Mediterranean Diet and the Incidence of Cardiovascular Disease: A Spanish Cohort

Nutr Metab Cardiovasc Dis. 2011 Apr;21(4):237-44. doi: 10.1016/j.numecd.2009.10.005. Epub 2010 Jan 21.

Abstract

Background and aim: The Mediterranean diet is considered a model for healthy eating. However, prospective evidence in Mediterranean countries evaluating the relationship between this dietary pattern and non-fatal cardiovascular events is scarce. The aim of the present study was to evaluate the association between the adherence to the Mediterranean diet and the incidence of fatal and non-fatal cardiovascular events among initially healthy middle-aged adults from the Mediterranean area.

Methods and results: We followed-up 13,609 participants (60 percent women, mean age: 38 years) initially free of cardiovascular disease (CVD) during 4.9 years. Participants were part of a prospective cohort study of university graduates from all regions of Spain. Baseline diet was assessed using a validated 136-item food-frequency questionnaire. A 9-point score was used to appraise adherence to the Mediterranean diet. Incident clinical events were confirmed by a review of medical records. We observed 100 incident cases of CVD. In multivariate analyses, participants with the highest adherence to the Mediterranean diet (score>6) exhibited a lower cardiovascular risk (hazard ratio=0.41, 95% confidence interval [CI]: 0.18-0.95) compared to those with the lowest score (<3). For each 2-point increment in the score, the adjusted hazard ratios were 0.80 (95% CI: 0.62-1.02) for total CVD and 0.74 (0.55-0.99) for coronary heart disease.

Conclusions: There is an inverse association between adherence to the Mediterranean diet and the incidence of fatal and non-fatal CVD in initially healthy middle-aged adults.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Cohort Studies
  • Coronary Disease / epidemiology
  • Coronary Disease / prevention & control
  • Diet, Mediterranean*
  • Female
  • Humans
  • Incidence
  • Male
  • Medical Records
  • Middle Aged
  • Patient Compliance
  • Proportional Hazards Models
  • Prospective Studies
  • Spain / epidemiology
  • Surveys and Questionnaires
  • Young Adult