Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies

Purpose To provide evidence of the relationship of Mediterranean diet (MD) on incidence/mortality for cardiovascular disease (CVD), coronary/ischemic heart disease (CHD)/acute myocardial infarction (AMI) and stroke (ischemic/hemorrhagic) by sex, geographic region, study design and type of MD score (...

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Bibliographic Details
Published in:European journal of nutrition 2019-02, Vol.58 (1), p.173-191
Main Authors: Rosato, Valentina, Temple, Norman J., La Vecchia, Carlo, Castellan, Giorgio, Tavani, Alessandra, Guercio, Valentina
Format: Article
Language:English
Subjects:
Cardiovascular disease
Cardiovascular diseases
Cerebral infarction
Chemistry
Chemistry and Materials Science
Coronary artery disease
Evidence-based medicine
Health risk assessment
Heart diseases
Hemorrhage
Ischemia
Meta-analysis
Mortality
Myocardial infarction
Nutrition
Observational studies
Original Contribution
Risk assessment
Stroke
Systematic review
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Summary:Purpose To provide evidence of the relationship of Mediterranean diet (MD) on incidence/mortality for cardiovascular disease (CVD), coronary/ischemic heart disease (CHD)/acute myocardial infarction (AMI) and stroke (ischemic/hemorrhagic) by sex, geographic region, study design and type of MD score (MDS). Methods We performed a systematic review and meta-analysis of observational studies. Pooled relative risks (RRs) were calculated using random-effects models. Results We identified 29 articles. The RR for the highest versus the lowest category of the MDS was 0.81 (95% CI 0.74–0.88) for the 11 studies that considered unspecified CVD, consistent across all strata. The corresponding pooled RR for CHD/AMI risk was 0.70 (95% CI 0.62–0.80), based on 11 studies. The inverse relationship was consistent across strata of study design, end point (incidence and mortality), sex, geographic area, and the MDS used. The overall RR for the six studies that considered unspecified stroke was 0.73 (95% CI 0.59–0.91) for the highest versus the lowest category of the MDS. The corresponding values were 0.82 (95% CI 0.73–0.92) for ischemic (five studies) and 1.01 (95% CI 0.74–1.37) for hemorrhagic stroke (four studies). Conclusions Our findings indicate and further quantify that MD exerts a protective effect on the risk of CVD. This inverse association includes CHD and ischemic stroke, but apparently not hemorrhagic stroke.
ISSN:1436-6207
1436-6215
DOI:10.1007/s00394-017-1582-0