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

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Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women

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

DOI 10.1161/circulationaha.108.816736PMC PMC2724471

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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.

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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)
ORCID: Fung, Teresa T.
Rexrode, Kathryn M.
Mantzoros, Christos S.
Manson, JoAnn E.
Willett, Walter C.
Hu, Frank B.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-03-03
Volume: 119
Issue: 8
Pages: 1093-1100
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.108.816736
PMC: PMC2724471
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
Update notices: correction (2009-03-31)
Open access: bronze
doi.org
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

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Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women

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