Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes

D’Alessandro, Annunziata; Pergola, Giovanni De

doi:10.3390/nu7095367

Cited by 57 publications

(26 citation statements)

References 86 publications

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“…It seems obvious that cutoff-points defined by medians vary between different populations, leading to an almost indefinite number of MedD subtypes. As a result, it will become impossible to differentiate between preferable and dissenting intakes [ 155 ]. Moreover, determination of the components of a MedD is inconsistent between different epidemiological studies.…”

Section: Discussionmentioning

confidence: 99%

Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis

et al. 2017

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The aim of the present systematic review and meta-analysis was to gain further insight into the effects of adherence to Mediterranean Diet (MedD) on risk of overall cancer mortality, risk of different types of cancer, and cancer mortality and recurrence risk in cancer survivors. Literature search was performed using the electronic databases PubMed, and Scopus until 25 August 2017. We included randomized trials (RCTs), cohort (for specific tumors only incidence cases were used) studies, and case-control studies. Study-specific risk ratios, hazard ratios, and odds ratios (RR/HR/OR) were pooled using a random effects model. Observational studies (cohort and case-control studies), and intervention trials were meta-analyzed separately. The updated review process showed 27 studies that were not included in the previous meta-analysis (total number of studies evaluated: 83 studies). An overall population of 2,130,753 subjects was included in the present update. The highest adherence score to a MedD was inversely associated with a lower risk of cancer mortality (RRcohort: 0.86, 95% CI 0.81 to 0.91, I2 = 82%; n = 14 studies), colorectal cancer (RRobservational: 0.82, 95% CI 0.75 to 0.88, I2 = 73%; n = 11 studies), breast cancer (RRRCT: 0.43, 95% CI 0.21 to 0.88, n = 1 study) (RRobservational: 0.92, 95% CI 0.87 to 0.96, I2 = 22%, n = 16 studies), gastric cancer (RRobservational: 0.72, 95% CI 0.60 to 0.86, I2 = 55%; n = 4 studies), liver cancer (RRobservational: 0.58, 95% CI 0.46 to 0.73, I2 = 0%; n = 2 studies), head and neck cancer (RRobservational: 0.49, 95% CI 0.37 to 0.66, I2 = 87%; n = 7 studies), and prostate cancer (RRobservational: 0.96, 95% CI 0.92 to 1.00, I2 = 0%; n = 6 studies). Among cancer survivors, the association between the adherence to the highest MedD category and risk of cancer mortality, and cancer recurrence was not statistically significant. Pooled analyses of individual components of the MedD revealed that the protective effects appear to be most attributable to fruits, vegetables, and whole grains. The updated meta-analysis confirms an important inverse association between adherence to a MedD and cancer mortality and risk of several cancer types, especially colorectal cancer. These observed beneficial effects are mainly driven by higher intakes of fruits, vegetables, and whole grains. Moreover, we were able to report for the first time a small decrease in breast cancer risk (6%) by pooling seven cohort studies.

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Section: Discussionmentioning

confidence: 99%

Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis

et al. 2017

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“…In fact, the MD pattern has been proposed as one of the best models for healthy eating because of its favorable inverse relationship with cardiovascular risk factors and outcomes [30]. Accordingly, the diet is frequently used to treat multifactorial diseases and traditional cardiovascular risk factors [31]. …”

Section: Discussionmentioning

confidence: 99%

Adherence to the “Mediterranean Diet” in Spain and Its Relationship with Cardiovascular Risk (DIMERICA Study)

et al. 2016

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Background: Nutritional studies focus on traditional cultural models and lifestyles in different countries. The aim of this study was to examine the adherence to the Mediterranean diet, life habits, and risk factors associated with cardiovascular diseases among people living in different geographical regions in Spain. Methods: A descriptive cross-sectional study was conducted in each region. The sampling scheme consisted of a random three-stage stratified sampling program according to geographic region, age, and gender. A total of 1732 subjects were asked to complete a questionnaire designed to assess their nutrient intake, dietary habits, and exercise. A diet score that assesses the adherence of participants to the Mediterranean diet (range 0–10) was also applied. Results: Southeastern Spain had the lowest score for adherence to the Mediterranean diet because of the low consumption of fish and plant products. A lower adherence score to the Mediterranean diet was strongly associated with the prevalence of hypertension (p = 0.018). Conclusions: A low level of adherence to the Mediterranean diet is accompanied by a high prevalence of hypertension and, therefore, a raised cardiovascular risk in the country. The adherence score could help identify individuals at greater cardiovascular risk.

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“…The Mediterranean diet is the golden standard for healthy nutrition. It is particularly rich in polyphenols and is associated with reduced risk of cardiovascular events . Thus, the Mediterranean diet is characterized by high intake of fruits, vegetables, cereals, fish and moderate wine consumption, with scarce intake of dairy products and red meat.…”

Section: Introductionmentioning

confidence: 99%

Antioxidant and antiplatelet activity by polyphenol‐rich nutrients: focus on extra virgin olive oil and cocoa

Loffredo

Perri

Nocella

2016

Brit J Clinical Pharma

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Cardiovascular disease is the most common cause of death in the Western world. In the last decades nutraceutical approaches have been proposed to counteract atherosclerotic complications. In particular, polyphenols, a class of bio‐active molecules prevalently contained in foods such as cocoa, fruits, vegetables, wine and tea, have been widely studied for their beneficial properties. Several epidemiological and interventional studies have shown that polyphenol‐rich nutrients, as in extra virgin olive oil (EVOO) and cocoa, are associated with a risk reduction of cardiovascular events and/or modulation of cardiovascular risk factors. Definition of the mechanisms accounting for this putative cardio‐protective effect is still elusive. This review focuses on the mechanisms that may be implicated in the beneficial effects of EVOO and cocoa, including down‐regulation of oxidative stress and platelet aggregation, improvement of endothelial function and cardiovascular risk factor such as blood pressure, serum cholesterol and insulin sensitivity.

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Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes

Cited by 57 publications

References 86 publications

Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis

Adherence to Mediterranean Diet and Risk of Cancer: An Updated Systematic Review and Meta-Analysis

Adherence to the “Mediterranean Diet” in Spain and Its Relationship with Cardiovascular Risk (DIMERICA Study)

Antioxidant and antiplatelet activity by polyphenol‐rich nutrients: focus on extra virgin olive oil and cocoa

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