Cited by 916Nutritional Studies and DietCardiovascular Health and Risk FactorsFatty Acid Research and Health

Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women

Open access
Fung, Teresa T., Rexrode, Kathryn M., Mantzoros, Christos S., Manson, JoAnn E., Willett, Walter C., Hu, Frank B.·2009·Circulation

Abstract

BACKGROUND: Several studies have documented an inverse association between adherence to the Mediterranean diet and risk of coronary heart disease (CHD), but few data are available on the relationship between Mediterranean diet and risk of stroke. METHODS AND RESULTS: For the present study, 74,886 women 38 to 63 years of age in the Nurses' Health Study, a cohort study of female nurses, without a history of cardiovascular disease and diabetes were followed up from 1984 to 2004. We computed an Alternate Mediterranean Diet Score from self-reported dietary data collected through validated food frequency questionnaires administered 6 times between 1984 and 2002. Relative risks for incident CHD, stroke, and combined fatal cardiovascular disease were estimated with Cox proportional-hazards models adjusted for cardiovascular risk factors. During 20 years of follow-up, 2391 incident cases of CHD, 1763 incident cases of stroke, and 1077 cardiovascular disease deaths (fatal CHD and strokes combined) were ascertained. Women in the top Alternate Mediterranean Diet Score quintile were at lower risk for both CHD and stroke compared with those in the bottom quintile (relative risk [RR], 0.71; 95% CI, 0.62 to 0.82; P for trend<0.0001 for CHD; RR, 0.87; 95% CI, 0.73 to 1.02; P for trend=0.03 for stroke). Cardiovascular disease mortality was significantly lower among women in the top quintile of the Alternate Mediterranean Diet Score (RR, 0.61; 95% CI, 0.49 to 0.76; P for trend<0.0001). CONCLUSIONS: A greater adherence to the Mediterranean diet, as reflected by a higher Alternate Mediterranean Diet Score, was associated with a lower risk of incident CHD and stroke in women.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/circulationaha.108.816736

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Several population-based and prospective epidemiological studies have shown that adherence to the Mediterranean diet might have a protective effect against cardiovascular disease, stroke, obesity, diabetes, hypertension, several types of cancers, allergic diseases, and Alzheimer and Parkinson's disease.

    “Several population-based and prospective epidemiological studies have shown that adherence to the Mediterranean diet might have a protective effect against cardiovascular disease, stroke, obesity, diabetes, hypertension, several type of cancers, allergic diseases and, most recently, Alzheimer and Parkinson’s disease (7–18).”
  • Similar evidence has been collected for non-fatal cardiovascular disease.

    “Subsequently, similar evidences have been collected for 'non-fatal' CVD.[3][4][5]”

    From Cohort Profile: Design and methods of the PREDIMED study (2012) · cites this paper as [3]

  • Both the Health Professionals Follow-up Study and the Nurses' Health Study find a ≈20% increased CHD risk in the highest category of SSB consumption compared with the lowest category.

    “Both the HPFS and the NHS find a ≈20% increased CHD risk in the highest category of SSB consumption compared with the lowest category (132,133);”
  • 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.”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [19]Fung TT McCullough ML Newby PK Manson JE Meigs JB Rifai N Willett WC Hu FB Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction American Journal of Clinical Nutrition 2005 82 163 173 16002815

Cited by

Sorted by citations

Authors
Fung, T. T., Rexrode, K. M., Mantzoros, C. S., Manson, J. E., Willett, W. C., & Hu, F. B.
Affiliations
Brigham and Women's Hospital (US)
Venue
Circulation
Published
2009-03-03
Volume
119
Issue
8
Pages
1093-1100
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2015746229
Cited by
916
References
37
Citations by year
2026: 43 · 2025: 63 · 2024: 58 · 2023: 59 · 2022: 47 · 2021: 59 · 2020: 68 · 2019: 47 · 2018: 56 · 2017: 46 · 2016: 51 · 2015: 59 · 2014: 54 · 2013: 49 · 2012: 48
FWCI
52.19
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Heart, Lung, and Blood Institute (HL60712, R01HL060712, HL88521, HL34594, R01HL034594, R01HL088521)
  • National Cancer Institute (CA-87969, P01CA087969)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK040561)
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, stroke, cardiovascular mortality, women, dietary adherence, alternate Mediterranean diet score, Nurses' Health Study, diet and cardiovascular risk
MeSH terms
Adult, Coronary Disease, Female, Follow-Up Studies, Humans, Middle Aged, Risk Factors, Cohort Studies, Incidence, Stroke, Diet, Mediterranean

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review