Long‑term efect of a dietary intervention with two‑healthy dietary approaches on food intake and nutrient density in coronary patients: results from the CORDIOPREV trial Cano Ibáñez, Naomi Delgado Lista, Javier López-Miranda, José Mediterranean diet Low-fat diet Dietary intervention Nutrient density Dietary intake Cardiovascular disease Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. N.C.-I. is a recipient of the Juan de la Cierva Formación Programme. E.M.Y-S is a recipient of the Nicolás Monardes Programme (C1-0005–2019, Servicio Andaluz de Salud, Junta de Andalucía, Spain). A.P.A-L is supported by a Río-Hortega Programme (Instituto de Salud Carlos III). The CORDIOPREV study is supported by the Fundacion Patrimonio Comunal Olivarero. The sponsor was not involved in the design or carrying out the study, and its participation was limited to funding and providing the olive oil used in the study. CORDIOPREV trial also received additional funding from CITOLIVA, CEAS, Junta de Andalucia (Consejeria de Salud, Consejeria de Agricultura y Pesca, Consejeria de Innovacion, Ciencia y Empresa), Diputaciones de Jaen y Cordoba, Centro de Excelencia en Investigacion sobre Aceite de Oliva y Salud and Ministerio de Medio Ambiente, Medio Rural y Marino and the Spanish Government. It was also partly supported by research grants from the Ministerio de Ciencia e Innovacion (AGL2009-122270 to J L-M, FIS PI10/01041 to P. P.-M, FIS PI13/00023 to J. D.-L); Ministerio de Economia y Competitividad (AGL2012/39615 to J L-M); Consejeria de Salud, Junta de Andalucia (PI0193/09 to J. L.-M, PI-0252/09 to J. D.-L, and PI-0058/10 to P. P.-M, PI-0206–2013 to A. G.-R); Proyecto de Excelencia, Consejería de Economía, Innovación, Ciencia y Empleo (CVI-7450 to J. L.-M). Background Cardiovascular disease (CVD) is the leading cause of disease burden in the world by non-communicable diseases. Nutritional interventions promoting high-quality dietary patterns with low caloric intake value and high nutrient density (ND) could be linked to a better control of CVD risk and recurrence of coronary disease. This study aims to assess the efects of a dietary intervention based on MedDiet or Low-Fat dietary intervention over changes in ND and food intake after 1 and 7 years of follow-up of the CORDIOPREV study. Methods We prospectively analyzed the results of the 802 coronary patients randomized to two healthy dietary patterns (MedDiet=425, Low-Fat Diet=377) who completed the 7 years of follow-up and had all the dietary data need. Dietary intake information obtained from a validated 137-item Food Frequency Questionnaire was used to calculate 1- and 7-year changes in dietary intake and ND (measured as nutrient intake per 1000 kcal). T test was used to ascertain diferences in food intake and ND between groups across follow-up time. Within-subject (dietary allocation group) diferences were analyzed with ANOVA repeated measures. Results From baseline to 7 years of follow-up, signifcant increases of vegetables, fruits, and whole cereals within groups (p<0.001) was found. We found a higher increase in dietary intake of certain food groups with MedDiet in comparison with Low-Fat Diet for vegetables (46.1 g/day vs. 18.1 g/day, p<00.1), fruits (121.3 g/day vs. 72.9 g/day), legumes (4.3 g/day vs. 0.16 g/day) and nuts (7.3 g/day vs. − 3.7 g/day). There was a decrease in energy intake over time in both groups, slightly higher in Low-Fat Diet compared to MedDiet group (− 427.6 kcal/day vs. − 279.8 kcal/day at 1st year, and − 544.6 kcal/ day vs. − 215.3 kcal/day after 7 years of follow-up). ND of all the nutrients increased within group across follow-up time, except for Saturated Fatty Acids (SFA), cholesterol and sodium (p<0.001). Conclusions A comprehensive dietary intervention improved quality of diet, reducing total energy intake and increasing the intake of healthy food groups and overall ND after 1 year and maintaining this trend after 7 years of follow-up. Our results reinforce the idea of the participation in trials, enhance nutrition literacy and produces better nutritional outcomes in adult patients with established CVD. Clinical trial registry The trial was registered in 2009 at ClinicalTrials.gov (number NCT00924937) 2022-04-21T11:14:06Z 2022-04-21T11:14:06Z 2022-03-29 journal article Cano-Ibáñez, N., Quintana-Navarro, G.M., Alcala-Diaz, J.F. et al. Long-term effect of a dietary intervention with two-healthy dietary approaches on food intake and nutrient density in coronary patients: results from the CORDIOPREV trial. Eur J Nutr (2022). [https://doi.org/10.1007/s00394-022-02854-7] http://hdl.handle.net/10481/74438 10.1007/s00394-022-02854-7 eng http://creativecommons.org/licenses/by/3.0/es/ open access Atribución 3.0 España Springer Science and Business Media Deutschland GmbH