Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis
Open accessAbstract
Background The Mediterranean diet has long been reported to be protective against the occurrence of several different health outcomes.Objective We aimed to update our previous meta-analysis of published cohort prospective studies that investigated the effects of adherence to the Mediterranean diet on health status.Design We conducted a comprehensive literature search through electronic databases up to June 2010.Results The updated review process showed 7 prospective studies published in the past 2 y that were not included in the previous meta-analysis (1 study for overall mortality, 3 studies for cardiovascular incidence or mortality, 1 study for cancer incidence or mortality, and 2 studies for neurodegenerative diseases). These recent studies included 2 health outcomes not previously investigated (ie, mild cognitive impairment and stroke). The meta-analysis for all studies with a random-effects model that was conducted after the inclusion of these recent studies showed that a 2-point increase in adherence to the Mediterranean diet was associated with a significant reduction of overall mortality [relative risk (RR) = 0.92; 95% CI: 0.90, 0.94], cardiovascular incidence or mortality (RR = 0.90; 95% CI: 0.87, 0.93), cancer incidence or mortality (RR = 0.94; 95% CI: 0.92, 0.96), and neurodegenerative diseases (RR = 0.87; 95% CI: 0.81, 0.94). The meta-regression analysis showed that sample size was the most significant contributor to the model because it significantly influenced the estimate of the association for overall mortality.Conclusion This updated meta-analysis confirms, in a larger number of subjects and studies, the significant and consistent protection provided by adherence to the Mediterranean diet in relation to the occurrence of major chronic degenerative diseases.
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Greater adherence to the Mediterranean diet, by a 2-point higher score, is associated with a 10% reduction in cardiovascular incidence or mortality (pooled RR 0.90, 95% CI 0.87-0.93) and an 8% reduction in all-cause mortality (pooled RR 0.92, 95% CI 0.90-0.94).
“The meta-analysis showed that greater adherence to the Mediterranean diet, by a 2-point higher score, was associated with a 10% reduction in cardiovascular incidence or mortality (pooled RR 0.90, 95% CI 0.87-0.93)and also with an 8% reduction in all-cause mortality (pooled RR 0.92, 95% CI 0.90-0.94).”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [276]
Adherence to the Mediterranean diet is protective against the occurrence of several diseases, in particular obesity and cardiovascular disease.
“The adherence to MD dietary pattern has been showed to be protective against the occurrence of several diseases, in particular obesity and CVD [12].”
From Mediterranean Diet and Obesity-related Disorders: What is the Evidence? (2022) · cites this paper as [12]
Ecological comparisons and prospective cohort studies consistently demonstrate inverse associations between consumption of traditional Mediterranean diets and risk of CHD, stroke, and total mortality.
“Ecological comparisons and prospective cohort studies consistently demonstrate inverse associations between consumption of traditional Mediterranean diets and risk of CHD, stroke, and total mortality.116”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [116]
A recent meta-analysis of cohort studies found that adherence to the Mediterranean diet was associated with lower total mortality and lower coronary heart disease mortality.
“A recent meta-analysis of these cohorts showed that adherence to the MeDiet was associated with reductions in total mortality and CHD mortality.2”
From Cohort Profile: Design and methods of the PREDIMED study (2012) · cites this paper as [2]
Sofi et al.'s systematic review and meta-analysis found a 2-point MD adherence increase was linked to lower overall mortality (RR=0.92; 95% CI 0.90,0.94), cardiovascular incidence or mortality (RR=0.90; 95% CI 0.87,0.93), and cancer incidence or mortality (RR=0.94; 95% CI 0.92,0.96).
“A systematic review and meta-analysis of observational by Sofi et al. (2010) found that a 2point increase (10 point scale) in adherence to the MD was associated with a significant reduction of overall mortality [relative risk (RR) = 0.92; 95% CI: 0.90, 0.94], cardiovascular incidence or mortality (RR = 0.90; 95% CI: 0.87, 0.93) and cancer incidence or mortality (RR = 0.94; 95% CI: 0.92, 0.96) (5).”
From Effect of an Internet-based, personalized nutrition randomized trial on dietary changes associated with the Mediterranean diet: the Food4Me Study (2016) · cites this paper as Sofi et al. (2010)
Sofi et al.'s systematic review and meta-analysis found a 2-point MD adherence increase was linked to lower overall mortality (RR=0.92; 95% CI 0.90,0.94), cardiovascular incidence or mortality (RR=0.90; 95% CI 0.87,0.93), and cancer incidence or mortality (RR=0.94; 95% CI 0.92,0.96).
“A systematic review and meta-analysis of observational by Sofi et al. (2010) found that a 2point increase (10 point scale) in adherence to the MD was associated with a significant reduction of overall mortality [relative risk (RR) = 0.92; 95% CI: 0.90, 0.94], cardiovascular incidence or mortality (RR = 0.90; 95% CI: 0.87, 0.93) and cancer incidence or mortality (RR = 0.94; 95% CI: 0.92, 0.96) (5).”
From Effect of an Internet-based, personalized nutrition randomized trial on dietary changes associated with the Mediterranean diet: the Food4Me Study (2016) · cites this paper as [5]
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- Authors
- Sofi, F., Abbate, R., Gensini, G. F., & Casini, A.
- Affiliations
- University of Florence (IT)
- Don Carlo Gnocchi Foundation (IT)
- Corresponding author
- Sofi, Francesco
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 92
- Issue
- 5
- Pages
- 1189-1196
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2105587305
- Cited by
- 1,605
- References
- 29
- Citations by year
- 2026: 46 · 2025: 61 · 2024: 61 · 2023: 69 · 2022: 77 · 2021: 117 · 2020: 103 · 2019: 122 · 2018: 112 · 2017: 111 · 2016: 132 · 2015: 138 · 2014: 158 · 2013: 156 · 2012: 86
- FWCI
- 13.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Mediterranean diet, dietary adherence, all-cause mortality, cardiovascular disease, cancer incidence and mortality, neurodegenerative diseases, mild cognitive impairment, stroke, chronic disease prevention, sample size effects
- MeSH terms
- Cardiovascular Diseases, Chronic Disease, Cognition Disorders, Health, Humans, Neoplasms, Prospective Studies, Neurodegenerative Diseases, Stroke, Diet, Mediterranean
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