Adherence to the Mediterranean Diet and Risk of Coronary Heart Disease in the Spanish EPIC Cohort Study

Buckland, Genevieve; González, Carlos A.; Agudo, Antonio; Vilardell, Mireia; Berenguer, Antoni; Amiano, Pilar; Ardanaz, Eva; Arriola, Larraitz; Barricarte, Aurelio; Basterretxea, Mikel; Chirlaque, María Dolores; Cirera, Lluís; Dorronsoro, Miren; Egüés, Nerea; Huerta, José María; Larrañaga, Nerea; Marin, Pilar; Martínez, Carmen; Molina, Esther; Navarro, Carmen; Quiŕos, J. Ramón; Rodríguez, Laudina; Sánchez, María‐José; Tormo, María-José; Moreno‐Iribas, Conchi

doi:10.1093/aje/kwp282

Cited by 267 publications

(162 citation statements)

References 46 publications

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“…Sixteen prospective studies were included in the meta-analysis for consumption of whole grains (16 reports) (Del Gobbo et al 2015;Djousse and Gaziano 2007;Hansen et al 2017;Helnaes et al 2016;Jensen et al 2004;Liu et al 2000b;Liu et al 1999;Mizrahi et al 2009;Muraki et al 2015;Neelakantan et al 2016;Nettleton et al 2008;Rautiainen et al 2012;Sonestedt et al 2015;Steffen et al 2003;Tektonidis et al 2015Tektonidis et al , 2016 (Supplemental Table 2), 9 studies for refined grains (8 reports) (Djousse and Gaziano 2007;Eshak et al 2014;Liu et al 2000b;Mizrahi et al 2009;Muraki et al 2015;Sonestedt et al 2015;Steffen et al 2003;Yu et al 2013) (Supplemental Table 3), 35 for vegetables (32 reports) (Belin et al 2011a;Bendinelli et al 2011;Bhupathiraju et al 2013;Buckland et al 2009;Dauchet et al 2004;Del Gobbo et al 2015;Dilis et al 2012;Gillman et al 1995;Hansen et al 2017;Hansen et al 2010;Hirvonen et al 2001;Johnsen et al 2003;Joshipura et al 1999;Keli et al 1996;…”

Section: Resultsmentioning

confidence: 99%

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Bechthold¹,

Boeing

Schwedhelm

et al. 2017

Critical Reviews in Food Science and Nutrition

464

492

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(2017): Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies, Critical Reviews in Food Science and Nutrition, DOI: 10.1080DOI: 10. /10408398.2017 Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this metaanalysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugarsweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains ( (1.02-1.34), RR HF : 1.12 (1.05-1.19)), and SSB consumption (RR CHD : 1.17 (1.11-1.23), RR stroke : 1.07 (1.02-1.12), RR HF : 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for nonlinear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.

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Section: Resultsmentioning

confidence: 99%

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Bechthold¹,

Boeing

Schwedhelm

et al. 2017

Critical Reviews in Food Science and Nutrition

464

492

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“…Sofi et al [50] analyzed cohort studies investigating a Mediterranean diet (which implies a higher amount of MUFA than usual) and observed a significant improvement in health status as indicated by a lower incidence in overall mortality (9%), cancer (6%), dementia (13%) and a decrease in mortality due to CVD (9%). In the Spanish branch of the EPIC study, adherence to a Mediterranean diet was associated with a significantly reduced risk for CHD, supporting its role in primary prevention at least in healthy populations [51]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Monounsaturated Fatty Acids on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis

2011

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The appropriate pattern of macronutrient distribution for dietary protocols aimed at treating or preventing obesity and its associated cardiovascular diseases is still a controversial topic of discussion. Recommendations considering a specific percentage or range for monounsaturated fatty acids (MUFA) are rare. It was the aim of this study to analyze long-term, randomized, controlled dietary intervention trials and to investigate the effects of MUFA on the biomarkers of obesity and cardiovascular risk factors. Dietary regimens with a high amount of MUFA (>12%) were compared to those with ≤12%. The biomarkers taken into account were weight, waist circumference, fat mass, total cholesterol, LDL cholesterol, HDL cholesterol, triacylglycerols, systolic and diastolic blood pressure, as well as C-reactive protein. A total of 12 studies met the inclusion criteria. Data analysis was performed using the Review Manager 5.0.25 software. Significant differences between high- and low-MUFA protocols could be observed with respect to fat mass [–1.94 kg (confidence interval –3.72, –0.17), p = 0.03], systolic blood pressure [–2.26 mm Hg (confidence interval –4.28, –0.25), p = 0.03] and diastolic blood pressure [–1.15 mm Hg (confidence interval –1.96, –0.34), p = 0.005] favoring the dietary protocols with >12% MUFA. Therefore, MUFA might represent a useful tool in the design of dietary regimens for obesity and cardiovascular disease.

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“…Those consuming a plant-based diet (fruits, vegetables, nuts, seeds and vegetable oils) have a reduced risk of CVD [7]. The diets followed traditionally in Mediterranean countries including Greece, Italy, Spain and France include these components and have been repeatedly linked to improvements in cardiovascular health indicators, and reduced mortality rates from CVD [8][9][10][11]. A metaanalysis of observational trials showed higher adherence to the MedDiet reduces risk of CVD including coronary heart disease and stroke, as well as overall mortality [1].…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled intervention trial evaluating the efficacy of an Australianised Mediterranean diet compared to the habitual Australian diet on cognitive function, psychological wellbeing and cardiovascular health in healthy older adults (MedLey study): protocol paper

et al. 2015

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Background: The Mediterranean diet (MedDiet) is associated with considerable health benefits for cardiovascular and cognitive health, particularly within the Mediterranean basin. Whether Australian populations will similarly benefit from the MedDiet is unknown. We aim to assess the effects of a MedDiet on cognitive and cardiovascular health indicators amongst the elderly (MedLey study). Here we describe in detail the protocol for the MedLey study. Methods: Medley is a randomised, parallel controlled dietary intervention trial. Data collection occurred at the Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia between 2013 and 2015. Omnivorous men and women aged ≥65 years, who were non-smokers, had no previously diagnosed cardiovascular disease, history of brain trauma, cognitive impairment, major disease or cancer were recruited from the general public (n = 166). The intervention comprised an Australianised version of the traditional MedDiet characterised by small amounts of red meat, processed deli meats and high sugar foods; moderate amounts of dairy and poultry; and a high plant food content including abundant extra virgin olive oil. Volunteers were stratified by age, gender and body mass index (kg/m 2 ) to follow either their habitual diet (control condition) or the intervention MedDiet for 24 weeks. Primary outcome measures included cognitive function, endothelial function, cerebrovascular flow, blood lipids, inflammatory markers, fasting glucose and insulin, blood pressure, and body composition. Secondary outcomes included food cravings, psychological wellbeing and DNA damage markers. These were assessed at baseline, 12 and 24 weeks. Dietary intakes were assessed at baseline, two and four months to assess adherence to the prescribed diet. For main outcome measures, groups will be compared over time using a linear mixed effects model, with Cohen's d effect sizes. Subgroup analysis based on adherence to the intervention, medications and alcohol consumption may be performed in an exploratory fashion.

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Adherence to the Mediterranean Diet and Risk of Coronary Heart Disease in the Spanish EPIC Cohort Study

Cited by 267 publications

References 46 publications

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Effects of Monounsaturated Fatty Acids on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis

A randomised controlled intervention trial evaluating the efficacy of an Australianised Mediterranean diet compared to the habitual Australian diet on cognitive function, psychological wellbeing and cardiovascular health in healthy older adults (MedLey study): protocol paper

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