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Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

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Sofi, Francesco, Macchi, Claudio, Abbate, Rosanna, Gensini, Gian Franco, Casini, Alessandro·2014·Public Health Nutrition

DOI 10.1017/s1368980013003169PMC PMC10282340

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Abstract

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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RETRACTED: Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1200303 · Cited by 4,257
Retracted
Adherence to a Mediterranean diet and survival in a Greek population
Trichopoulou, A., Costacou, T., Bamia, C., & Trichopoulos, D. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025039 · Cited by 4,397
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Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008) · BMJ · doi:10.1136/bmj.a1344 · Cited by 1,717
Self-citation
Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis
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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
ORCID: Sofi, Francesco
Macchi, Claudio
Casini, Alessandro
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
DOI: 10.1017/s1368980013003169
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
FWCI: 6.47
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified)
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 (medical) › 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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Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score

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