December 07, 2018
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Mediterranean diet decreases risk for CVD events in women

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Women with a greater Mediterranean diet eating pattern had decreased risk for CVD events compared with those less adherent to the Mediterranean diet, according to a study published in JAMA Network Open.

Shafqat Ahmad, MD, postdoctoral research fellow in molecular and genetic epidemiology at Uppsala University in Sweden, postdoctoral research fellow at Harvard T.H. Chan School of Public Health and researcher at Brigham and Women’s Hospital, and colleagues analyzed data from 25,994 women (mean age, 55 years) from the Women’s Health Study who were free from CVD at baseline. Information was obtained from baseline blood samples, food frequency questionnaires and baseline questionnaires regarding use of postmenopausal hormone therapy, hypertension history, physical activity, smoking, family history of premature MI and alcohol consumption. Weight, height and BP were also measured at baseline.

Researchers used information from the food frequency questionnaire to calculate a Mediterranean diet score, which ranged from 0 to 9, with higher scores representing better adherence. Women were then stratified based on their scores: low intake (0-3; n = 10,140; mean age, 52 years), middle intake (4-5; n = 9,416; mean age, 53 years) and upper intake (6-9; n = 6,438; mean age, 54 years).

The primary endpoint was incident CVD, defined as confirmed first events of stroke, MI, CV death and coronary artery revascularization. Patients were followed up for up to 12 years.

During follow-up, incident CVD events occurred in 4.2% of women with low intake, 3.8% of women with medium intake and 3.8% of women with high intake.

Reductions in CVD risk were seen in women with medium (HR = 0.77; 95% CI, 0.67-0.9) and high intakes of the Mediterranean diet (HR = 0.72; 95% CI, 0.61-0.86; P for trend < .001) compared with those with low intakes.

The largest factors associated with Mediterranean diet intake and CVD risk reduction were glucose metabolism and insulin resistance (27.9%), biomarkers of inflammation (29.2%), BP (26.6%), BMI (27.3%) HDL (24%), VLDL (20.8%) and traditional lipids (26%). Factors that contributed less to this association were LDL (13%), apolipoproteins (6.5%), branched-chain amino acids (13.6%) and other small-molecule metabolites (5.8%).

“Despite this, a sizeable proportion of the potential benefit of [Mediterranean diet] intake with CVD risk reduction remains unexplained and requires future investigation into additional mechanisms,” Ahmad and colleagues wrote. – by Darlene Dobkowski

Disclosures: Ahmad reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.