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
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Article info
Publication history
Published online: January 22, 2010
Accepted:
October 20,
2009
Received in revised form:
July 13,
2009
Received:
March 31,
2009
Identification
Copyright
© 2009 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
