Diet plays a crucial role in lifestyle interventions for secondary cardiovascular prevention [1–5]. Recent guidelines for reducing cardiovascular risk in secondary prevention populations recommend, among other strategies, the Mediterranean Diet [4,5]. In the CORDIOPREV study, we previously demonstrated that the Mediterranean Diet is effective in preventing ASCVD events in secondary prevention when compared to a low-fat diet, based on an intention-to-treat analysis [6]. However, until now, we had not assessed whether adherence levels to the dietary assessment scores used in the study (the 14-point Mediterranean Diet Adherence Screener [MEDAS] for the Mediterranean Diet and a 9-point low-fat diet adherence questionnaire for the low-fat diet) influenced the incidence of MACE, or whether the main results of the CORDIOPREV Study were reproduced according to adherence to the diet to which each participant had been randomized.
