The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease
Open accessAbstract
Background The role of the Mediterranean diet among individuals with previous cardiovascular disease (CVD) is uncertain.Objective The aim of this study was to assess the association between the Alternate Mediterranean Diet (aMED) score and all-cause, cardiovascular, and cancer mortality in men and women with CVD from the Health Professionals Follow-Up Study and the Nurses' Health Study.Design This study included 6137 men and 11,278 women with myocardial infarction, stroke, angina pectoris, coronary bypass, and coronary angioplasty. Diet was first assessed in 1986 for men and in 1980 for women with a food-frequency questionnaire (FFQ) and then repeatedly every 2-4 y. Cumulative consumption was calculated with all available FFQs from the diagnosis of CVD to the end of the follow-up in 2008.Results During a median follow-up of 7.7 y (IQR: 4.2-11.8) for men and 5.8 y (IQR: 3.8-8.0) for women, we documented 1982 deaths (1142 from CVD and 344 from cancer) among men and 1468 deaths (666 from CVD and 197 from cancer) among women. In multivariable Cox regression models, the pooled RR of all-cause mortality from a comparison of the top with the bottom quintiles of the aMED score was 0.81 (95% CI: 0.72, 0.91; P-trend < 0.001). The corresponding pooled RR for CVD mortality was 0.85 (95% CI: 0.67, 1.09; P-trend = 0.30), for cancer mortality was 0.85 (95% CI: 0.65, 1.11; P-trend = 0.10), and for other causes was 0.79 (95% CI: 0.65, 0.97; P-trend = 0.01). A 2-point increase in adherence to the aMED score was associated with a 7% (95% CI: 3%, 11%) reduction in the risk of total mortality.Conclusion Adherence to a Mediterranean-style dietary pattern was associated with lower all-cause mortality in individuals with CVD.
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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).”
From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [8]
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- Authors
- Lopez-Garcia, E., Rodriguez-Artalejo, F., Li, T. Y., Fung, T. T., Li, S., Willett, W. C., Rimm, E. B., & Hu, F. B.
- Affiliations
- Brigham and Women's Hospital (US)
- Simmons University (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 99
- Issue
- 1
- Pages
- 172-180
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3862454
- OpenAlex
- W2130098214
- Cited by
- 190
- References
- 60
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 13 · 2023: 14 · 2022: 12 · 2021: 22 · 2020: 19 · 2019: 17 · 2018: 16 · 2017: 10 · 2016: 11 · 2015: 27 · 2014: 13
- FWCI
- 17.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health (CA 87969, CA055075)
- National Heart, Lung, and Blood Institute (HL60712, R01HL060712)
- National Cancer Institute (P01CA087969, P01CA055075)
- 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, alternate Mediterranean diet score, cardiovascular disease, mortality, all-cause mortality, cardiovascular mortality, cancer mortality, dietary adherence, sex differences, myocardial infarction, stroke, coronary artery disease, Health Professionals Follow-up Study, Nurses' Health Study, cardiovascular risk factors
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Feeding Behavior, Female, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Neoplasms, Patient Compliance, Prospective Studies, Surveys and Questionnaires, Nutrition Assessment, Body Mass Index, Multivariate Analysis, Proportional Hazards Models, 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 ›
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