Highlights
- •Mediterranean diet was associated with a lower risk of MI, HF and ischemic stroke.
- •There was no association between Mediterranean diet and hemorrhagic stroke.
- •The Mediterranean diet is likely to be beneficial in primary prevention of atherosclerosis related cardiovascular disease.
Abstract
Background and aims
The Mediterranean diet, which is palatable and easily achievable, has been associated
with lower all-cause and cardiovascular disease (CVD) incidence and mortality. Data
on heart failure (HF) and stroke types are lacking. The aim was to examine a Mediterranean
diet in relation to incidence of myocardial infarction (MI), HF and stroke types in
a Swedish prospective cohort.
Methods
In a population-based cohort of 32,921 women, diet was assessed through a self-administered
questionnaire. The modified Mediterranean diet (mMED) score was created based on high
consumption of vegetables, fruits, legumes, nuts, whole grains, fermented dairy products,
fish and monounsaturated fat, moderate intakes of alcohol and low consumption of red
meat, on a 0–8 scale. Relative risks (RR) with 95% confidence intervals (CI), adjusted
for potential confounders, were estimated by Cox proportional hazards regression models.
Results
During 10 y of follow-up (1998–2008), 1109 MIs, 1648 HFs, 1270 ischemic strokes and
262 total hemorrhagic strokes were ascertained. A high adherence to the mMED score
(6–8), compared to low, was associated with a lower risk of MI (RR: 0.74, 95% CI:
0.61–0.90, p = 0.003), HF (RR: 0.79, 95% CI: 0.68–0.93, p = 0.004) and ischemic stroke
(RR: 0.78, 95% CI: 0.65–0.93, p = 0.007), but not hemorrhagic stroke (RR: 0.88, 95%
CI: 0.61–1.29, p = 0.53).
Conclusions
Better adherence to a Mediterranean diet was associated with lower risk of MI, HF
and ischemic stroke. The Mediterranean diet is most likely to be beneficial in primary
prevention of all major types of atherosclerosis-related CVD.
Keywords
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Article Info
Publication History
Published online: September 02, 2015
Accepted:
August 28,
2015
Received in revised form:
August 21,
2015
Received:
June 11,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
