Adherence to the Mediterranean Diet in Preventing Major Cardiovascular Events in Patients with Ischemic Heart Disease: The EVA Study

Abstract

Background: Adherence to healthy dietary patterns, such as the Mediterranean diet (Med-diet), is recommended for the maintenance of cardiovascular health. The determinants for adherence to Med-diet and its importance in secondary cardiovascular disease prevention are still unclear. The aim of the study was to evaluate the influence of sex- and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence and its role in preventing major cardiovascular events (MACEs) in patients with ischemic heart disease (IHD). Methods: Med-diet adherence was evaluated among 503 consecutive adults with IHD. MACEs were collected during a long-term follow-up. Results: Male Bem Sex-Role Inventory score (i.e., male personality traits) and physical functional capacity were associated with higher adherence, while cohabitation with a smoker and physical inactivity with poorer adherence. During a median follow-up of 22 months, 48 participants experienced MACEs (17.5%, 8.1%, and 3.9% of patients with low, medium, and high adherence, respectively; p = 0.016). At multivariate Cox--regression analysis, a greater adherence remained inversely associated with MACEs (HR: 0.49; 95% CI: 0.29–0.82; p = 0.006) after adjusting for confounding factors. Conclusion: The study suggests that gender-related factors have a role in maintaining a healthy dietary pattern. Improving Med-diet adherence may lower the risk of recurring cardiovascular events.

The Mediterranean Diet, Its Microbiome Connections, and Cardiovascular Health: A Narrative Review”

“…The concept that higher adherence to the MD was associated with a lower cardiovascular disease (CVD) incidence and mortality was first proposed in the 1950s. From then, epidemiological studies in Italy [33,34] Greece [35][36][37][38] and Spain [39,40] ,and even in non-Mediterranean populations [41][42][43][44][44][45][46][47][48][49] showed benefits from long-term adhesion to the MD. As well as, randomized controlled intervention trials, like the secondary prevention trial Lyon Diet Heart Study [50], the PREDIMED (PREvención con DIeta MEDiterránea) trial in a low-risk population [51], and others [52] reported associations with lower CVD.…”