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Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score
Open accessAbstract
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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“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]
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“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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Metadata
- 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
- 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 (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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