The Mediterranean diet in relation to mortality and CVD: a Danish cohort study

Abstract

The aim of the present study was to determine whether the Mediterranean Diet Score (MDS) is associated with reduced total mortality, cardiovascular incidence and mortality in a Danish population. Analyses were performed on 1849 men and women sampled during the 1982 -83 Danish MONICA (MONItoring trends and determinants of Cardiovascular disease) population study, whose diet was assessed by means of a validated 7 d food record. The adherence to a Mediterranean dietary pattern was calculated by three different scores: one based on a classification excluding ingredients from mixed dishes and recipes (score 1); another based on a classification including ingredients (score 2); the last one based on a variant of the latter including wine instead of alcohol intake (score 3). The association between these scores and, respectively, total mortality, cardiovascular incidence and mortality was tested by a Cox proportional hazards model adjusted for several potential confounders of the association. Generally, all three scores were inversely associated with the endpoints, although associations with score 1 did not reach statistical significance. Score 2 was inversely associated with total mortality (hazard ratio 0·94; 95 % CI 0·88, 0·99). This association was confirmed for total cardiovascular as well as myocardial infarction (MI) incidence and mortality, but not for stroke. Score 3 was slightly more associated with the same outcomes. All associations were also resistant to adjustment for covariates related to potential CVD pathways, such as blood lipids, blood pressure and weight change after 11 years of follow-up. In a Danish cohort, the MDS was inversely associated with total mortality and with cardiovascular and MI incidence and mortality, but not with stroke incidence or mortality.

Dietary Patterns and Mediterranean Diet Score and Hazard of Recurrent Coronary Heart Disease Events and All‐Cause Mortality in the REGARDS Study

“…In agreement with our results, a Mediterranean dietary pattern was inversely associated with all‐cause mortality in the US Multiethnic Cohort,37 the US National Institutes of Health–AARP Diet and Health Study,38 Spanish cohorts,32, 39 an Italian cohort,40 the UK‐based EPIC (European Prospective Investigation of Cancer)–Norfolk study,41 a Danish cohort,42 and a cohort of elderly European men and women 43. However, there was no association of a Mediterranean‐type diet with all‐cause mortality in the UK‐based Whitehall II study 33.…”

Treatment of dyslipidemia

“…A similar result was found by a meta-analysis of 50 studies involving 534,906 individuals, assessing effects of the diet on components of the metabolic syndrome [49]. A recent study in a Danish cohort found that adherence to the Mediterranean diet was associated with reduced all-cause mortality and cardiovascular events and mortality, but not stroke [52]. …”

Adherence to a Mediterranean-like dietary pattern in children from eight European countries. The IDEFICS study

“…[38][39][40] Accordingly, we have previously published a paper based on a version of the MDS adapted to the food frequency data used in the IDEFICS study to assess children's usual diets 29 in relation to their weight status. In the present paper, we used data collected in the same study using another methodology, 24 h recall data, which could provide more detailed food and nutrient data but which is less useful than the FFQ for considering associations with health-related outcomes such as body weight.…”