Mediterranean diet trajectories and 20-year incidence of cardiovascular disease: The ATTICA cohort study (2002–2022)

Georgoulis, Michael; Damigou, Evangelia; Chrysohoou, Christina; Barkas, Fotios; Anastasiou, Georgia; Kravvariti, Evridiki; Tsioufis, Costas; Liberopoulos, Evangelos; Sfikakis, Petros P.; Pitsavos, Christos; Panagiotakos, Demosthenes B.

doi:10.1016/j.numecd.2023.09.019

Cited by 12 publications

(4 citation statements)

References 59 publications

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“…Our results support the idea that, concerning MTD adherence, the initial adherence has beneficial effects, but getting closer to the MTD later in life-course does not, after adjusting for major socio-economic, clinical, and lifestyle factors. In one of our previous reports from the ATTICA cohort study, we found that those who moved closer to the MTD were older participants, with deteriorated health statuses [ 43 ]. Thus, reverse causality could apply to them; improvements in (potentially long-established) dietary habits could have taken place due to medical advice to attenuate disease burden [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…In one of our previous reports from the ATTICA cohort study, we found that those who moved closer to the MTD were older participants, with deteriorated health statuses [ 43 ]. Thus, reverse causality could apply to them; improvements in (potentially long-established) dietary habits could have taken place due to medical advice to attenuate disease burden [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

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Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002–2022)

Damigou,

Georgoulis,

Chrysohoou

et al. 2024

Nutrients

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Evidence of the association between dietary habits and long-term body weight status is scarce. This study aimed to evaluate changes in Mediterranean-type diet (MTD) adherence in relation to body weight during 20 years of follow-up. Data from n = 1582 participants from the ATTICA cohort study (2002–2022) were used. MTD adherence was assessed via MedDietScore, and body weight status via body mass index (BMI) by 3 different measurements. We found that MTD adherence and changes in this adherence were inversely related to BMI at 20 years and the mean BMI during the 20-year follow-up. In multi-adjusted linear regression models, a 1/55 increase in baseline, 10-year, and 20-year MedDietScore was associated with a decrease of 0.05–0.13 kg/m2 in BMI at 20 years and of 0.08–0.09 kg/m2 in the mean BMI. Being consistently close to the MTD for 20 years was associated with a >90% decreased risk of maintaining overweight/obesity during the 20-year period. Strong, protective, long-lasting effects of the MTD were observed, even in those who deviated from the MTD in the follow-up (41% of the sample). Our results highlight the need to focus on the overall diet quality to minimize the risk of maintaining an excessive body weight during the life-course.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002–2022)

Damigou,

Georgoulis,

Chrysohoou

et al. 2024

Nutrients

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“…Likewise, yet another meta-analysis of 16 prospective cohort studies including only women detected a significant association between a higher adherence to the MDP and a lower incidence of total cardiovascular and coronary events, as well as total mortality, and a weaker association between MDP adhesion and the risk of stroke [30]. A very recent observational study, including approximately 2000 middle-aged male and female Greek participants, showed that those who sustained a high degree of adhesion to the MDP over the years had the lowest 20-year CVD risk [31]. In agreement with these results, other prospective cohort studies provided evidence that high adherence to the MDP improves survival in people with a history of CVD [32].…”

Section: Introductionmentioning

confidence: 99%

Dietary Salt Restriction and Adherence to the Mediterranean Diet: A Single Way to Reduce Cardiovascular Risk?

D’Elia,

Strazzullo

2024

JCM

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The dietary restriction of salt intake and the adhesion to Mediterranean dietary patterns are among the most recommended lifestyle modifications for the prevention of cardiovascular diseases. A large amount of evidence supports these recommendations; indeed, several studies show that a higher adherence to Mediterranean dietary patterns is associated with a reduced risk of cardiovascular disease. Likewise, findings from observational and clinical studies suggest a causal role of excess salt intake in blood pressure increase, cardiovascular organ damage, and the incidence of cardiovascular diseases. In this context, it is also conceivable that the beneficial effects of these two dietary patterns overlap because Mediterranean dietary patterns are typically characterized by a large consumption of plant-based foods with low sodium content. However, there is little data on this issue, and heterogeneous results are available on the relationship between adherence to salt restriction and to Mediterranean dietary patterns. Thus, this short review focuses on the epidemiological and clinical evidence of the relationship between the adherence to Mediterranean dietary patterns and dietary salt restriction in the context of cardiovascular risk.

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“…The Mediterranean diet is a nutritional pattern inspired by the traditional eating habits of countries bordering the Mediterranean Sea, emphasizing fruits, vegetables, whole grains, fish, and olive oil while minimizing red meat and processed foods. It is associated with various health benefits, including reduced risk of heart disease and improved overall well-being [ 9 ]. The Mediterranean diet and lifestyle share a common philosophical basis with mindfulness, as they both encompass values such as eudaemonia, sustainability, and sociability [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Mindfulness, Gut–Brain Axis, and Health-Related Quality of Life: The Paradigm of IBD Patients

Christodoulou,

Mpali,

Dimitriadou

et al. 2024

Healthcare

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Health-related quality of life (HRQoL) is a comprehensive measure that evaluates an individual’s well-being across physical, mental, and social dimensions. Enhancing HRQoL, particularly in individuals with chronic conditions like inflammatory bowel diseases (IBD), necessitates a holistic approach. Mindfulness, a scientifically supported strategy for managing anxiety, has shown promise in improving both physical and mental health. Its benefits may be partly explained through its effects on the gut–brain axis (GBA), a bidirectional communication link between the gastrointestinal system and the central nervous system. By exploring the interplay between mindfulness and the GBA, this study aims to uncover how these elements collectively influence HRQoL in both healthy individuals and those with IBD, offering insights into potential therapeutic pathways. A cross-sectional investigation involved 338 adults, including 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterranean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, anthropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate correlation with the MAAS-15 scale (r = 0.389, p < 0.05) and a low correlation with 14-MEDAS (r = 0.131, p < 0.05). IBD patients exhibited significantly lower mean EQ-5D-5L scores than healthy individuals (0.75 vs. 0.85, p < 0.05). MAAS-15 demonstrated a robust correlation (r = 0.414, p < 0.001) with EQ-5D-5L in IBD patients. Elevated mindfulness levels emerged as predictive factors for higher HRQoL in IBD patients (OR: 1.101, 95% CI: 1.008, 1.202, p < 0.05, compared to low mindfulness). In summary, factors influencing the GBA, including mindfulness and the Mediterranean diet, exhibit positive associations with HRQoL. Increased mindfulness levels predict better HRQoL in IBD patients, emphasizing the potential for clinical trials to validate these cross-sectional study findings.

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Mediterranean diet trajectories and 20-year incidence of cardiovascular disease: The ATTICA cohort study (2002–2022)

Cited by 12 publications

References 59 publications

Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002–2022)

Mediterranean-Type Diet Adherence and Body Mass Index through 20 Years of Follow-Up: Results from the ATTICA Cohort Study (2002–2022)

Dietary Salt Restriction and Adherence to the Mediterranean Diet: A Single Way to Reduce Cardiovascular Risk?

Mindfulness, Gut–Brain Axis, and Health-Related Quality of Life: The Paradigm of IBD Patients

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