Adherence to the Mediterranean Diet and Risk of Coronary Heart Disease in the Spanish EPIC Cohort Study
Open Access
- 10 November 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Epidemiology
- Vol. 170 (12), 1518-1529
- https://doi.org/10.1093/aje/kwp282
Abstract
No known cohort study has investigated whether the Mediterranean diet can reduce incident coronary heart disease (CHD) events in a Mediterranean population. This study examined the relation between Mediterranean diet adherence and risk of incident CHD events in the 5 Spanish centers of the European Prospective Investigation into Cancer and Nutrition. Analysis included 41,078 participants aged 29–69 years, recruited in 1992–1996 and followed up until December 2004 (mean follow-up:10.4 years). Confirmed incident fatal and nonfatal CHD events were analyzed according to Mediterranean diet adherence, measured by using an 18-unit relative Mediterranean diet score. A total of 609 participants (79% male) had a fatal or nonfatal confirmed acute myocardial infarction (n = 468) or unstable angina requiring revascularization (n = 141). After stratification by center and age and adjustment for recognized CHD risk factors, high compared with low relative Mediterranean diet score was associated with a significant reduction in CHD risk (hazard ratio = 0.60, 95% confidence interval: 0.47, 0.77). A 1-unit increase in relative Mediterranean diet score was associated with a 6% reduced risk of CHD (95% confidence interval: 0.91, 0.97), with similar risk reductions by sex. Mediterranean diet adherence was associated with a significantly reduced CHD risk in this Mediterranean country, supporting its role in primary prevention of CHD in healthy populations.Keywords
This publication has 46 references indexed in Scilit:
- Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort studyBMJ, 2009
- Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in WomenCirculation, 2009
- Validity and repeatability of the EPIC physical activity questionnaire: a validation study using accelerometers as an objective measureInternational Journal of Behavioral Nutrition and Physical Activity, 2008
- Modified Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly studyEuropean Journal of Epidemiology, 2007
- Components of the mediterranean-type food pattern and serum inflammatory markers among patients at high risk for cardiovascular diseaseEuropean Journal of Clinical Nutrition, 2007
- EPIC-Heart: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countriesEuropean Journal of Epidemiology, 2007
- Mediterranean diet, endothelial function and vascular inflammatory markersPublic Health Nutrition, 2006
- Changes in food supply in Mediterranean countries from 1961 to 2001Public Health Nutrition, 2006
- Diet and cancer — the European Prospective Investigation into Cancer and NutritionNature Reviews Cancer, 2004
- Primary Prevention of Coronary Heart Disease in Women through Diet and LifestyleThe New England Journal of Medicine, 2000