Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes

Nutrients. 2015 Sep 16;7(9):7863-88. doi: 10.3390/nu7095367.


The aim of this paper is to analyze the a priori dietary indexes used in the studies that have evaluated the role of the Mediterranean Diet in influencing the risk of developing cardiovascular disease. All the studies show that this dietary pattern protects against cardiovascular disease, but studies show quite different effects on specific conditions such as coronary heart disease or cerebrovascular disease. A priori dietary indexes used to measure dietary exposure imply quantitative and/or qualitative divergences from the traditional Mediterranean Diet of the early 1960s, and, therefore, it is very difficult to compare the results of different studies. Based on real cultural heritage and traditions, we believe that the a priori indexes used to evaluate adherence to the Mediterranean Diet should consider classifying whole grains and refined grains, olive oil and monounsaturated fats, and wine and alcohol differently.

Keywords: Mediterranean diet; a priori dietary indexes; cardiovascular disease; cerebrovascular disease; coronary heart disease.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / prevention & control*
  • Cultural Characteristics
  • Diet, Mediterranean* / ethnology
  • Fatty Acids, Monounsaturated / classification
  • Humans
  • Life Style*
  • Olive Oil / classification
  • Patient Compliance
  • Prognosis
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Whole Grains / classification
  • Wine / classification


  • Fatty Acids, Monounsaturated
  • Olive Oil