Comparison of the Mediterranean diet and the Dietary Approach Stop Hypertension in reducing the risk of 10-year fatal and non-fatal CVD events in healthy adults: the ATTICA Study (2002–2012)

Abstract

Objective: To compare the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets in deterring 10-year CVD. Design: Prospective cohort (n 2020) with a 10-year follow-up period for the occurrence of combined (fatal or non-fatal) CVD incidence (International Classification of Diseases (ICD)-10). Baseline adherence to the Mediterranean and DASH diets was assessed via a semi-quantitative FFQ according to the MedDietScore and DASH scores, respectively. Setting: Attica, Greece. Participants: Two thousand twenty individuals (mean age at baseline 45·2 (sd 14·0) years). Results: One-third of individuals in the lowest quartile of Mediterranean diet consumption, as compared with 3·1 % of those in the highest quartile, developed 10-year CVD (P < 0·0001). In contrast, individuals in the lowest and highest DASH diet quartiles exhibited similar 10-year CVD rates (n (%) of 10-year CVD in DASH diet quartiles 1 v. 4: 79 (14·7 %) v. 75 (15·3 %); P = 0·842). Following adjustment for demographic, lifestyle and clinical confounding factors, those in the highest Mediterranean diet quartile had a 4-fold reduced 10-year CVD risk (adjusted hazard ratio (HR) 4·52, 95 % CI 1·76, 11·63). However, individuals with highest DASH diet quartile scores did not differ from their lowest quartile counterparts in developing such events (adjusted HR 1·05, 95 % CI 0·69, 1·60). Conclusions High adherence to the Mediterranean diet, and not to the DASH diet, was associated with a lower risk of 10-year fatal and non-fatal CVD. Therefore, public health interventions aimed at enhancing adherence to the Mediterranean diet, rather than the DASH diet, may most effectively deter long-term CVD outcomes particularly in Mediterranean populations.

Interaction between rheumatoid arthritis and mediterranean diet on the risk of cardiovascular disease for the middle aged and elderly from National Health and Nutrition Examination Survey (NHANES)

“…Recently, MD has been suggested to be beneficial in preventing and improving CVD [ 26 ]. In the study of Critselis E, et al, they found that high adherence to the MD was associated with a lower 10-year risk of fatal and non-fatal CVD [ 27 ]. Consistent with established studies [ 25 , 27 ], our study also indicated the risk of CVD for individuals with independent RA was 2.65 times than non-RA individuals, and the risk of CVD decreased as adherence to the MD increased.…”

“…In the study of Critselis E, et al, they found that high adherence to the MD was associated with a lower 10-year risk of fatal and non-fatal CVD [ 27 ]. Consistent with established studies [ 25 , 27 ], our study also indicated the risk of CVD for individuals with independent RA was 2.65 times than non-RA individuals, and the risk of CVD decreased as adherence to the MD increased. As pointed out by Johansson et al, [ 28 ] there was an inverse association between MD and RA risk among only men or in seropositive RA.…”

Contribution of edible flowers to the Mediterranean diet: Phytonutrients, bioactivity evaluation and applications

“…The protective role of dietary patterns rich in bioactive molecules, antioxidants, and food‐derived platelet‐activating factor (PAF) inhibitors, including those present in the Mediterranean diet are made effective by inhibiting PAF activities and/or modulating its metabolism towards homeostatic PAF levels, since the key to reduce CVD incidence is to effectively prevent the PAF/PAF‐R pathways and PAF synthesis towards homeostatic re‐equilibration of PAF levels and other inflammatory mediators via diet and healthy lifestyle (Tsoupras et al., 2018). A 10‐year epidemiological study has indicated that increasing adherence to Mediterranean diets reliably correlates with decreased CVD rates, particularly fatal and nonfatal myocardial infarction (Critselis et al., 2021). The other epidemiological report shows that the Mediterranean diet minimizes the occurrence of cardiovascular diseases by 30%, and inhibit the development of acute diabetes and improves glycemic regulation compared to control diet for diabetic patients (Kouvari et al., 2021).…”

GLSP and GLSP-derived triterpenes attenuate atherosclerosis and aortic calcification by stimulating ABCA1/G1-mediated macrophage cholesterol efflux and inactivating RUNX2-mediated VSMC osteogenesis

“…Cardiovascular diseases have high morbidity and mortality and have become the major cause of death worldwide [1]. Atherosclerosis is the major pathogenesis of cardiovascular disease and is characterized by lipid-loaded lesions in the vascular wall.…”