Gómez, I. Llompart, A. Martorell, C.M. Mascaró, D. Mateos, M, Monserrat, S. Montemayor, A. Pons, A. Pouso, J. Ramos, V. Ramos, T. Ripoll, T. Rodríguez, L. Sanz, A. Sureda, S. Tejada, L. Ugarriza. Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain: M.R. Bernal López, M. Macías González, J. Ruiz Nava, J.C. Fernández García, A. Muñoz Garach, A. Vilches Pérez, A. González Banderas, A.V. Alarcón-Martín, M. García Ruiz de Mier, J. Alcaide Torres, A. Vargas Candela, M. León Fernández, R. Hernández Robles, S. Santamaría Fernández, J.M. Marín. University of Las Palmas de Gran Canaria, Las Palmas, Spain: J. Álvarez-Pérez, E.M. Díaz Benítez, F. Díaz-Collado, A. Sánchez-Villegas, J. Pérez-Cabrera, L.T. Casañas-Quintana, R.B. García-Guerra, I. Bautista-Castaño, C. Ruano-Rodríguez, F. Sarmiento de la Fe, J.A. García-Pastor, B. Macías-Gutiérrez, I. Falcón-Sanabria, C. Simón-García, A.J. Santana-Santana, J.B. Álvarez-Álvarez, B.V. Díaz-González, J.M. Castillo Anzalas, R.E. Sosa-Also, J. Medina-Ponce. Biomedicine Institute (IBIOMED); University of León, and Primary Health Care Management of León (Sacyl), León, Spain: Biomedicine Institute (IBIOMED); University of León, and Primary Health Care Management of León (Sacyl), León, Spain: S. Abajo Olea, L. Álvarez-Álvarez, M. Rubín García, A. Torres, P. Farias, N. Cubelos, A. AdlbiSibai, M. Ajenjo, E. CarriedoUle, M. Escobar Fernández, J.I. Ferradal García, J.P. Fernández Vázquez, C. González Quintana, F. González Rivero, M. Lavinia Popescu, J.I. López Gil, J. López de la Iglesia, A. Marcos Delgado, C. Merino Acevedo, S. Reguero Celada, M. Rodríguez Bul, E. Fernández Mielgo. Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain: J.M. Santos-Lozano, L. Miró-Moriano, C. Domínguez-Espinaco, S. Vaquero-Díaz, F.J. García-Corte, A. Santos-Calonge, C. Toro-Cortés, N. Pelegrina-López, V. Urbano-Fernández, M. Ortega-Calvo, J. Lozano-Rodríguez, I. Rivera-Benítez, M. Caballero-Valderrama, P. Iglesias-Bonilla, P. Román-Torres, Y. Corchado-Albalat, L. Mellado-Martín. Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, Spain: A.I. de Cos, S. Gutierrez, S. Artola, A. Galdon, I. Gonzalo. Lipids and Vascular Risk Unit, Internal Medicine, University Hospital of Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain: X. Pintó, A. Galera, M. Gimenez-Gracia, E. de la Cruz, R. Figueras, M. Poch, R. Freixedas, F. Trias, I. Sarasa, M. Fanlo-Maresma, H. Lafuente, M. Liceran, A. Rodriguez-Sanchez, C. Pallarols, E. Gómez-Sanchez, V. Esteve-Luque, J. Monedero, X. Corbella, E. Corbella. Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain: A. Altés, I. Vinagre, C. Mestre, J. Viaplana, M. Serra, J. Vera, T. Freitas, E. Ortega, I. Pla, R. Olbeyra. Nutritional Control of the Epigenome Group. Precision Nutrition and Obesity Program, Institute IMDEA-Food, CEI UAM+CSIC, Madrid, Spain: J.M. Ordovás, V. Micó, L. Berninches, L. Díez, M.J. Concejo, J. Muñoz, M. Adrián, Y. de la Fuente, C. Albertos, M.L. Cornejo, C. Cuesta. A. Montero., J. Aroca. Division of Preventive Medicine, University of Jaén, Jaén, Spain: J.J. Gaforio, S. Moraleda, N. Liétor, J.I. Peis, T. Ureña, M. Rueda, M.I. Ballesta. Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España (Spain para internacionales: C. Moreno Lopera, C. Aragoneses Isabel, M.A. Sirur Flores, M. Ceballos de Diego, T. Bescos Cáceres, Y. Peña Cereceda, M. Martínez Abad, R. Cabrera Vélez, M. González Cerrajero, M.A. Rubio Herrera, M. Torrego Ellacuría, A. Barabash Bustelo, M. Ortiz Ramos, A. Larrad Sainz. Department of Basic and Clinical Psychology and Psychobiology, University Jaume I, Castellón de la Plana, Spain: R. Baños, A. García-Palacios. Oxidative Pathology Unit. Department of Biochemistry and Molecular Biology, School of Medicine-INCLIVA, Service of Clinical Analyses, University Hospital Doctor Peset, Valencia, Spain. University of Valencia, Valencia Spain: G. Sáez Tormo (Sáez GT), N. Estañ-Capell, A. Iradi Casal, L. Monzó Beltrán, C. Bañuls Morant, E. Alonso Iglesias, D. Acevedo León, A. Hernando Espinilla, A. Mora Herranz, S. Alcover Sáez, J. A. Sánchez Herrero, J. Ventura Gayete, JM. López Ortega, ML Santaolaria Ayora, A. Carbonell Moncho, S. Mayo de Andrés. Department of Preventive Medicine, University of Malaga, Malaga, Spain: J. Fernández-Crehuet Navajas, M. Gutiérrez Bedmar, A. García Rodriguez, A. Mariscal Larrubia, M. Carnero Varo, C. Muñoz Bravo. Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain: F. Fernández-Aranda, S. Jiménez-Murcia, N. Mallorqui-Bagué, R. Granero, Z. Agüera, M. Lozano-Madrid.

Funding

The PREDIMED-Plus trial was supported by the Spanish government’s official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS) and co-funded by European Union ERDF/ESF, “A way to make Europe”/ “Investing in your future” (five coordinated FIS projects led by JS-S and JVid, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560 and PI19/01332), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S, the European Research Council (Advanced Research Grant 2013–2018, 340918) to MÁM-G, the Recercaixa Grant to JS-S (2013ACUP00194), grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016 and PI0137/2018), a grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03). This research was also partially funded by EU-H2020 Grant (EAT2BENICE/H2020-SFS-2016–2; Ref 728018). Study resulting from the SLT006/17/00246 grant was funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut.” We thank CERCA Programme/Generalitat de Catalunya for institutional support. This work is partially supported by ICREA under the ICREA Academia program. IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). L.C.-B. is the recipient of a predoctoral fellowship from the Generalitat de Catalunya's Department of Universities (FI-DGR 2017). NB-T is supported by a postdoctoral fellowship (Juan de la Cierva-Formación, FJC2018-036016-I) MRBL was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER.

Author information

Authors and Affiliations

  1. Department of Biochemistry and Biotechnology, Human Nutrition Unit, Rovira i Virgili University, Reus, Spain

    Indira Paz-Graniel, Nancy Babio, Nerea Becerra-Tomás, Lucia Camacho-Barcia & Jordi Salas-Salvadó

  2. Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain

    Indira Paz-Graniel, Nancy Babio, Nerea Becerra-Tomás, Lucia Camacho-Barcia & Jordi Salas-Salvadó

  3. CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain

    Indira Paz-Graniel, Nancy Babio, Nerea Becerra-Tomás, Estefania Toledo, Lucia Camacho-Barcia, Dolores Corella, Olga Castañer-Niño, Dora Romaguera, Ángel M. Alonso-Gómez, Julia Wärnberg, J. Alfredo Martínez, Luís Serra-Majem, Ramon Estruch, Francisco J. Tinahones, Fernando Fernandez-Aranda, José Lapetra, Xavier Pintó, Josep A. Tur, Antonio García-Rios, Vicente Martín Sánchez, Emilio Ros, Cristina Razquin, José V. Sorli, Aida M. Cuenca-Royo, Jessica Vaquero-Luna, Napoleon Pérez-Farinós, M. Angeles Zulet, Almudena Sanchez-Villegas, Rosa Casas, M Rosa Bernal-Lopez, José Manuel Santos-Lozano, David Mateos, Pilar Buil-Cosiales, Susana Jiménez-Murcia, Rebeca Fernandez-Carrion, Laura Forcano-Gamazo, Anai Moreno-Rodriguez, Alfredo Gea, Rafael de la Torre-Fornell & Jordi Salas-Salvadó

  4. Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010, Valencia, Spain

    Nerea Becerra-Tomás

  5. Department of Preventive Medicine and Public Health, IdiSNA, University of Navarra, Pamplona, Spain

    Estefania Toledo, Cristina Razquin, Pilar Buil-Cosiales & Alfredo Gea

  6. Department of Preventive Medicine, University of Valencia, Valencia, Spain

    Dolores Corella, José V. Sorli & Rebeca Fernandez-Carrion

  7. Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute (IMIM), Barcelona, Spain

    Olga Castañer-Niño & Dora Romaguera

  8. Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain

    Josep A. Tur, Angel Rios & Meritxell López

  9. CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, Madrid, Spain

    Jesús Vioque, José J. Gaforio, Laura Torres-Collado & David Mateos

  10. ISABIAL-UMH, Miguel Hernandez University, Alicante, Spain

    Jesús Vioque & Laura Torres-Collado

  11. Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Ángel M. Alonso-Gómez, Aurora Bueno-Cavanillas, Jessica Vaquero-Luna & Anai Moreno-Rodriguez

  12. Department of Nursing, School of Health Sciences, University of Málaga-Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain

    Julia Wärnberg

  13. Department of Nutrition, Food Science and Physiology, IDISNA, University of Navarra, Pamplona, Spain

    J. Alfredo Martínez & M. Angeles Zulet

  14. Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain

    J. Alfredo Martínez

  15. Research Institute of Biomedical and Health Sciences (IUIBS), Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, University of Las Palmas de Gran Canaria, Las Palmas, Spain

    Luís Serra-Majem & Almudena Sanchez-Villegas

  16. Department of Internal Medicine, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain

    Ramon Estruch & Rosa Casas

  17. Department of Endocrinology. Biomedical Research Institute of Malaga (IBIMA), Virgen de la Victoria Hospital, University of Málaga, Málaga, Spain

    Francisco J. Tinahones

  18. Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain

    Fernando Fernandez-Aranda & Susana Jiménez-Murcia

  19. Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain

    José Lapetra & José Manuel Santos-Lozano

  20. Lipids and Vascular Risk Unit, Internal Medicine, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain

    Xavier Pintó & Xavier Corbella

  21. Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain

    Josep A. Tur & David Mateos

  22. Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain

    Antonio García-Rios

  23. Department of Preventive Medicine, University of Granada, Granada, Spain

    Aurora Bueno-Cavanillas

  24. Departamento de Ciencias de La Salud, Centro de Estudios Avanzados en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain

    José J. Gaforio

  25. Department of Endocrinology and Nutrition, Health Research Institute of the San Carlos Clinical Hospital (IdISSC), Madrid, Spain

    Pilar Matía-Martín

  26. Nutritional Genomics and Epigenomics Group , IMDEA Food, CEI UAM + CSIC, Madrid, Spain

    Lidia Daimiel

  27. Institute of Biomedicine (IBIOMED), University of León, León, Spain

    Vicente Martín Sánchez

  28. CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Carlos III Health Institute (ISCIII), Madrid, Spain

    Josep Vidal

  29. Department of Endocrinology, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain

    Josep Vidal

  30. Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain

    Lucía Prieto-Sanchez

  31. Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic, Barcelona, Spain

    Emilio Ros

  32. Joan XXIII University Hospital, Tarragona, Spain

    Cristina Mestres

  33. Horts de Miró Health Center, Reus, Spain

    Cristina Mestres

  34. Integrative Pharmacology and Systems Neurosciences (FINS), Hospital del Mar Research Institute (IMIM), Barcelona, Spain

    Aida M. Cuenca-Royo, Laura Forcano-Gamazo & Rafael de la Torre-Fornell

  35. Department of Public Health, School of Medicine, University of Malaga-Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain

    Napoleon Pérez-Farinós

  36. Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain

    M. Angeles Zulet

  37. Regional University Hospital of Malaga, Internal Medicine Department , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain

    M Rosa Bernal-Lopez

  38. Medicine and Health Science Faculty, Universitat Internacional de Catalunya, Barcelona, Spain

    Xavier Corbella

  39. Santa Pola Health Center, Alicante, Spain

    Miguel Ángel Sempere-Pascual

  40. The Sant Joan University Hospital, Human Nutrition Unit, Reus, Spain

    Jordi Salas-Salvadó

Authors
  1. Indira Paz-Graniel
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  2. Nancy Babio
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  3. Nerea Becerra-Tomás
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  4. Estefania Toledo
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  5. Lucia Camacho-Barcia
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  6. Dolores Corella
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  7. Olga Castañer-Niño
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  8. Dora Romaguera
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  9. Jesús Vioque
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  10. Ángel M. Alonso-Gómez
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  11. Julia Wärnberg
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  12. J. Alfredo Martínez
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  13. Luís Serra-Majem
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  14. Ramon Estruch
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  15. Francisco J. Tinahones
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  16. Fernando Fernandez-Aranda
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  17. José Lapetra
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  18. Xavier Pintó
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  19. Josep A. Tur
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  20. Antonio García-Rios
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  21. Aurora Bueno-Cavanillas
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  22. José J. Gaforio
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  23. Pilar Matía-Martín
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  24. Lidia Daimiel
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  25. Vicente Martín Sánchez
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  26. Josep Vidal
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  27. Lucía Prieto-Sanchez
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  28. Emilio Ros
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  29. Cristina Razquin
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  30. Cristina Mestres
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  31. José V. Sorli
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  32. Aida M. Cuenca-Royo
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  33. Angel Rios
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  34. Laura Torres-Collado
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  35. Jessica Vaquero-Luna
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  36. Napoleon Pérez-Farinós
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  37. M. Angeles Zulet
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  38. Almudena Sanchez-Villegas
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  39. Rosa Casas
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  40. M Rosa Bernal-Lopez
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  41. José Manuel Santos-Lozano
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  42. Xavier Corbella
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  43. David Mateos
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  44. Pilar Buil-Cosiales
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  45. Susana Jiménez-Murcia
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  46. Rebeca Fernandez-Carrion
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  47. Laura Forcano-Gamazo
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  48. Meritxell López
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  49. Miguel Ángel Sempere-Pascual
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  50. Anai Moreno-Rodriguez
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  51. Alfredo Gea
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  52. Rafael de la Torre-Fornell
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  53. Jordi Salas-Salvadó
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Consortia

the PREDIMED-Plus Investigators

  • J. Salas-Salvadó
  • , M. A. Martínez-González
  • , M. Fitó
  • , E. Ros
  • , F. J. Tinahones
  • , D. Corella
  • , R. Estruch
  • , J. Vioque
  • , D. Romaguera
  • , J. A. Martínez
  • , J. Wärnberg
  • , J. Lopez-Miranda
  • , A. Bueno-Cavanillas
  • , Á. M. Alonso-Gómez
  • , J. A. Tur
  • , L. Serra-Majem
  • , V. Martin
  • , J. Lapetra
  • , C. Vázquez
  • , X. Pinto
  • , J. Vidal
  • , L. Daimiel
  • , M. Delgado-Rodríguez
  • , M. A. Rubio
  • , N. Babio
  • , A. Sánchez-Tainta
  • , H. Schröder
  • , A. Marcos
  • , J. Warnberg
  • , F. Fernández-Aranda
  • , C. Botella
  • , F. Arós
  • , M. Aldamiz
  • , A. Alonso-Gómez
  • , L. Forga
  • , A. García-Layana
  • , J. Portu
  • , J. Timiraos
  • , A. González-Pinto
  • , I. Zorrilla
  • , M. Martínez-Kareaga
  • , P. Seoane
  • , Juan Timiraos
  • , Mikel Aldamiz
  • , Joseba Portu
  • , Lluis Forga
  • , Alfredo García-Layana
  • , Ana González Pinto
  • , Iñaki Zorrilla
  • , Mireia Martínez
  • , Patricia Seoane
  • , M. J. Stampfer
  • , J. Sabate
  • , A. Astrup
  • , F. Fernandez-Aviles
  • , X. Pi-Sunyer
  • , R. Pedret Llaberia
  • , R. Gonzalez
  • , R. Sagarra Álamo
  • , F. París Palleja
  • , J. Balsells
  • , J. M. Roca
  • , T. Basora Gallisa
  • , J. Vizcaino
  • , P. Llobet Alpizarte
  • , C. Anguera Perpiñá
  • , M. Llauradó Vernet
  • , C. Caballero
  • , M. Garcia Barco
  • , M. D. Morán Martínez
  • , J. García Rosselló
  • , A. Del Pozo
  • , C. PobletCalaf
  • , P. Arcelin Zabal
  • , X. Floresví
  • , M. Ciutat Benet
  • , A. Palau Galindo
  • , J. J. Cabré Vila
  • , F. Dolz Andrés
  • , M. Soler
  • , M. Gracia Vidal
  • , J. Vilalta
  • , J. Boj Casajuana
  • , M. Ricard
  • , F. Saiz
  • , A. Isach
  • , M. Sanchez Marin Martinez
  • , E. Granado Font
  • , C. Lucena Luque
  • , C. Mestres Sola
  • , N. Becerra-Tomás
  • , G. Mestres
  • , J. Basora
  • , G. Mena-Sánchez
  • , L. Barrubés Piñol
  • , M. Gil Segura
  • , N. Rosique-Esteban
  • , S. Chig
  • , I. Abellán Cano
  • , V. Ruiz García
  • , C. Gomez-Martinez
  • , L. Lopez-Gonzalez
  • , A. Salas-Huetos
  • , I. Paz-Graniel
  • , J. Roig Vallverdú
  • , C. Claudia Miñana Garcia
  • , L. Sánchez Niembro
  • , P. Hernandez-Alonso
  • , S. Canudas
  • , A. Díaz-López
  • , M. Ruiz-Canela
  • , E. Toledo
  • , P. Buil-Cosiales
  • , Z. Vázquez
  • , C. Razquin
  • , M. Bes-Rastrollo
  • , A. Gea
  • , B. SanJulian Aranguren
  • , E. Goñi
  • , L. Goñi
  • , M. J. Cobo
  • , A. Rico-Campa
  • , F. J. Basterra Gortari
  • , A. Garcia Arellano
  • , J. Diez-Espino
  • , O. Lecea-Juarez
  • , J. Carlos Cenoz-Osinaga
  • , I. Alvarez-Alvarez
  • , M. C. Sayon-Orea
  • , C. I. Fernandez-Lázaro
  • , L. Ruiz-Estigarribia
  • , J. Bartolome-Resano
  • , A. Sola-Larraza
  • , E. Lozano-Oloriz
  • , B. Cano-Valles
  • , S. Eguaras
  • , E. Pascual Roquet-Jalmar
  • , I. Galilea-Zabalza
  • , H. Lancova
  • , R. Ramallal
  • , M. L. Garcia-Perez
  • , V. Estremera-Urabayen
  • , M. J. Ariz-Arnedo
  • , C. Hijos-Larraz
  • , C. Fernandez-Alfaro
  • , B. Iñigo-Martinez
  • , R. Villanueva Moreno
  • , S. Martin-Almendros
  • , L. Barandiaran-Bengoetxea
  • , C. Fuertes-Goñi
  • , A. Lezaun-Indurain
  • , M. J. Guruchaga-Arcelus
  • , O. Olmedo-Cruz
  • , L. Escriche-Erviti
  • , R. Ansorena-Ros
  • , R. Sanmatin-Zabaleta
  • , J. Apalategi-Lasa
  • , J. Villanueva-Telleria
  • , M. M. Hernández-Espinosa
  • , L. Herrera-Valdez
  • , L. Dorronsoro-Dorronsoro
  • , Lourdes Echeverria-Lizarraga
  • , J. A. Cabeza-Beunza
  • , P. Fernández-Urretavizcaya
  • , P. Gascó-García
  • , C. Royo-Jimenez
  • , J. Moran-Pí
  • , F. Salazar-Fernández
  • , F. J. Chasco-Ros
  • , F. Cortés-Ugalde
  • , J. J. Jurio-Burgui
  • , P. Pascual-Pascual
  • , A. I. Rodríguez-Ezpeleta
  • , M. Esparza-Cáceres
  • , C. Arroyo-Azpa
  • , M. Rodríguez-Sanz de Galdeano
  • , T. Forcen-Alonso
  • , M. Armendariz-Marcotegui
  • , A. Brugos-Larumbe
  • , A. Arillo
  • , B. López-Aisa
  • , J. I. González
  • , J. V. Sorlí
  • , O. Portolés
  • , R. Fernández-Carrión
  • , C. Ortega-Azorín
  • , R. Barragán
  • , E. M. Asensio
  • , O. Coltell
  • , R. Martínez-Lacruz
  • , I. Giménez‐Alba
  • , C. Sáiz
  • , R. Osma
  • , E. Férriz
  • , I. González-Monje
  • , P. Guillém-Sáiz
  • , F. Giménez-Fernández
  • , L. Quiles
  • , P. Carrasco
  • , A. Carratalá-Calvo
  • , C. Valero-Barceló
  • , C. Mir
  • , S. Sánchez-Navarro
  • , J. Navas
  • , I. González-Gallego
  • , L. Bort-Llorca
  • , L. Pérez-Ollero
  • , M. Giner-Valero
  • , R. Monfort-Sáez
  • , J. Nadal-Sayol
  • , V. Pascual-Fuster
  • , M. Martínez-Pérez
  • , C. Riera
  • , M. V. Belda
  • , A. Medina
  • , E. Miralles
  • , M. J. Ramírez-Esplugues
  • , M. Rojo-Furió
  • , G. Mattingley
  • , M. A. Delgado
  • , M. A. Pages
  • , Y. Riofrío
  • , L. Abuomar
  • , N. Blasco-Lafarga
  • , R. Tosca
  • , L. Lizán
  • , A. M. Valcarce
  • , M. D. Medina
  • , S. de Valcárcel
  • , N. Tormo
  • , O. Felipe-Román
  • , S. Lafuente
  • , E. I. Navío
  • , G. Aldana
  • , J. V. Crespo
  • , J. L. Llosa
  • , L. González-García
  • , R. Raga-Marí. O. Castañer
  • , M. A. Muñoz
  • , M. D. Zomeño
  • , A. Hernaéz
  • , L. Torres
  • , M. Quifer
  • , R. Llimona
  • , G. Freixer
  • , K. A. Pérez-Vega
  • , M. Farràs
  • , R. Elosua
  • , J. Vila
  • , I. Subirana
  • , S. Pérez
  • , A. Goday
  • , J. J. Chillaron Jordan
  • , J. A. Flores Lerroux
  • , D. Benaiges Boix
  • , G. Llauradó
  • , M. Farré
  • , E. Menoyo
  • , A. Aldea-Perona
  • , M. Pérez-Otero
  • , D. Muñoz-Aguayo
  • , S. Gaixas
  • , G. Blanchart
  • , A. Sanllorente
  • , M. Soria
  • , J. Valussi
  • , A. Cuenca
  • , L. Forcano
  • , A. Pastor
  • , A. Boronat
  • , S. Tello
  • , M. Cabañero
  • , L. Franco
  • , R. De la Torre
  • , C. Medrano
  • , J. Bayó
  • , M. T. García
  • , V. Robledo
  • , P. Babi
  • , E. Canals
  • , N. Soldevila
  • , L. Carrés
  • , C. Roca
  • , M. S. Comas
  • , G. Gasulla
  • , X. Herraiz
  • , A. Martínez
  • , E. Vinyoles
  • , J. M. Verdú
  • , M. Masague Aguade
  • , E. Baltasar Massip
  • , M. López Grau
  • , M. Mengual
  • , V. Moldon
  • , M. Vila Vergaz
  • , R. Cabanes Gómez
  • ,  Ciurana
  • , M. Gili Riu
  • , A. Palomeras Vidal
  • , F. Peñas
  • , A. Raya
  • , M. A. Sebastian
  • , M. Valls
  • , J. Guerrero
  • , M. Marne
  • , E. Minguella
  • , M. Montenegro
  • , A. Sala
  • , M. R. Senan
  • , N. Talens
  • , N. Vera
  • , M. García-de-la-Hera
  • , E. M. Navarrete-Muñoz
  • , S. Gonzalez-Palacios
  • , L. Torres-Collado
  • , L. Compañ-Gabucio
  • , A. Oncina-Canovas
  • , L. Notario-Barandiaran
  • , D. Orozco-Beltran
  • , S. Pertusa Martínez
  • , A. Asensio
  • , I. Candela-García
  • , J. M. Zazo
  • , C. Gisbert Sellés
  • , N. Fernándis-Brufal
  • , J. Román Maciá
  • , C. Sánchez Botella
  • , M. García Muñoz
  • , C. Barceló
  • , M. C. Altozano-Rodado
  • , N. Iranzo García
  • , M. C. Martínez Vergara
  • , M. A. Sempere Pascual
  • , S. J. Miralles Gisbert
  • , A. González Botella
  • , C. M. López García
  • , R. Valls Enguix
  • , N. Gómez Bellvert
  • , I. López Aguilera
  • , R. Lloret Macián
  • , A. Pastor Morell
  • , E. Alonso Bartolomé
  • , J. J. Ballester Baixauli
  • , M. T. Cano Sánchez
  • , B. E. Ayús Rojo
  • , E. P. Cases Pérez
  • , C. Tercero Maciá
  • , L. A. Mira Castejón
  • , I. A. García García
  • , M. Jordá Ballesta
  • , C. Pastor Polo
  • , E. Puig Agulló
  • , M. Fiol
  • , M. Moñino
  • , A. Colom
  • , J. Konieczna
  • , M. Morey
  • , R. Zamanillo
  • , A. M. Galmés-Panadés
  • , V. Pereira
  • , M. A. Martín
  • , A. Yáñez
  • , J. Llobera
  • , J. Ripoll
  • , R. Prieto
  • , F. Grases
  • , A. Costa
  • , C. Fernández-Palomeque
  • , E. Fortuny
  • , M. Noris
  • , S. Munuera
  • , F. Tomás
  • , F. Fiol
  • , A. Jover
  • , J. M. Janer
  • , C. Vallespir
  • , I. Mattei
  • , N. Feuerbach
  • , M. del Mar Sureda
  • , S. Vega
  • , L. Quintana
  • , A. Fiol
  • , M. Amador
  • , S. González
  • , J. Coll
  • , A. Moyá
  • , T. Piqué Sistac
  • , M. D. Sanmartín Fernández
  • , M. C. Piña Valls
  • , M. A. Llorente San Martín
  • , J. PouBordoy
  • , I. Abete
  • , I. Cantero
  • , C. Cristobo
  • , I. Ibero-Baraibar
  • , M. Zulet
  • , J. Ágreda-Peiró
  • , M. D. Lezáun-Burgui
  • , N. Goñi-Ruiz
  • , R. Bartolomé-Resano
  • , E. Cano-Cáceres
  • , T. Elcarte-López
  • , E. Echarte-Osacain
  • , B. Pérez-Sanz
  • , I. Blanco-Platero
  • , A. Andueza-Azcárate
  • , A. Gimeno-Aznar
  • , E. Ursúa-Sesma
  • , B. Ojeda-Bilbao
  • , J. Martinez-Jarauta
  • , L. Ugalde-Sarasa
  • , B. Rípodas-Echarte
  • , M. V. Güeto-Rubio
  • , C. Napal-Lecumberri
  • , M. D. Martínez-Mazo
  • , E. Arina-Vergara
  • , A. Parra-Osés
  • , F. Artal-Moneva
  • , F. Bárcena-Amigo
  • , F. Calle-Irastoza
  • , J. Abad-Vicente
  • , J. I. Armendáriz-Artola
  • , P. Iñigo-Cibrian
  • , J. Escribano-Jarauta
  • , J. Ulibarri-delportillo
  • , B. Churio-Beraza
  • , Y. Monzón-Martínez
  • , E. Madoz-Zubillaga
  • , C. Arroniz
  • , F. J. Barón-López
  • , J. C. Fernández García
  • , N. Pérez-Farinós
  • , N. Moreno-Morales
  • , M. del C. Rodríguez-Martínez
  • , J. Pérez-López
  • , J. C. Benavente-Marín
  • , E. Crespo Oliva
  • , E. Contreras Fernández
  • , F. J. Carmona González
  • , R. Carabaño Moral
  • , S. Torres Moreno
  • , M. V. Martín Ruíz
  • , M. Alcalá Cornide
  • , V. Fuentes Gómez
  • , J. López-Miranda
  • , A. Garcia-Rios
  • , J. Criado García
  • , A. I. Jiménez Morales
  • , A. Ortiz Morales
  • , J. D. Torres Peña
  • , F. J. Gómez Delgado
  • , J. F. Alcalá
  • , A. León Acuña
  • , A. P. Arenas Larriva
  • , F. Rodríguez Cantalejo
  • , J. Caballero Villaraso
  • , I. Nieto Eugenio
  • , P. Coronado Carvajal
  • , M. C. del Campo Molina
  • , P. J. Peña Orihuela
  • , I. Perez Corral
  • , G. Quintana Navarro
  • , R. Casas
  • , M. Domenech
  • , C. Viñas
  • , S. Castro-Barquero
  • , A. M. Ruiz-León
  • , R. Losno
  • , L. Tarés
  • , A. Jordán
  • , R. Soriano
  • , M. Camafort
  • , C. Sierra
  • , E. Sacanella
  • , A. Sala-Vila
  • , J. M. Cots
  • , I. Sarroca
  • , M. García
  • , N. Bermúdez
  • , A. Pérez
  • , I. Duaso
  • , A. de la Arada
  • , R. Hernández
  • , C. Simón
  • , M. A. de la Poza
  • , I. Gil
  • , M. Vila
  • , C. Iglesias
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Contributions

NB and JS-S contributed to study concept and design. IP-G, NB and JS-S performed statistical analyses. IP-G, NB, NB-T, LC-B and JS-S drafted the manuscript. All authors reviewed the manuscript for important intellectual content and approved the final version to be published.

Corresponding authors

Correspondence to Nancy Babio or Jordi Salas-Salvadó.

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Conflict of interest

JS-S serves on the board of (and receives grant support through his institution from) the International Nut and Dried Fruit Council and the Eroski Foundation. He also serves on the Executive Committee of the Instituto Danone, Spain, and on the Scientific Committee of the Danone International Institute. He has received research support from the Patrimonio Comunal Olivarero, Spain, and Borges S.A., Spain. He receives consulting fees or travel expenses from Danone, the Eroski Foundation, the Instituto Danone, Spain, and Abbot Laboratories. ER has received research funding through his institution from the California Walnut Commission, Folsom, CA, USA; was a paid member of its Health Research Advisory Group; and is a nonpaid member of its Scientific Advisory Council.

Consent for publication

Not applicable.

Ethical standards

All participants provided their written informed consent. The study protocol and procedures were approved in accordance with the ethical standards of the Declaration of Helsinki.

Additional information

A complete list of PREDIMED-Plus investigators is included as an acknowledgements.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 37 kb)

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Paz-Graniel, I., Babio, N., Becerra-Tomás, N. et al. Association between coffee consumption and total dietary caffeine intake with cognitive functioning: cross-sectional assessment in an elderly Mediterranean population. Eur J Nutr 60, 2381–2396 (2021). https://doi.org/10.1007/s00394-020-02415-w

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