Mediterranean diet and the incidence of cardiovascular disease: A Spanish cohort

Martínez-González, M.A.; García-López, M.; Bes-Rastrollo, M.; Toledo, E.; Martínez-Lapiscina, E.H.; Delgado-Rodriguez, M.; Vazquez, Z.; Benito, S.; Beunza, J.J.

doi:10.1016/j.numecd.2009.10.005

« Previous Next »Nutrition, Metabolism & Cardiovascular Diseases
Volume 21, Issue 4 , Pages 237-244, April 2011

Mediterranean diet and the incidence of cardiovascular disease: A Spanish cohort

M.A. Martínez-González
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
- Corresponding author. Tel.: +34 948425600x6463; fax: +34 948425649.
M. García-López
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
- Department of Cardiology, Medical School–Clinica Universitaria, University of Navarra, Spain
M. Bes-Rastrollo
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
E. Toledo
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
- Department of Preventive Medicine and Quality Management, Hospital Virgen del Camino, Pamplona, Navarra, Spain
E.H. Martínez-Lapiscina
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
- Department of Neurology, Hospital de Navarra, Pamplona, Navarra, Spain
M. Delgado-Rodriguez
- Division of Preventive Medicine and Public Health, University of Jaen, Jaen, Spain
Z. Vazquez
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
S. Benito
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain
J.J. Beunza
- Department of Preventive Medicine and Public Health, Medical School–Clinica Universitaria, University of Navarra, c/ Irunlarrea, 1 Ed. Investigacion, 31080 Pamplona, Navarra, Spain

Received 31 March 2009; received in revised form 13 July 2009; accepted 20 October 2009. published online 22 January 2010.

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.

Keywords: Mediterranean diet, Nutrition, Myocardial infarction, Stroke