Adherence to a Mediterranean lifestyle improves metabolic status in coronary heart disease patients: A prospective analysis from the CORDIOPREV study

Abstract

Background and objectives A Mediterranean lifestyle may prevent and mitigate cardiometabolic disorders. We explored whether adherence to a Mediterranean lifestyle was prospectively associated with the risk of metabolic syndrome (MetS) among coronary heart disease (CHD) patients. Methods The Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention (CORDIOPREV) study was an interventional diet study to compare a Mediterranean diet with a low‐fat diet, in 1002 CHD patients. The Mediterranean lifestyle (MEDLIFE) index was used to assess adherence to a MEDLIFE at baseline, and after 5 years, in 851 participants from the CORDIOPREV study. Subjects were classified as having high (>13 points), moderate (12–13 points), and low (<12 points) adherence to the MEDLIFE. Multivariable logistic regression models were used to determine the association between MEDLIFE adherence and the risk of MetS development or reversal. Results During the 5‐year follow‐up, CORDIOPREV participants with high adherence to MEDLIFE had a lower risk of MetS development (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19–0.75, p < 0.01) and a higher likelihood of reversing preexisting MetS (OR 2.08 CI 95% 1.11–3.91, p = 0.02) compared with participants in the low MEDLIFE adherence group. Each additional one‐point increment in the MEDLIFE index was associated with a 24% lower risk of MetS development (OR 0.76, 95% CI 0.64–0.90, p < 0.01) and a 21% higher likelihood of reversing preexisting MetS (OR 1.21 CI 95% 1.04–1.41, p = 0.01). Conclusions Our results showed that greater adherence to a MEDLIFE reduced the risk of subsequent MetS development and increased the likelihood of reversing preexisting MetS among patients with CHD at baseline.

Relationship of Mediterranean Diet with Metabolic Syndrome and Its Components in Caucasian Subjects: A Cross-Sectional trial

“…Some longitudinal studies have examined the importance of Mediterranean lifestyles, as measured with the adherence to the Mediterranean lifestyle (MEDLIFE) questionnaire. A 5-year follow-up of the subjects included in the CORDIOPREV study showed that those with greater adherence to the Mediterranean lifestyle had a lower incidence of MetS (odds ratio 0.37; 95% CI: 0.19-0.75) and a higher probability of reversing MetS (odds ratio 2.08; 95% CI 1.11-3.91) compared to participants in the low adherence group of MEDLIFE [34]. Similarly, with the cohort of the ENRICA study at 8.7 years of follow-up, assessing the Mediterranean lifestyle with the MEDLIFE index showed that greater adherence to it was associated with a lower incidence of MetS [35].…”

Combined Influence of Eight Lifestyle Factors on Metabolic Syndrome Incidence: A Prospective Cohort Study from the MECH-HK Study

“…Likewise, another 6-year prospective cohort study showed that among 3480 Iranian adults, a four-item lifestyle index (smoking, physical activity, obesity, and diet) had an inverse association with MetS incidence [ 29 ]. Additionally, a 5-year prospective cohort study with 363 Spanish coronary heart disease patients demonstrated that a Mediterranean lifestyle comprising 27 components was inversely associated with MetS incidence (OR = 0.37; 95% CI = 0.19–0.75; the highest vs. lowest groups) [ 47 ]. Nonetheless, these results might not be applied to Chinese populations directly due to the diverse lifestyles and disease characteristics among different ethnic groups [ 21 , 22 , 23 ].…”

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

“…The ongoing PREDIMED-Plus trial ( http://www.predimedplus.com ) is evaluating MedDiet with caloric restriction and weight loss and has reported some preliminary findings on body weight, waist circumference, and metabolic markers after 12 months of follow-up [ 96 ]. Similarly, the CORDIOPREV trial more recently showed that adherence to a MedDiet intervention attenuated the risk of MetS development and increased the chance of reversing preexisting MetS [ 97 ].…”