Mediterranean diet and CHD: the Greek European Prospective Investigation into Cancer and Nutrition cohort

Abstract

Adherence to the Mediterranean diet (MD) has been reported to improve CHD prognosis and to be inversely associated with CHD mortality. The aim of the present study was to investigate the association of adherence to the MD with CHD incidence and mortality in the Greek European Prospective Investigation into Cancer and Nutrition cohort, a population with traditional Mediterranean roots. In a general population sample of 23 929 adult men and women with no CVD or cancer at enrolment, a validated FFQ was interviewer-administered, sociodemographic, physical activity and other characteristics were recorded, and arterial blood pressure and anthropometric characteristics were measured. In a median period of 10 years, 636 incident CHD cases and 240 CHD deaths were recorded. Associations of adherence to the MD, operationalised through a nine-component score (0, poor; 9, excellent), with CHD incidence and mortality were evaluated through Cox regression controlling for potentially confounding variables. A two-point increase in the MD score was associated with lower CHD mortality by 25 % (95 % CI 0·57, 0·98) among women and 19 % (95 % CI 0·67, 0·99) among men. The association of adherence to the MD with CHD incidence was again inverse, but weaker (hazard ratios 0·85 (95 % CI 0·71, 1·02) among women and 0·98 (95 % CI 0·87, 1·10) among men). With respect to score components, only meat among men (positively) and fruits and nuts among women (inversely) were associated with both the incidence of and mortality from CHD. The MD, as an integral entity, is inversely associated with CHD incidence and, particularly, mortality.

Legume consumption and CVD risk: a systematic review and meta-analysis

“…A possible explanation for such difference between men and women may rely on the fact that men were generally more likely to be smokers and drink more alcohol (18,20,25) , thus somehow counteracting the potential beneficial effects of legumes. Another methodological issue may depend on lower accuracy in reporting dietary patterns among men than women.…”

“…One possible explanation for the lack of significant results in meta-analyses of studies conducted in Mediterranean countries could be the impact on cardiovascular health of all components of the diet typically consumed in these countries, or at least those included in the individual analyses. (17) Bernstein et al (2010) (23) , F Buckland et al (2009) (20) , M Kelemen et al (2005) (18) , F Kokubo et al (2007) (19) , M Buckland et al (2009) (20) , F Kokubo et al (2007) (19) , F Martinez-Gonzalez et al (2011) (24) Nagura et al (2009) (22) Dilis et al (2012) (25) , F Dilis et al (2012) (25) , M Haring et al (2014) (23) Total ( (19) , M Mizrahi et al (2009) (21) Misirili et al (2012) (27) Haring et al (2015) (29) Total ( (24) Bazzano et al (2001) (17) Kokubo et al (2007) (19) , F Kokubo et al (2007) (19) , M Nouri et al (2016) (30) Nagura et al (2009) (22) Total ( The study-specific RR and 95 % CI are represented by the black square and horizontal line, respectively; the area of the black square is proportional ...…”

“…Legume consumption and CHD risk The analysis relative to CHD risk related to consumption of legumes comprised twelve data sets derived from eight studies (17)(18)(19)(20)23,24,25,28) . Comparison of the highest v. the lowest legume consumption category showed a similar risk estimate to the previous analysis considering CVD as outcome (RR = 0·90; 95 % CI 0·84, 0·97; Fig.…”

Nutrition and healthy ageing: the key ingredients

“…Although, several indices of MD patterns as well as adherence to the DASH diet and other healthy diet scores are associated with a lower risk of stroke, CHD and CVD in numerous prospective cohort studies in different populations (69,(80)(81)(82)(83)(84) , residual confounding by other lifestyle and socioeconomic factors remains a major challenge in determining causality. While a trial of the DASH diet has demonstrated that adherence to DASH can reduce numerous cardiovascular risk factors (85) the causal effects on mortality and on other age-related end points are unknown.…”

Postnatal exposure to voluntary exercise but not the antioxidant catechin protects the vasculature after a switch to an atherogenic environment in middle-age mice

“…It starts during the intrauterine environment that influences health outcome at adult age, as low birth weight is associated with an increased risk of diseases [2]. Epidemiological studies have clearly established that a lifelong healthy lifestyle, composed of moderate but regular physical exercise (EX) and a balanced diet, prolongs lifespan and reduces the odds of developing cardiovascular diseases (CVD) [10,16,45,46,59,76]. The detrimental effects of the so-called Western diet (WD) and lifestyle on the cardiovascular system have, therefore, been established by numerous studies showing the contribution of physical inactivity (PI) and poor-quality/high-calorie intake on the development of obesity, hypertension, diabetes, and CVD [9,37].…”