Mediterranean diet and CHD: the Greek European prospective investigation into cancer and nutrition cohort
Open accessAbstract
Adherence to the Mediterranean diet (MD) has been reported to improve CHD prognosis and to be inversely associated with CHD mortality. The aim of the present study was to investigate the association of adherence to the MD with CHD incidence and mortality in the Greek European Prospective Investigation into Cancer and Nutrition cohort, a population with traditional Mediterranean roots. In a general population sample of 23,929 adult men and women with no CVD or cancer at enrolment, a validated FFQ was interviewer-administered, sociodemographic, physical activity and other characteristics were recorded, and arterial blood pressure and anthropometric characteristics were measured. In a median period of 10 years, 636 incident CHD cases and 240 CHD deaths were recorded. Associations of adherence to the MD, operationalised through a nine-component score (0, poor; 9, excellent), with CHD incidence and mortality were evaluated through Cox regression controlling for potentially confounding variables. A two-point increase in the MD score was associated with lower CHD mortality by 25 % (95 % CI 0.57, 0.98) among women and 19 % (95 % CI 0.67, 0.99) among men. The association of adherence to the MD with CHD incidence was again inverse, but weaker (hazard ratios 0.85 (95 % CI 0.71, 1.02) among women and 0.98 (95 % CI 0.87, 1.10) among men). With respect to score components, only meat among men (positively) and fruits and nuts among women (inversely) were associated with both the incidence of and mortality from CHD. The MD, as an integral entity, is inversely associated with CHD incidence and, particularly, mortality.
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A Mediterranean diet including nuts lowers CVD risk in observational studies and RCTs.
“In observational studies (133,217–220) and RCTs (164,221–223) a Mediterranean diet including nuts lowers CVD risk.”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [218]
Several additional large cohort studies on nut consumption and CAD risk have been published.
“Furthermore, several additional, large cohort studies have been published on nut consumption and CAD risk (5,8,9).”
From Nut consumption in relation to cardiovascular disease risk and type 2 diabetes: a systematic review and meta-analysis of prospective studies (2014) · cites this paper as [9]
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- Authors
- Dilis, V., Katsoulis, M., Lagiou, P., Trichopoulos, D., Naska, A., & Trichopoulou, A.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Harvard University (US)
- Corresponding author
- Trichopoulou, Antonia
- Venue
- British Journal Of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-07-04
- Volume
- 108
- Issue
- 4
- Pages
- 699-709
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W2136358279
- Cited by
- 121
- References
- 40
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 6 · 2022: 8 · 2021: 7 · 2020: 9 · 2019: 11 · 2018: 12 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 23 · 2013: 10 · 2012: 3
- FWCI
- 13.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Stavros Niarchos Foundation
- Hellenic Health Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- Mediterranean diet, coronary artery disease, CHD incidence, coronary heart disease mortality, dietary adherence, diet score, sex differences, meat consumption, Greek population
- MeSH terms
- Adult, Aged, Aged, 80 and over, Coronary Disease, Female, Follow-Up Studies, Greece, Humans, Male, Meat, Middle Aged, Patient Compliance, Prospective Studies, Sex Characteristics, Cohort Studies, Incidence, Proportional Hazards Models, Diet, Mediterranean, Young Adult
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