Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

Abstract

Objective: To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. Design: We conducted a comprehensive literature search through all electronic databases up to June 2013. Setting: Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. Subjects: The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. Results: A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk 5 0?92; 95 % CI 0?91, 0?93), a 10 % reduced risk of CVD (relative risk 5 0?90; 95 % CI 0?87, 0?92) and a 4 % reduction of neoplastic disease (relative risk 5 0?96; 95 % CI 0?95, 0?97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. Conclusions: The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.

Empirically-derived food patterns and the risk of total mortality and cardiovascular events in the PREDIMED study

“…In fact, participants in 274 the upper baseline quartiles of MDP followed a diet rich in plant based foods and poor in 275 animal foods, and had the lowest risk of mortality. Third, the available evidence about olive 276 oil, suggests that it plays a role in the prevention of coronary heart disease, and cancer, and 277 may influence survival [1,2,21,22,25] . Besides, olive oil and particularly EVOO improves 278 the lipid profile and has potent antioxidant and anti-inflammatory properties [27,28] .…”

Association between Family Meals and the Adherence to the Mediterranean Diet in Spanish Adolescents

“…Numerous studies have shown the health-promotion and diseaseprevention characteristics of the Mediterranean diet (MD) [1][2][3]. The MD has been postulated as a protective factor against different diseases, including hypertension and coronary heart disease [4][5][6][7].…”

Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

“…Dietary patterns can be defined in a number of ways including general principals and descriptions of the diet, a priori scoring systems, a posteriori dietary pattern formation, dietary pyramids or by food and nutrient analysis [53, 65-67, 70, 71]. Over the past several years, adherence to the MedDiet has been estimated mainly through the creation of diet quality indices such as a priori scoring systems as they simplify analysis of adherence to the diet in relation to different primary health outcomes [50,67,72].…”