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Systematic Review

Mediterranean Diet and Mortality in People with Cardiovascular Disease: A Meta-Analysis of Prospective Cohort Studies

1
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
2
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
3
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou 215000, China
*
Author to whom correspondence should be addressed.
Academic Editor: Maria D. Mesa
Nutrients 2021, 13(8), 2623; https://doi.org/10.3390/nu13082623
Received: 21 June 2021 / Revised: 20 July 2021 / Accepted: 28 July 2021 / Published: 29 July 2021
(This article belongs to the Section Nutritional Epidemiology)
The association of the Mediterranean diet (MD) with mortality among people with a history of cardiovascular disease (CVD) has not been systematically examined. Hereby, our objective was to investigate the association of MD with all-cause and cardiovascular mortality in people with a history of CVD. We searched five electronic databases including Embase, PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials to screen eligible studies published before 31 August 2020. A random-effect model was used to examine the association of a 2-unit increment in MD score with the risk of all-cause and cardiovascular mortality. We conducted sensitivity and subgroup analyses and examined potential publication bias by Egger’s and Begg’s tests. Seven cohort studies (eight datasets) with a total of 37,879 participants who had a history of CVD were eligible for the main analysis. The pooled hazard ratios were 0.85 (95% CIs: 0.78–0.93; n = 8) for all-cause mortality and 0.91 (95% CIs; 0.82–1.01; n = 4) for cardiovascular mortality for each 2-unit increment in a score of adherence to MD. Subgroup analyses for all-cause mortality showed that the association appeared relatively stronger in Mediterranean areas (HR = 0.76 [0.69–0.83]) than non-Mediterranean areas (HR = 0.95 [0.93–0.98]) and in studies with a shorter duration (HR = 0.75 [0.66–0.84] for <7 years vs. HR = 0.94 [0.91–0.98] for ≥7 years). No evidence of publication bias was observed. The present meta-analysis of prospective cohort studies provided evidence that adherence to MD improved survival in people with a history of CVD. View Full-Text
Keywords: mediterranean diet; secondary prevention; cardiovascular disease; mortality; meta-analysis; cohort studies mediterranean diet; secondary prevention; cardiovascular disease; mortality; meta-analysis; cohort studies
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MDPI and ACS Style

Tang, C.; Wang, X.; Qin, L.-Q.; Dong, J.-Y. Mediterranean Diet and Mortality in People with Cardiovascular Disease: A Meta-Analysis of Prospective Cohort Studies. Nutrients 2021, 13, 2623. https://doi.org/10.3390/nu13082623

AMA Style

Tang C, Wang X, Qin L-Q, Dong J-Y. Mediterranean Diet and Mortality in People with Cardiovascular Disease: A Meta-Analysis of Prospective Cohort Studies. Nutrients. 2021; 13(8):2623. https://doi.org/10.3390/nu13082623

Chicago/Turabian Style

Tang, Chengyao, Xiaowen Wang, Li-Qiang Qin, and Jia-Yi Dong. 2021. "Mediterranean Diet and Mortality in People with Cardiovascular Disease: A Meta-Analysis of Prospective Cohort Studies" Nutrients 13, no. 8: 2623. https://doi.org/10.3390/nu13082623

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