Coronary heart disease in seven countries
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The Seven Countries Study found lower rates of CVD and cancer with the traditional Mediterranean diet, despite 37% of total daily energy coming from fat, versus only 11% in the traditional Japanese diet.
“In contrast to the high-nitrate diet of Japan, the Seven Countries Study[378] found lower rates of CVD and cancer with the traditional Mediterranean diet, despite 37% of total daily energy coming from fat, versus only 11% in the traditional Japanese diet[378,379].”
From Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health (2017) · cites this paper as [378]
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Cardiovascular risk factor changes in Finland, 1972–1997
Vartiainen, E. A., Jousilahti, P., Alfthan, G., Sundvall, J., Pietinen, P., & Puska, P. (2000) · International Journal of Epidemiology · doi:10.1093/ije/29.1.49 · Cited by 401 · see citing works
Nutritional approaches to combat oxidative stress in Alzheimer’s disease
Butterfield, D. A., Castegna, A., Pocernich, C. B., Drake, J., Scapagnini, G., & Calabrese, V. (2002) · The Journal of Nutritional Biochemistry · doi:10.1016/s0955-2863(02)00205-x · Cited by 403 · see citing works
“Red wine In the 1970s, studies [146] showing a correlation between a Mediterranean diet and low incidence of coronary and ischemic heart disease, raised public interest as to the effects of beverages such as red wine protecting against health problems and aging.”
BackgroundPhytosterols—health benefits and potential concerns: a review
Kritchevsky, D., & Chen, S. C. (2005) · Nutrition Research · doi:10.1016/j.nutres.2005.02.003 · Cited by 323 · see citing works
“de Vries et al [98] analyzed the fat and sterol content of food composites (made up to approximate consumption in the 1960s) eaten by men in the Seven Countries Study [99].”
BackgroundCross-National Comparisons of Seafood Consumption and Rates of Bipolar Disorders
Noaghiul, S., & Hibbeln, J. R. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.12.2222 · Cited by 317 · see citing works
“Prior studies that have compared ecological and cross-national differences in dietary fat (4) and seafood intake (5) with prevalence rates of cardiovascular disease have stimulated research that led to the dietary recommendations of the American Heart Association for the prevention of cardiovascular diseases (6).”
BackgroundCrawford, M. A., Bloom, M., Broadhurst, C., Schmidt, W. F., Cunnane, S. C., Galli, C., Gehbremeskel, K., Linseisen, F., Lloyd-Smith, J. O., & Parkington, J. (2007) · Lipids · doi:10.1007/bf02562227 · Cited by 264 · see citing works
“If we now examine the contemporary evidence on cardiovascular disease, we find that land-based animal fats have been causally linked to heart disease since the Seven Countries Study of the 1950s and even earlier ( 27 ).”
BackgroundSelf rated health and mortality: a long term prospective study in eastern Finland
Heistaro, S., Jousilahti, P., Lahelma, E., Vartiainen, E., & Puska, P. (2001) · Journal of Epidemiology & Community Health · doi:10.1136/jech.55.4.227 · Cited by 282 · see citing works
Fatty acids in cardiovascular health and disease: A comprehensive update
Baum, S. J., Kris‐Etherton, P. M., Willett, W. C., Lichtenstein, A. H., Rudel, L. L., Maki, K. C., Whelan, J., Ramsden, C. E., & Block, R. (2012) · Journal of clinical lipidology · doi:10.1016/j.jacl.2012.04.077 · Cited by 279 · see citing works
Accurso, A., Bernstein, R. K., Dahlqvist, A., Draznin, B., Feinman, R. D., Fine, E. J., Gleed, A., Jacobs, D. B., Larson, G., Lustig, R. H., et al. (2008) · Nutrition & Metabolism · doi:10.1186/1743-7075-5-9 · Cited by 263 · see citing works
Metabolic and Vascular Effect of the Mediterranean Diet
Tuttolomondo, A., Simonetta, I., Daidone, M., Mogavero, A., Ortello, A., & Pinto, A. V. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20194716 · Cited by 269 · see citing works
“In this way, several studies indicated how dietary patterns that were obtained from nutritional cluster analysis were able to predict disease risk or mortality [1,2].”
Chernev, A., & Gal, D. (2010) · Journal of Marketing Research · doi:10.1509/jmkr.47.4.738 · Cited by 262 · see citing works
Volek, J. S., & Feinman, R. D. (2005) · Nutrition & Metabolism · doi:10.1186/1743-7075-2-31 · Cited by 223 · see citing works
Nutraceutical therapies for atherosclerosis
Moss, J. W. E., & Ramji, D. P. (2016) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.103 · Cited by 186 · see citing works
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“In contrast to the high-nitrate diet of Japan, the Seven Countries Study [378] found”
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Linoleic Acid: A Nutritional Quandary
Jandacek, R. J. (2017) · Healthcare · doi:10.3390/healthcare5020025 · Cited by 185 · see citing works
“He analyzed diets and health in seven countries and found that atherosclerosis and mortality were positively correlated with a high intake of saturated fatty acids [11].”
BackgroundThe Health Benefiting Mechanisms of Virgin Olive Oil Phenolic Compounds
Parkinson, L., & Cicerale, S. (2016) · Molecules · doi:10.3390/molecules21121734 · Cited by 179 · see citing works
“The first suggestion of healthful effects arose from the Seven Countries Study conducted in the 1970’s [1].”
BackgroundSerum Lipid Effects of a High–Monounsaturated Fat Diet Based on Macadamia Nuts
Curb, J. D., Wergowske, G. L., Dobbs, J. C., Abbott, R. D., & Huang, B. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.8.1154 · Cited by 172 · see citing works
Dietary strategies implicated in the prevention and treatment of metabolic syndrome
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“The concept of the Mediterranean Diet (MedDiet) was for the first time defined by the scientific Ancel Keys who observed that those countries around the Mediterranean Sea, which had a characteristic diet, had less risk of suffering coronary heart diseases [102,103].”
BackgroundJovanović, G. K., Zubalj, N. D., Majanović, S. K., Rahelić, D., Rahelić, V., Lončar, J. V., & Žeželj, S. P. (2021) · Nutrients · doi:10.3390/nu13113788 · Cited by 170 · see citing works
“Given that Croatia as a Mediterranean country encourages the Mediterranean diet as a reference dietary pattern [34], and part of Croatia where this survey was conducted resides by the Mediterranean Sea where the traditional Mediterranean diet is the inherited diet, the diet quality of school children was assessed with…”
MethodPapadaki, A., Johnson, L., Toumpakari, Z., England, C. Y., Rai, M., Toms, S., Penfold, C. M., Zazpe, I., Martínez‐González, M. Á., & Feder, G. S. (2018) · Nutrients · doi:10.3390/nu10020138 · Cited by 168 · see citing works
“The Mediterranean diet (MedDiet), rich in olive oil, nuts, fruits and vegetables, whole grains and pulses, low-fat dairy, fish, moderate alcohol amounts and limited quantities of red meat and sweets, has been the factor most frequently cited to explain the low CVD incidence and mortality [5] as well as high life expec…”
BackgroundPolyunsaturated Fatty Acids and Cardiovascular Health
Kris‐Etherton, P. M., Hecker, K. D., & Binkoski, A. E. (2004) · Nutrition Reviews · doi:10.1111/j.1753-4887.2004.tb00013.x · Cited by 159 · see citing works
Nutrition and Cardiovascular Disease: Finding the Perfect Recipe for Cardiovascular Health
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“There is observational evidence reporting a positive association between SFA intake and atherosclerosis dating back to as early as the mid-1950s when Ancel Keys and colleagues first reported the results from their examination of diet and health in 7 countries that showed a positive correlation between high SFA intake…”
BackgroundLin, L.-Y., Chuang, C., Chen, H., & Yang, K. (2019) · Foods · doi:10.3390/foods8090398 · Cited by 126 · see citing works
“In recent decades, consumer-increased intake of high simple carbohydrates and high-fat diets has been found to have obvious effects on the serum triglyceride concentrations of people worldwide [13].”
BackgroundNutrition and Cardiovascular Disease
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Dietary links to Alzheimer’s disease
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The 'forgotten' bile acid sequestrants: is now a good time to remember?
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“Population studies from 16 different locations in seven countries reported that the highest rate of CHD deaths occurred in locations with the highest cholesterol levels.(38) Epidemiologic reports such as the Framingham Study, which was initiated in 1948, and which included over 10,000 men and women 30 to 65 years of a…”
BackgroundRondanelli, M., Giacosa, A., Opizzi, A., Faliva, M. A., Sala, P., Perna, S., Riva, A., Morazzoni, P., & Bombardelli, E. (2012) · International Journal of Food Sciences and Nutrition · doi:10.3109/09637486.2012.700920 · Cited by 79 · see citing works
“Although there are many causes for the high prevalence of CVD, it appears that nutritional factors, notably high saturated fat consumption, play an important role in promoting atherosclerosis (Keys 1997).”
BackgroundWine, Polyphenols, and Mediterranean Diets. What Else Is There to Say?
Santos‐Buelga, C., González‐Manzano, S., & Gonzaléz‐Paramás, A. M. (2021) · Molecules · doi:10.3390/molecules26185537 · Cited by 76 · see citing works
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Pelkonen, M. (2000) · Thorax · doi:10.1136/thorax.55.9.746 · Cited by 71 · see citing works
Mediterranean Diet and Parkinson’s Disease
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“The first indication came from a study performed long ago, based on about 10,000 middle-aged men from 14 cohorts in 7 countries, in which it was observed that the MeDiet pattern was associated with a low incidence of coronary heart disease and results beneficial in a number of other chronic diseases [45].”
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“In the Seven Countries Study conducted by Ancel Keys in 1950e1960, low incidences of coronary heart diseasewere found to be associated with Mediterranean diets (Keys, 1995, 1997).”
BackgroundDiet quality and cardiovascular outcomes: A systematic review and meta‐analysis of cohort studies
Taylor, R., Haslam, R. L., Herbert, J., Whatnall, M. C., Trijsburg, L. E., de Vries, J. H. M., Josefsson, M. S., Koochek, A., Nowicka, P., Neuman, N., et al. (2023) · Nutrition & Dietetics · doi:10.1111/1747-0080.12860 · Cited by 62 · see citing works
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“Taken together, our findings receive support from and give support to the widely accepted belief that Mediterranean diets, by virtue of richness in olive products, are associated with lower morbidity and mortality due to coronary heart diseases (Keys 1997).”
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“This result was, in fact, anticipated by the original Seven Countries Study [40], the Framingham study [41,42], the Tecumseh study [43] and the Nurses Health Study[44,45].”
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“…fat: Maternal diet: Fetal liver fatty acids: Docosahexaenoic acid: Diabetes mellitus The high intake of saturated fatty acids in Western diets has been linked to endemic coronary vascular disease since the first substantive evidence from the Seven Countries Study in the 1950s (Keys, 1980, 1997).”
BackgroundMaternal diet rich in saturated fats has deleterious effects on plasma lipids of mice.
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“Between 1958 and 1964, Ancel Keys proposed the concept of a different diet model, named the “Mediterranean Diet”, through his “Study of the Seven Countries” [22].”
BackgroundNutrition education: a questionnaire for assessment and teaching
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“This score was chosen because the town of Rijeka is in the littoral part of Croatia, where the Mediterranean diet is considered an inherited diet (Keys, 1997), and MD is considered a model for a sustainable diet (Trajkovska Petkoska and Trajkovska-Broach, 2021).”
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“Several epidemiological studies have shown that a Mediterranean diet comprising of large quantities of olive oil and nuts daily has displayed beneficial effects and lowered the incidence rates of atherosclerosis progression (Kromhout et al., 1989; Keys, 1997; Sofi et al., 2014).”
BackgroundLipid minor constituents in wines. A biochemical approach in the French paradox
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“These unexpected results caused researchers to conclude that elevated serum cholesterol levels, although a strong indicator, do not always predict CHD risk.(1,5,6) Subsequent investigations into the diets of people living in Finland, Japan, and Greece have led to some of the most interesting hypotheses regarding the e…”
Martíncrespo-Blanco, M., Varillas‐Delgado, D., Blanco-Abril, S., Cid‐Expósito, M., & Robledo‐Martín, J. (2022) · Nutrients · doi:10.3390/nu14081536 · Cited by 26 · see citing works
“The Mediterranean diet has been studied since the 1950s, when Keys compared the dietary habits of different cohorts from seven countries (USA, Japan, Finland, The Netherlands, the former Yugoslavia, Italy and Greece) and after a follow-up of 5–15 years, confirmed lower overall and coronary heart disease mortality and…”
BackgroundPietrabissa, G., Ceccarini, M., Borrello, M., Manzoni, G. M., Titon, A., Nibbio, F., Montano, M., Bertone, G., Gondoni, L. A., & Castelnuovo, G. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00298 · Cited by 26 · see citing works
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Proinflammatory status, genetics and atherosclerosis.
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“trends were linked to heart disease.(33,34) Keys took the preliminary data collected in support of his research idea to the WHO in 1955.”
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“High plasma LDL‐C is a well‐known risk factor for the develop‐ ment and progression of atherosclerosis (37,38).”
BackgroundInfluence of habitual high dietary fat intake on endothelium-dependent vasodilation
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“Epidemiologic and clinical studies have demonstrated that plasma total cholesterol con- centrations are strongly associated with the risk for coronary heart disease (Verschuren et al. 1995; Keys 1997) and that plasma cholesterol levels are directly linked to dietary fat intake (Keys et al. 1957).”
Balogun, K. A., Randunu, R. S., & Cheema, S. K. (2014) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2014.05.002 · Cited by 18 · see citing works
“Individuals with a high concentration of small LDL particles are more at risk of developing CVD compared to those with equal concentration of large LDL particle size [115-117].”
BackgroundInfluentialPinches, I. J. L., Pinches, Y. L., Johnson, J. O., Haddad, N., Boueri, M. G., Oke, L. M., & Haddad, G. E. (2022) · Nutrition · doi:10.1016/j.nut.2022.111629 · Cited by 16 · see citing works
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Cruz, N., Flores, M., Urquiaga, I., & Ávila, F. (2022) · Antioxidants · doi:10.3390/antiox11081513 · Cited by 15 · see citing works
“Clinical intervention trials for primary and secondary prevention, in which the diet was modified by increasing their adherence to the MedDiet, have been shown to decrease the incidence of numerous chronic diseases [155,159].”
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Vascular Pathobiology: Atherosclerosis and Large Vessel Disease
Bonafiglia, Q. A., Bendeck, M. P., & Gotlieb, A. I. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-822224-9.00006-2 · Cited by 18 · see citing works
Nakano, K., Kuraoka, S., Oda, M., Ohba, T., Mitsubuchi, H., Nakamura, K., Katoh, T., & the Japan Environment and Children’s Study (JECS) Group (2023) · Nutrients · doi:10.3390/nu15071772 · Cited by 14 · see citing works
“The Seven Countries Study reported that people in Mediterranean countries had a lower risk of cardiovascular disease, and the MD then became recognized as a healthy dietary style [2].”
BackgroundXu, S., Bendeck, M. P., & Gotlieb, A. I. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-420219-1.00003-3 · Cited by 16 · see citing works
Huggins, K. W., Colvin, P. L., Burleson, E. R., Kelley, K. L., Sawyer, J. K., Barrett, P. H. R., Rudel, L. L., & Parks, J. S. (2001) · Journal of Lipid Research · doi:10.1016/s0022-2275(20)30279-0 · Cited by 15 · see citing works
Gut Microbiota and Alzheimer’s Disease: Pathophysiology and Therapeutic Perspectives
Li, Y., Wang, R., Li, Q., Wang, Y., & Guo, J. (2021) · Journal of Alzheimer s Disease · doi:10.3233/jad-210381 · Cited by 16 · see citing works
“The MeDi is characterized by frequent consumption of bread, legumes, vegetables, fruits, and fats rich in unsaturated fatty acids, moderate intake of fish and poultry, low intake of dairy and meat, and regular but moderate consumption of wine with meals [106].”
Smith, D. E., Espino-Montoro, A., Pérez‐Jiménez, F., Pedro‐Botet, J., Perepérez, J. A. J., & Ordovás, J. M. (2000) · Nutrition Research · doi:10.1016/s0271-5317(00)00212-8 · Cited by 14 · see citing works
Chechi, K., Yasui, N., Ikeda, K., et al. (2010) · British Journal Of Nutrition · doi:10.1017/s0007114510002187 · Cited by 14 · see citing works
Guillén, N., Acı́n, S., Navarro, M. Á., Surra, J. C., Arnal, C., Lou-Bonafonte, J. M., Muniesa, P., Martínez-Gracia, M. V., & Osada, J. (2009) · Revista Española de Cardiología (English Edition) · doi:10.1016/s1885-5857(09)71560-9 · Cited by 13 · see citing works
Rasmussen, E., Morgan, A. M. F., Munson, R., Ong, A. L., Patel, S. S., Yucus, C. J., Pham, A. T., Patel, V. A., Frigerio, R., Lai, R., et al. (2018) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2017.12.003 · Cited by 13 · see citing works
“2 vascular events.(3-7) More recently, the Mediterranean diet has been associated with improved cognition, reduced risk of Alzheimer disease, and delayed conversion to Alzheimer disease from mild cognitive impairment.”
BackgroundInfluentialKrieglstein, J., Kewitz, T., Kirchhefer, U., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0009561 · Cited by 13 · see citing works
- Authors
- Keys, A.
- Corresponding author
- Keys, Ancel
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 1997-03
- Volume
- 13
- Issue
- 3
- Pages
- 249-253
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W1965972676
- Cited by
- 154
- References
- 0
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 13 · 2020: 7 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 7 · 2013: 7 · 2012: 3
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- coronary artery disease, cross-national comparison, dietary factors, cardiovascular risk factors
- MeSH terms
- Coronary Disease, Europe, Humans, Japan, Male, United States, History, 20th Century
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