Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score
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Objective: To update previous meta-analyses of cohort studies that investigated the association between the Mediterranean diet and health status and to utilize data coming from all of the cohort studies for proposing a literature-based adherence score to the Mediterranean diet. Design: We conducted a comprehensive literature search through all electronic databases up to June 2013. Setting: Cohort prospective studies investigating adherence to the Mediterranean diet and health outcomes. Cut-off values of food groups used to compute the adherence score were obtained. Subjects: The updated search was performed in an overall population of 4 172 412 subjects, with eighteen recent studies that were not present in the previous meta-analyses. Results: A 2-point increase in adherence score to the Mediterranean diet was reported to determine an 8 % reduction of overall mortality (relative risk = 0·92; 95 % CI 0·91, 0·93), a 10 % reduced risk of CVD (relative risk = 0·90; 95 % CI 0·87, 0·92) and a 4 % reduction of neoplastic disease (relative risk = 0·96; 95 % CI 0·95, 0·97). We utilized data coming from all cohort studies available in the literature for proposing a literature-based adherence score. Such a score ranges from 0 (minimal adherence) to 18 (maximal adherence) points and includes three different categories of consumption for each food group composing the Mediterranean diet. Conclusions: The Mediterranean diet was found to be a healthy dietary pattern in terms of morbidity and mortality. By using data from the cohort studies we proposed a literature-based adherence score that can represent an easy tool for the estimation of adherence to the Mediterranean diet also at the individual level.
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The DASH and Mediterranean diets have proved effective in reducing cardiovascular risk factors.
“both have proved to be effective in reducing CV risk factors and, possibly, to contribute to ASCVD prevention [133].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [133]
A meta-analysis of nearly 5 million participants found that each 2-point increase in Mediterranean diet adherence was associated with an 8% lower overall mortality.
“A meta-analysis of nearly 5 million subjects reported an 8% reduction of overall mortality for each 2-point increase in adherence to the Mediterranean diet (139).”
From Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies , (2017) · cites this paper as [139]
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- Authors
- Sofi, F., Macchi, C., Abbate, R., Gensini, G. F., & Casini, A.
- Affiliations
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Don Carlo Gnocchi Foundation (IT)
- University of Florence (IT)
- Corresponding author
- Sofi, Francesco
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-11-29
- Volume
- 17
- Issue
- 12
- Pages
- 2769-2782
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC10282340
- OpenAlex
- W2167807738
- Cited by
- 997
- References
- 43
- Citations by year
- 2026: 31 · 2025: 56 · 2024: 71 · 2023: 87 · 2022: 113 · 2021: 112 · 2020: 117 · 2019: 97 · 2018: 103 · 2017: 72 · 2016: 79 · 2015: 35 · 2014: 22 · 2012: 1
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- Mediterranean diet, diet and health outcomes, all-cause mortality, cardiovascular disease, cancer risk, food group intake, dietary habits, cohort studies
- MeSH terms
- Cardiovascular Diseases, Feeding Behavior, Health Status, Humans, Neoplasms, Diet, Mediterranean
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