Mediterranean diet and the incidence of cardiovascular disease: A Spanish cohort
Received 31 March 2009; received in revised form 13 July 2009; accepted 20 October 2009. published online 22 January 2010. Corrected Proof
Abstract
Background and aim
The Mediterranean diet is considered a model for healthy eating. However, prospective evidence in Mediterranean countries evaluating the relationship between this dietary pattern and non-fatal cardiovascular events is scarce. The aim of the present study was to evaluate the association between the adherence to the Mediterranean diet and the incidence of fatal and non-fatal cardiovascular events among initially healthy middle-aged adults from the Mediterranean area.
Methods and results
We followed-up 13,609 participants (60 percent women, mean age: 38 years) initially free of cardiovascular disease (CVD) during 4.9 years. Participants were part of a prospective cohort study of university graduates from all regions of Spain. Baseline diet was assessed using a validated 136-item food-frequency questionnaire. A 9-point score was used to appraise adherence to the Mediterranean diet. Incident clinical events were confirmed by a review of medical records. We observed 100 incident cases of CVD. In multivariate analyses, participants with the highest adherence to the Mediterranean diet (score>6) exhibited a lower cardiovascular risk (hazard ratio=0.41, 95% confidence interval [CI]: 0.18–0.95) compared to those with the lowest score (<3). For each 2-point increment in the score, the adjusted hazard ratios were 0.80 (95% CI: 0.62–1.02) for total CVD and 0.74 (0.55–0.99) for coronary heart disease.
Conclusions
There is an inverse association between adherence to the Mediterranean diet and the incidence of fatal and non-fatal CVD in initially healthy middle-aged adults.
aDepartment of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
bDepartment of Cardiology, Medical School–Clinica Universitaria, University of Navarra, Spain
cDepartment of Preventive Medicine and Quality Management, Hospital Virgen del Camino, Pamplona, Navarra, Spain
dDepartment of Neurology, Hospital de Navarra, Pamplona, Navarra, Spain
eDivision of Preventive Medicine and Public Health, University of Jaen, Jaen, Spain
ABSTRACT
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