Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes
Abstract
:1. Introduction
2. Methods
3. Results
Authors (Year) (Reference) | A priori Index | Subjects, Number, Age | Study’s Name, Type of Study and Follow-Up | Main Results |
---|---|---|---|---|
Bilenko et al., (2005) [10] ° | MDS | Israeli Jewish population, 1159 adults, ≥35 year | NNS, transverse study | In men for each MDS decrease significant increased risk for MI, CABG, PTCA, CVD. In women similar trend, but not statistical significance. |
Hoşcan et al., (2015) [11] ° | MDS | Turkish population, 900 adults, 25–70 year | Cohort, (5.1 year) | Men with a lower adherence to the Mediterranean Diet had a significantly higher risk of CHD morbidity compared to men with a higher adherence. No association was found in women. |
Trichopoulou et al., (2003) [12] | t-MED | Greek population, 22,043 adults, 20–86 year | EPIC, cohort, (3.7 year) | A 2-point increase in t-MED is associated with a CHD mortality reduction by 33%. |
Dilis et al., (2012) [13] | t-MED | Greek population, 23,572 adults, 20–86 year | EPIC, cohort, (10 year) | A 2-point increase in t-MED was associated with a decrease in CHD mortality by 22% (p = 0.003) and a non-significant reduction in CHD incidence |
Misirli et al., (2012) [14] | t-MED | Greek population, 23,601 adults 20–86 year | EPIC, cohort, (10.6 year) | A 2-point increase in t-MED was associated with a significant decrease in cerebrovascular disease incidence and a non-significant decrease in cerebrovascular disease mortality |
Tsivgoulis et al., (2015) * [15] | t-MED | U.S. population, 20,197 adults, 65 ± 9 year | REGARDS, cohort, (6.5 year) | A 1-point increase in t-MED was independently associated with a 5% reduction in the risk of incident ischemic stroke. No association with incident hemorrhagic stroke |
Martínez-González et al., (2011) [16] | t-MED | Spanish population, 13,609 young, mean 38 year | SUN, cohort, (4.9 year) | A 2-point increase in t-MED was associated with a 20% decrease in total CVD risk and to a 26% reduction in CHD risk |
Gardener et al., (2011) * [17] | t-MED | U.S. population, 2568 adult, mean 69 ± 10 year | NOMAS, cohort (9 year) | A 1-point increase in t-MED was associated with a 9% (p < 0.05) decrease in risk of vascular death. No association was found for vascular events (ischemic stroke and MI) |
Agnoli et al., (2011) [18] | t-MED | Italian population, 40,681 adults, 35–74 year | EPICOR, cohort , (7.89 year) | t-MED was inversely associated with the risk of ischemic stroke and positively with the risk of hemorrhagic stroke without statistical significance |
Turati et al., (2015) [19] | t-MED | Italian population, 760 patients with a first episode of non-fatal MI/682 controls, 16–79 year | Case-control | A 1-point increase in the t-MED was associated with a reduced risk of a first episode of MI by 9% |
Knoops et al., (2004) [20] | The score according to Knoops | European population (11 European countries), 2339 elderly people, 70–90 year | HALE study, cohort, (10 year) | A score of at least four points reduced the CHD mortality by 39% and the CVD mortality by 29% |
Agnoli et al., (2011) [18] | The Italian Mediterranean Index | Italian population, 40,681 adults, 35–74 year | EPICOR, cohort, (7.89 year) | The Italian Mediterranean Index was inversely associated with ischemic stroke (p for trend = 0.001) and hemorrhagic stroke (p for trend = 0.07) |
Fung et al., (2009) [21] | a-MED | U.S. population, 74,886 females nurses, 38–63 year | NHS, cohort, (20 year) | Women in the highest a-MED quintile were at lower risk for both total CHD and total stroke compared with those in the lowest quintile (p for trend = 0.001 and = 0.03, respectively) |
Mitrou et al., (2007) [22] | a-MED | U.S. population, 380,296 adults, median age 62 year | NIH-AARP Diet and Health Study, cohort (5 year) | The risk of mortality for CVD was lower in men and women with higher adherence to the Mediterranean Diet compared to those with a lower adherence (p < 0.001 and p = 0.01, respectively) |
Buckland et al., (2009) [23] | r-MED | Spanish population, 41,078 adults, 29–69 year | EPIC, cohort, (10.4 year) | A 1-point increase in the r-MED was associated with a 6% lower risk of total CHD (p for trend < 0.001) |
Hoevenaar-Blom et al., (2012) [24] | m-MED | Dutch population, 34,708 adults, 20–70 year | EPIC, cohort, (10–15 year) | A 2-point increase in the m-MED was inversely and significantly associated with fatal CVD, composite CVD, incident MI, incident stroke, and pulmonary embolism |
Sjögren et al., (2010) [25] | The score according to Sjogren | Swedish men, 924 elderly, 71 ± 1 year | Cohort, (10.2 year) | A higher adherence to the Mediterranean Diet was associated with a lower risk of CVD mortality as compared to lower adherence (p for trend = 0.009) |
Tognon et al., (2012) [26] | The score according to Tognon 2012 | Sweden population, 77,151 adults, 30–70 year | VIP, cohort , (median 9 year) | The score according to Tognon 2012 was significantly associated only in women but not in men with mortality for CVD and mortality for MI. No association was found with stroke mortality in both genders. |
Tognon et al., (2014) [27] | The score according to Tognon 2014 | Danish population, 1849 adults | MONICA project, longitudinally | The score according to Tognon 2014 was inversely associated with CVD incidence and mortality. The strength of the associations depended on the way in which the score was built (see text) |
Panagiotakos et al., (2015) [28] | DS | Greek population, 2583 adults, 18–89 year | ATTICA study, cohort, (10 year) | A 1-point increase in the DS decreased CVD risk by 4% |
Panagiotakos et al., (2015) [29] | DS | Greek population, 848 patients with a first symptom of CHD/1078 controls | CARDIO 2000, case-control | An 11/55 unit increase in DS was associated with a reduced odds of having a first acute coronary syndrome by 27% |
Kastorini et al., (2011) [30] | DS | Greek population, 250 patients with a first episode of acute coronary syndrome and 250 patients with a first ischemic stroke/500 controls | Case-control | A 1-point increase in the DS reduced the odds of having acute coronary syndrome by 9% and of having a stroke by 12% |
Kastorini et al., (2012) [31] | DS | Greek population, 250 patients with a first ischemic stroke/250 controls | Case-control | A 1-point increase in DS reduced the odds of having a first ischemic stroke by 17% in non-hypercolesterolemic participants and by 10% in hypercolesterolemic participants |
Fidanza et al., (2004) [32] | MAI | USA, Europe, Japan, 12,763 men, 40–59 year | Seven Countries Study, cohort, (25 year) | The MAI was inversely correlated with death rates from CHD (p = 0.001) in 16 cohorts of Seven Countries Study |
Menotti et al., (2012) [33] | MAI | Italian population, 1139 men, 45–64 year | Seven Countries Study, two Italian cohorts, (20–40 year) | The hazard ratio for 2.7 units of MAI was associated with a CHD mortality reduction of 26% in 20y and 21% in 40y of follow-up |
Martínez-González et al., (2002) [7] | a priori Mediterranean Dietary Pattern | Spanish population, 171 patients with a first MI/171 controls, <80 year | Case-control | A 1-point increase in the a priori Mediterranean Dietary Pattern was associated with a reduced risk of 8% for a first MI (p < 0.01) |
Estruch et al., (2013) [34] | PREDIMED score | Spanish population, 7447 adults, 50–80 year | Randomized trial (4.8 year) | The rate of major CVD events was reduced by 30% (p = 0.01) in the group assigned to the Mediterranean Diet with extra-virgin olive oil and by 28% (p = 0.03) in the group assigned to the Mediterranean Diet with nuts compared with the control group. In subgroup analyses the supplemented Mediterranean Diet was significantly protective towards stroke but not towards MI and CVD deaths in comparison with the control diet |
A priori Index | Authors (Year) (Reference) | Index Components | Score Range |
---|---|---|---|
MDS | Trichopoulou et al., (1995) [4] Bilenko et al., (2005) [10] ° Hoşcan et al., (2015) [11] ° | MDS | 0–8 |
8 components: M/S ratio; cereals (including bread and potatoes); vegetables; fruit; legumes; alcohol; meat and meat products; milk and dairy products | |||
Other Indexes adapted from the MDS: t-MED | Trichopoulou et al., (2003) [12] Dilis et al., (2012) [13] Misirli et al., (2012) [14] Tsivgoulis et al., (2015) [15] * Martínez-González (2011) [16] Gardener et al., (2011) [17] * Agnoli et al., (2011) [18] Turati et al., (2015) [19] | t-MED | 0–9 |
9 components: M/S ratio; cereals (including bread and potatoes); vegetables; fruit and nuts; legumes; fish; alcohol; meat and meat products; milk and dairy products | |||
Other indexes adapted from the t-MED | |||
the score according to Knoops | Knoops et al., (2004) [20] | the score according to Knoops | 0–8 |
8 components: M/S ratio; legumes, nuts and seeds; cereals; fruits; vegetables and potatoes; fish; meat and meat products; dairy products | |||
the Italian Mediterranean Index | Agnoli et al., (2011) [18] | the Italian Mediterranean Index | 0–11 |
11 components: pasta; typical Mediterranean vegetables; fruit; legumes; olive oil; fish; soft drinks; butter; red meat; potatoes; alcohol | |||
a-MED | Fung et al., (2009) [21] Mitrou et al., (2007) [22] | a-MED | 0–9 |
9 components: M/S ratio; legumes; fruits; vegetables (excluding potatoes); nuts; whole grains; fish; red and processed meats; alcohol | |||
r-MED | Buckland et al., (2009) [23] | r-MED | 0–18 |
9 components: Fruit, nuts, seeds (excluding fruit juices); vegetables (excluding potatoes); legumes; cereals; fish, sea foods; olive oil; meat and meat products, dairy products, alcohol | |||
m-MED | Trichopoulou et al., (2005) [35] Hoevenaar-Blom et al., (2012) [24] | m-MED | 0–9 |
9 components: M + P/S ratio; vegetables; legumes; fruit; cereals; fish; meat; dairy products; alcohol | |||
Other indexes adapted from the m-MED | |||
the score according to Sjögren | Sjögren et al., (2010) [25] | the score according to Sjögren | 0–8 |
8 components: P/S ratio; vegetables and legumes, fruit; cereals and potatoes; fish; meat and meat products; milk and milk products; alcohol | |||
the scores according to Tognon | Tognon et al., (2012) [26] | the score according to Tognon (2012) | 0–8 |
8 components: M + P/S ratio; vegetables and potatoes; fruit and juices; whole grain cereals; fish and fish products, meat and meat products; dairy products; alcohol | |||
Tognon et al., (2014) [27] | the score according to Tognon (2014) | 0–8 | |
8 components: M + P/S ratio; vegetables; fruit; cereal grains; fish and fish products; meat, meat products and eggs; dairy products; alcohol | |||
DS | Pitsavos et al., (2005) [5] Panagiotakos et al., (2015) [28] Panagiotakos et al., (2006) [29] Kastorini et al., (2011) [30] Kastorini et al., (2012) [31] | DS | 0–55 |
11 components: olive oil; whole grains; fruit; vegetables; potatoes; legumes; fish; meat and meat products; poultry; full fat dairy; alcohol | |||
MAI | Alberti-Fidanza et al., (1999) [6] Fidanza et al., (2004) [32] Menotti et al., (2012) [33] | MAI | 0.6–11.6 # |
18 components: bread; cereals; legumes; potatoes; vegetables; fresh fruit; nuts; fish; wine; vegetable oils; milk; cheese; meat; eggs; animal fat and margarines; sweet beverages; cakes, pies, cookies; sugar | |||
a priori Mediterranean Dietary Pattern | Martínez-González et al., (2002) [7] | a priori Mediterranean Dietary Pattern | 0–40 |
8 components: olive oil; fiber; fruit; vegetables; fish; alcohol; meat and meat products; bread, pasta and rice | |||
PREDIMED score | Schröder et al., (2011) [8] Estruch et al., (2013) [34] | PREDIMED score | 0–14 |
14-componennts: olive oil; vegetables; fruit (including natural fruit juices); red meat and meat products; animal fats; sugar sweetened beverages; red wine; legumes; fish and shell fish; sweets and pastries; nuts; sofrito; white meat; olive oil as main culinary fat |
4. Review
4.1. The Mediterranean Diet Score (MDS)
4.2. The Dietary Score (DS)
4.3. The Mediterranean Adequacy Index (MAI)
4.4. A Priori Mediterranean Dietary Pattern
4.5. The (PREDIMED) Score
- ≥4 tablespoons of olive oil per day (including that used in frying, salads etc.) (1 tablespoon = 13.5 g
- ≥2 servings of vegetables per day (at least 1 portion raw or as salad) (1 serving = 200 g)
- ≥3 fruit units (including natural fruit juices) per day
- <1 serving of red meat or meat products (1 serving =100–150 g) per day
- <1 serving of animal fat per day (1 serving = 12 g)
- <1 cup of sugar-sweetened beverage per day (1 cup = 100 mL)
- ≥7 glasses of red wine per week
- ≥3 servings of legumes per week (1 serving = 150 g)
- ≥3 servings of fish or shellfish per week (1 serving: 100–150 g fish, or 4–5 units, 200 g shellfish)
- <3 commercial sweets or pastries per week (not homemade)
- ≥3 servings of nuts (including peanuts) per week
- ≥2 times per week of a dish with a traditional sauce of tomatoes, garlic, onion, or leeks sautéed in olive oil
- olive oil as main culinary fat
- preferential consumption of chicken, turkey, rabbit meat instead of veal, pork, hamburger or sausage
4.6. The Mediterranean-Style Dietary Pattern Score (MSDPS)
5. Critical Appraisal
5.1. Qualitative Score Divergences from Traditional Mediterranean Diet
5.2. Quantitative Score Divergences from Traditional Mediterranean Diet
6. Conclusions
Acknowledgment
Author Contributions
Conflicts of Interest
References
- Hu, F.B. Dietary pattern analysis: A new direction in nutritional epidemiology. Curr. Opin. Lipidol. 2002, 13, 3–9. [Google Scholar] [CrossRef] [PubMed]
- Kant, A.K. Dietary patterns and health outcomes. J. Am. Diet. Assoc. 2004, 104, 615–635. [Google Scholar] [CrossRef] [PubMed]
- Panagiotakos, D.B.; Pitsavos, C.; Stefanadis, C. Alpha priori and alpha-posterior dietary pattern analyses have similar estimating and discriminating ability in predicting 5-Y incidence of cardiovascular disease: Methodological issues in nutrition assessment. J. Food Sci. 2009, 74, H218–H224. [Google Scholar] [CrossRef] [PubMed]
- Trichopoulou, A.; Kouris-Blazos, A.; Wahlqvist, M.L.; Gnardellis, C.; Lagiou, P.; Polychronopoulos, E.; Vassilakou, T.; Lipworth, L.; Trichopoulos, D. Diet and overall survival in elderly people. BMJ 1995, 311, 1457–1460. [Google Scholar] [CrossRef] [PubMed]
- Pitsavos, C.; Panagiotakos, D.B.; Tzima, N.; Chrysohoou, C.; Economou, M.; Zampelas, A.; Stefanadis, C. Adherence to the Mediterranean diet is associated with total antioxidant capacity in healthy adults: The ATTICA study. Am. J. Clin. Nutr. 2005, 82, 694–699. [Google Scholar] [PubMed]
- Alberti-Fidanza, A.; Fidanza, F.; Chiuchiù, M.P.; Verducci, G.; Fruttini, D. Dietary studies on two rural Italian population groups of the Seven Countries Study. 3. Trend of food and nutrient intake from 1960 to 1991. Eur. J. Clin. Nutr. 1999, 53, 854–860. [Google Scholar] [CrossRef] [PubMed]
- Martínez-González, M.A.; Fernández-Jarne, E.; Serrano-Martínez, M.; Marti, A.; Martinez, J.A.; Martín-Moreno, J.M. Mediterranean diet and reduction in the risk of a first acute myocardial infarction: An operational healthy dietary score. Eur. J. Nutr. 2002, 41, 153–160. [Google Scholar] [CrossRef] [PubMed]
- Schröder, H.; Fitó, M.; Estruch, R.; Martínez-González, M.A.; Corella, D.; Salas-Salvadó, J.; Lamuela-Raventós, R.; Ros, E.; Salaverría, I.; Fiol, M.; et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J. Nutr. 2011, 141, 1140–1145. [Google Scholar] [CrossRef] [PubMed]
- Rumawas, M.E.; Dwyer, J.T.; McKeown, N.M.; Meigs, J.B.; Rogers, G.; Jacques, P.F. The development of the Mediterranean-style dietary pattern score and its application to the American diet in the Framingham Offspring Cohort. J. Nutr. 2009, 139, 1150–1156. [Google Scholar] [CrossRef] [PubMed]
- Bilenko, N.; Fraser, D.; Vardi, H.; Shai, I.; Shahar, D.R. Mediterranean diet and cardiovascular diseases in an Israeli population. Prev. Med. 2005, 40, 299–305. [Google Scholar] [CrossRef] [PubMed]
- Hoşcan, Y.; Yiğit, F.; Müderrisoğlu, H. Adherence to Mediterranean diet and its relation with cardiovascular diseases in Turkish population. Int. J. Clin. Exp. Med. 2015, 8, 2860–2866. [Google Scholar] [PubMed]
- Trichopoulou, A.; Costacou, T.; Bamia, C.; Trichopoulos, D. Adherence to a Mediterranean diet and survival in a Greek population. N. Engl. J. Med. 2003, 348, 2599–2608. [Google Scholar] [CrossRef] [PubMed]
- Dilis, V.; Katsoulis, M.; Lagiou, P.; Trichopoulos, D.; Naska, A.; Trichopoulou, A. Mediterranean diet and CHD: The Greek European Prospective Investigation into Cancer and Nutrition cohort. Br. J. Nutr. 2012, 108, 699–709. [Google Scholar] [CrossRef] [PubMed]
- Misirli, G.; Benetou, V.; Lagiou, P.; Bamia, C.; Trichopoulos, D.; Trichopoulou, A. Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. Am. J. Epidemiol. 2012, 176, 1185–1192. [Google Scholar] [CrossRef] [PubMed]
- Tsivgoulis, G.; Psaltopoulou, T.; Wadley, V.G.; Alexandrov, A.V.; Howard, G.; Unverzagt, F.W.; Moy, C.; Howard, V.J.; Kissela, B.; Judd, S.E. Adherence to a Mediterranean diet and prediction of incident stroke. Stroke 2015, 46, 780–785. [Google Scholar] [CrossRef] [PubMed]
- Martínez-González, M.A.; García-López, M.; Bes-Rastrollo, M.; Toledo, E.; Martínez-Lapiscina, E.H.; Delgado-Rodriguez, M.; Vazquez, Z.; Benito, S.; Beunza, J.J. Mediterranean diet and the incidence of cardiovascular disease: A Spanish cohort. Nutr. Metab. Cardiovasc. Dis. 2011, 21, 237–244. [Google Scholar] [PubMed]
- Gardener, H.; Wright, C.B.; Gu, Y.; Demmer, R.T.; Boden-Albala, B.; Elkind, M.S.; Sacco, R.L.; Scarmeas, N. Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: The Northern Manhattan Study. Am. J. Clin. Nutr. 2011, 94, 1458–1464. [Google Scholar] [CrossRef] [PubMed]
- Agnoli, C.; Krogh, V.; Grioni, S.; Sieri, S.; Palli, D.; Masala, G.; Sacerdote, C.; Vineis, P.; Tumino, R.; Frasca, G.; et al. A priori-defined dietary patterns are associated with reduced risk of stroke in a large Italian cohort. J. Nutr. 2011, 141, 1552–1558. [Google Scholar] [CrossRef] [PubMed]
- Turati, F.; Pelucchi, C.; Galeone, C.; Praud, D.; Tavani, A.; La Vecchia, C. Mediterranean diet and non-fatal acute myocardial infarction: A case-control study from Italy. Public Health Nutr. 2015, 18, 713–720. [Google Scholar] [CrossRef] [PubMed]
- Knoops, K.T.; de Groot, L.C.; Kromhout, D.; Perrin, A.E.; Moreiras-Varela, O.; Menotti, A.; van Staveren, W.A. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA 2004, 292, 1433–1439. [Google Scholar] [CrossRef] [PubMed]
- Fung, T.T.; Rexrode, K.M.; Mantzoros, C.S.; Manson, J.E.; Willett, W.C.; Hu, F.B. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 2009, 119, 1093–1100. [Google Scholar] [CrossRef] [PubMed]
- Mitrou, P.N.; Kipnis, V.; Thiébaut, A.C.; Reedy, J.; Subar, A.F.; Wirfält, E.; Flood, A.; Mouw, T.; Hollenbeck, A.R.; Leitzmann, M.F.; et al. Mediterranean dietary pattern and prediction of all-cause mortality in a US population: Results from the NIH-AARP Diet and Health Study. Arch. Intern. Med. 2007, 167, 2461–2468. [Google Scholar] [CrossRef] [PubMed]
- Buckland, G.; González, C.A.; Agudo, A.; Vilardell, M.; Berenguer, A.; Amiano, P.; Ardanaz, E.; Arriola, L.; Barricarte, A.; Basterretxea, M.; et al. Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study. Am. J. Epidemiol. 2009, 170, 1518–1529. [Google Scholar] [CrossRef] [PubMed]
- Hoevenaar-Blom, M.P.; Nooyens, A.C.; Kromhout, D.; Spijkerman, A.M.; Beulens, J.W.; van der Schouw, Y.T.; Bueno-de-Mesquita, B.; Verschuren, W.M. Mediterranean style diet and 12-year incidence of cardiovascular diseases: The EPIC-NL cohort study. PLoS ONE 2012, 7, e45458. [Google Scholar] [CrossRef] [PubMed]
- Sjögren, P.; Becker, W.; Warensjö, E.; Olsson, E.; Byberg, L.; Gustafsson, I.B.; Karlström, B.; Cederholm, T. Mediterranean and carbohydrate-restricted diets and mortality among elderly men: A cohort study in Sweden. Am. J. Clin. Nutr. 2010, 92, 967–974. [Google Scholar] [CrossRef] [PubMed]
- Tognon, G.; Nilsson, L.M.; Lissner, L.; Johansson, I.; Hallmans, G.; Lindahl, B.; Winkvist, A. The Mediterranean diet score and mortality are inversely associated in adults living in the subarctic region. J. Nutr. 2012, 142, 1547–1553. [Google Scholar] [CrossRef] [PubMed]
- Tognon, G.; Lissner, L.; Sæbye, D.; Walker, K.Z.; Heitmann, B.L. The Mediterranean diet in relation to mortality and CVD: A Danish cohort study. Br. J. Nutr. 2014, 111, 151–159. [Google Scholar] [CrossRef]
- Panagiotakos, D.B.; Georgousopoulou, E.N.; Pitsavos, C.; Chrysohoou, C.; Skoumas, I.; Pitaraki, E.; Georgiopoulos, G.A.; Ntertimani, M.; Christou, A.; Stefanadis, C. Exploring the path of Mediterranean diet on 10-year incidence of cardiovascular disease: The ATTICA study (2002–2012). Nutr. Metab. Cardiovasc. Dis. 2015, 25, 327–335. [Google Scholar] [CrossRef] [PubMed]
- Panagiotakos, D.B.; Pitsavos, C.; Stefanadis, C. Dietary patterns: A Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr. Metab. Cardiovasc. Dis. 2006, 16, 559–568. [Google Scholar] [CrossRef] [PubMed]
- Kastorini, C.M.; Milionis, H.J.; Ioannidi, A.; Kalantzi, K.; Nikolaou, V.; Vemmos, K.N.; Goudevenos, J.A.; Panagiotakos, D.B. Adherence to the Mediterranean diet in relation to acute coronary syndrome or stroke nonfatal events: A comparative analysis of a case/case-control study. Am. Heart J. 2011, 162, 717–724. [Google Scholar] [CrossRef] [PubMed]
- Kastorini, C.M.; Milionis, H.J.; Kantas, D.; Bika, E.; Nikolaou, V.; Vemmos, K.N.; Goudevenos, J.A.; Panagiotakos, D.B. Adherence to the mediterranean diet in relation to ischemic stroke nonfatal events in nonhypercholesterolemic and hypercholesterolemic participants: Results of a case/case–control study. Angiology 2012, 63, 509–515. [Google Scholar] [CrossRef] [PubMed]
- Fidanza, F.; Alberti, A.; Lanti, M.; Menotti, A. Mediterranean Adequacy Index: Correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr. Metab. Cardiovasc. Dis. 2004, 14, 254–258. [Google Scholar] [CrossRef]
- Menotti, A.; Alberti-Fidanza, A.; Fidanza, F. The association of the Mediterranean Adequacy Index with fatal coronary events in an Italian middle-aged male population followed for 40 years. Nutr. Metab. Cardiovasc. Dis. 2012, 22, 369–375. [Google Scholar] [CrossRef] [PubMed]
- Estruch, R.; Salas-Salvadó, J.; Corella, D.; Arós, F.; Gómez-Gracia, E.; Ruiz-Gutiérrez, V.; Fiol, M.; Lapetra, J.; Lamuela-Raventos, R.M.; Serra-Majem, L.; et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N. Engl. J. Med. 2013, 368, 1279–1290. [Google Scholar] [CrossRef] [PubMed]
- Trichopoulou, A.; Orfanos, P.; Norat, T.; Bueno-de-Mesquita, B.; Ocké, M.C.; Peeters, P.H.; van der Schouw, Y.T.; Boeing, H.; Hoffmann, K.; Boffetta, P.; et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ 2005, 330, 991–995. [Google Scholar] [CrossRef] [PubMed]
- Costacou, T.; Bamia, C.; Ferrari, P.; Riboli, E.; Trichopoulos, D.; Trichopoulou, A. Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population. Eur. J. Clin. Nutr. 2003, 57, 1378–1385. [Google Scholar] [CrossRef] [PubMed]
- Brand-Miller, J.; Dickinson, S.; Barclay, A.; Celermajer, D. The glycemic index and cardiovascular disease risk. Curr. Atheroscler. Rep. 2007, 9, 479–485. [Google Scholar] [CrossRef] [PubMed]
- Fung, T.T.; McCullough, M.L.; Newby, P.K.; Manson, J.E.; Meigs, J.B.; Rifai, N.; Willett, W.C.; Hu, F.B. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am. J. Clin. Nutr. 2005, 82, 163–173. [Google Scholar] [PubMed]
- Supreme Scientific Health Council, Ministry of Health and Welfare. Dietary guidelines for adults in Greece. Arch. Hell. Med. 1999, 16, 516–524. [Google Scholar]
- Menotti, A.; Kromhout, D.; Blackburn, H.; Fidanza, F.; Buzina, R.; Nissinen, A. Food intake patterns and 25-year mortality from coronary heart disease: Cross-cultural correlations in the Seven Countries Study. Eur. J. Epidemiol. 1999, 15, 507–515. [Google Scholar] [CrossRef] [PubMed]
- Keys, A.; Menotti, A.; Karvonen, M.J.; Aravanis, C.; Blackburn, H.; Buzina, R.; Djordjevic, B.S.; Dontas, A.S.; Fidanza, F.; Keys, M.H.; et al. The diet and 15-year death rate in the seven countries study. Am. J. Epidemiol. 1986, 124, 903–915. [Google Scholar] [PubMed]
- Fidanza, F.; Alberti, A.; Fruttini, D. The Nicotera diet: The reference Italian Mediterranean diet. World Rev. Nutr. Diet. 2005, 95, 115–121. [Google Scholar] [PubMed]
- Istituto Nazionale Per la Dieta Mediterranea e la Nutrigenomica (I.N.Di.M.); Barbalace, P. Pietanze di un Tempo. Saperi e Sapori Della Cucina Nicoterese. Available online: http://www.indim.it/Documenti/Capitolo-I-II.pdf (accessed on 11 February 2013).
- Cresta, M.; Ledermann, S.; Garnier, A.; Lombardo, E.; Lacourly, G. Etude des Consommations Alimentaires des Populations de Onze Regions de la Communaute Europeenne en vue de la Determination des Niveaux de Contamination Radioactive. Rapport Établi au Centre d’Etude Nucléaire de Fontenay-Aux-Roses-France; EURATOM: Bruxelles, Belgium, 1969; pp. 1–589. [Google Scholar]
- Ferro-Luzzi, A.; Sette, S. The Mediterranean Diet: An attempt to define its present and past composition. Eur. J. Clin. Nutr. 1989, 43 (Suppl. S2), 13–29. [Google Scholar] [PubMed]
- Morris, J.N.; Marr, J.W.; Clayton, D.G. Diet and heart: A postscript. BMJ 1977, 2, 1307–1314. [Google Scholar] [CrossRef] [PubMed]
- Fardet, A.; Boirie, Y. Associations between food and beverage groups and major diet-related chronic diseases: An exhaustive review of pooled/meta-analyses and systematic reviews. Nutr. Rev. 2014, 72, 741–762. [Google Scholar] [CrossRef] [PubMed]
- Fung, T.T.; Hu, F.B.; Pereira, M.A.; Liu, S.; Stampfer, M.J.; Colditz, G.A.; Willett, W.C. Whole-grain intake and the risk of type 2 diabetes: A prospective study in men. Am. J. Clin. Nutr. 2002, 76, 535–540. [Google Scholar] [PubMed]
- Murtaugh, M.A.; Jacobs, D.R., Jr.; Jacob, B.; Steffen, L.M.; Marquart, L. Epidemiological support for the protection of whole grains against diabetes. Proc. Nutr. Soc. 2003, 62, 143–149. [Google Scholar] [CrossRef] [PubMed]
- Montonen, J.; Knekt, P.; Järvinen, R.; Aromaa, A.; Reunanen, A. Whole-grain and fiber intake and the incidence of type 2 diabetes. Am. J. Clin. Nutr. 2003, 77, 622–629. [Google Scholar] [PubMed]
- De Munter, J.S.; Hu, F.B.; Spiegelman, D.; Franz, M.; van Dam, R.M. Whole grain, bran, and germ intake and risk of type 2 diabetes: A prospective cohort study and systematic review. PLoS Med. 2007, 4, e261. [Google Scholar] [CrossRef] [PubMed]
- Ye, E.Q.; Chacko, S.A.; Chou, E.L.; Kugizaki, M.; Liu, S. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J. Nutr. 2012, 142, 1304–1313. [Google Scholar] [CrossRef] [PubMed]
- Aune, D.; Norat, T.; Romundstad, P.; Vatten, L.J. Whole grain and refined grain consumption and the risk of type 2 diabetes: A systematic review and dose-response meta-analysis of cohort studies. Eur. J. Epidemiol. 2013, 28, 845–858. [Google Scholar] [CrossRef] [PubMed]
- Newby, P.K.; Maras, J.; Bakun, P.; Muller, D.; Ferrucci, L.; Tucker, K.L. Intake of whole grains, refined grains, and cereal fiber measured with 7-d diet records and associations with risk factors for chronic disease. Am. J. Clin. Nutr. 2007, 86, 1745–1753. [Google Scholar] [PubMed]
- Giacco, R.; Clemente, G.; Cipriano, D.; Luongo, D.; Viscovo, D.; Patti, L.; di Marino, L.; Giacco, A.; Naviglio, D.; Bianchi, M.A.; et al. Effects of the regular consumption of wholemeal wheat foods on cardiovascular risk factors in healthy people. Nutr. Metab. Cardiovasc. Dis. 2010, 20, 186–194. [Google Scholar] [CrossRef] [PubMed]
- Wang, L.; Gaziano, J.M.; Liu, S.; Manson, J.E.; Buring, J.E.; Sesso, H.D. Whole- and refined-grain intakes and the risk of hypertension in women. Am. J. Clin. Nutr. 2007, 86, 472–479. [Google Scholar] [PubMed]
- Flint, A.J.; Hu, F.B.; Glynn, R.J.; Jensen, M.K.; Franz, M.; Sampson, L.; Rimm, E.B. Whole grains and incident hypertension in men. Am. J. Clin. Nutr. 2009, 90, 493–498. [Google Scholar] [CrossRef] [PubMed]
- Tighe, P.; Duthie, G.; Vaughan, N.; Brittenden, J.; Simpson, W.G.; Duthie, S.; Mutch, W.; Wahle, K.; Horgan, G.; Thies, F. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: A randomized controlled trial. Am. J. Clin. Nutr. 2010, 92, 733–740. [Google Scholar] [CrossRef] [PubMed]
- Esposito, K.; Giugliano, D. Whole-grain intake cools down inflammation. Am. J. Clin. Nutr. 2006, 83, 1440–1441. [Google Scholar] [PubMed]
- Montonen, J.; Boeing, H.; Fritsche, A.; Schleicher, E.; Joost, H.G.; Schulze, M.B.; Steffen, A.; Pischon, T. Consumption of red meat and whole-grain bread in relation to biomarkers of obesity, inflammation, glucose metabolism and oxidative stress. Eur. J. Nutr. 2013, 52, 337–345. [Google Scholar] [CrossRef] [PubMed]
- Liu, S.; Willett, W.C.; Manson, J.E.; Hu, F.B.; Rosner, B.; Colditz, G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am. J. Clin. Nutr. 2003, 78, 920–927. [Google Scholar] [PubMed]
- Harland, J.I.; Garton, L.E. Whole-grain intake as a marker of healthy body weight and adiposity. Public Health Nutr. 2008, 11, 554–563. [Google Scholar] [CrossRef] [PubMed]
- Good, C.K.; Holschuh, N.; Albertson, A.M.; Eldridge, A.L. Whole grain consumption and body mass index in adult women: An analysis of NHANES 1999–2000 and the USDA pyramid servings database. J. Am. Coll. Nutr. 2008, 27, 80–87. [Google Scholar] [CrossRef] [PubMed]
- O’Neil, C.E.; Zanovec, M.; Cho, S.S.; Nicklas, T.A. Whole grain and fiber consumption are associated with lower body weight measures in US adults: National Health and Nutrition Examination Survey 1999–2004. Nutr. Res. 2010, 30, 815–822. [Google Scholar] [CrossRef] [PubMed]
- Huang, T.; Xu, M.; Lee, A.; Cho, S.; Qi, L. Consumption of whole grains and cereal fiber and total and cause-specific mortality: Prospective analysis of 367,442 individuals. BMC Med. 2015, 13, 59. [Google Scholar] [CrossRef] [PubMed]
- Williams, P.G. Evaluation of the evidence between consumption of refined grains and health outcomes. Nutr. Rev. 2012, 70, 80–99. [Google Scholar] [CrossRef] [PubMed]
- Waijers, P.M.; Feskens, E.J.; Ocké, M.C. A critical review of predefined diet quality scores. Br. J. Nutr. 2007, 97, 219–231. [Google Scholar] [CrossRef] [PubMed]
- Visioli, F.; Galli, C. The effect of minor constituents of olive oil on cardiovascular disease: New findings. Nutr. Rev. 1998, 56, 142–147. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.L.; Sumpio, B.E. Olive oil, the mediterranean diet, and cardiovascular health. J. Am. Coll. Surg. 2008, 207, 407–416. [Google Scholar] [CrossRef] [PubMed]
- Covas, M.I.; Konstantinidou, V.; Fitó, M. Olive oil and cardiovascular health. J. Cardiovasc. Pharmacol. 2009, 54, 477–482. [Google Scholar] [CrossRef] [PubMed]
- Degirolamo, C.; Rudel, L.L. Dietary monounsaturated fatty acids appear not to provide cardioprotection. Curr. Atheroscler. Rep. 2010, 12, 391–396. [Google Scholar] [CrossRef] [PubMed]
- Banca Dati di Composizione Degli Alimenti Per Gli Studi Epidemiologici in Italia. Available online: http://www.ieo.it/bda (accessed on 9 April 2015).
- Schwingshackl, L.; Hoffmann, G. Monounsaturated fatty acids, olive oil and health status: A systematic review and meta-analysis of cohort studies. Lipids Health Dis. 2014, 13, 154. [Google Scholar] [CrossRef] [PubMed]
- Grønbaek, M. Alcohol, type of alcohol, and all-cause and coronary heart disease mortality. Ann. N. Y. Acad. Sci. 2002, 957, 16–20. [Google Scholar] [CrossRef] [PubMed]
- Arranz, S.; Chiva-Blanch, G.; Valderas-Martínez, P.; Medina-Remón, A.; Lamuela-Raventós, R.M.; Estruch, R. Wine, beer, alcohol and polyphenols on cardiovascular disease and cancer. Nutrients 2012, 4, 759–781. [Google Scholar] [CrossRef] [PubMed]
- Chiva-Blanch, G.; Arranz, S.; Lamuela-Raventos, R.M.; Estruch, R. Effects of wine, alcohol and polyphenols on cardiovascular disease risk factors: Evidences from human studies. Alcohol Alcohol. 2013, 48, 270–277. [Google Scholar] [CrossRef] [PubMed]
- Hu, F.B. Plant-based foods and prevention of cardiovascular disease: An overview. Am. J. Clin. Nutr. 2003, 78, S544–S551. [Google Scholar]
- Mozaffarian, D.; Appel, L.J.; van Horn, L. Components of a cardioprotective diet: New insights. Circulation 2011, 123, 2870–2891. [Google Scholar] [CrossRef] [PubMed]
- Kourlaba, G.; Panagiotakos, D.B. Dietary quality indices and human health: A review. Maturitas 2009, 62, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Kourlaba, G.; Panagiotakos, D. The diagnostic accuracy of a composite index increases as the number of partitions of the components increases and when specific weights are assigned to each component. J. Appl. Stat. 2010, 37, 537–554. [Google Scholar] [CrossRef]
- Arvaniti, F.; Panagiotakos, D.B. Healthy indexes in public health practice and research: A review. Crit. Rev. Food. Sci. Nutr. 2008, 48, 317–327. [Google Scholar] [CrossRef] [PubMed]
- Panagiotakos, D. Health measurement scales: Methodological issues. Open Cardiovasc. Med. J. 2009, 3, 160–165. [Google Scholar] [CrossRef] [PubMed]
- Sofi, F.; Abbate, R.; Gensini, G.F.; Casini, A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: An updated systematic review and meta-analysis. Am. J. Clin. Nutr. 2010, 92, 1189–1196. [Google Scholar] [CrossRef] [PubMed]
- Sofi, F.; Macchi, C.; Abbate, R.; Gensini, G.F.; Casini, A. Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr. 2014, 17, 2769–2782. [Google Scholar] [CrossRef] [PubMed]
- Hoevenaar-Blom, M.P.; Spijkerman, A.M.; Boshuizen, H.C.; Boer, J.M.; Kromhout, D.; Verschuren, W.M. Effect of using repeated measurements of a Mediterranean style diet on the strength of the association with cardiovascular disease during 12 years: The Doetinchem Cohort Study. Eur. J. Nutr. 2014, 53, 1209–1215. [Google Scholar] [CrossRef] [PubMed]
- Hoffman, R.; Gerber, M. Evaluating and adapting the Mediterranean diet for non-Mediterranean populations: A critical appraisal. Nutr. Rev. 2013, 71, 573–584. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- West, S.G.; Skulas-Ray, A.C. Spices and herbs may improve cardiovascular risk factors. Nutr. Today 2014, 49, S8–S9. [Google Scholar] [CrossRef]
- D’Alessandro, A.; De Pergola, G. Mediterranean Diet Pyramid: A Proposal for Italian People. Nutrients 2014, 6, 4302–4316. [Google Scholar] [CrossRef] [PubMed]
© 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
D'Alessandro, A.; De Pergola, G. Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes. Nutrients 2015, 7, 7863-7888. https://doi.org/10.3390/nu7095367
D'Alessandro A, De Pergola G. Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes. Nutrients. 2015; 7(9):7863-7888. https://doi.org/10.3390/nu7095367
Chicago/Turabian StyleD'Alessandro, Annunziata, and Giovanni De Pergola. 2015. "Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes" Nutrients 7, no. 9: 7863-7888. https://doi.org/10.3390/nu7095367
APA StyleD'Alessandro, A., & De Pergola, G. (2015). Mediterranean Diet and Cardiovascular Disease: A Critical Evaluation of A Priori Dietary Indexes. Nutrients, 7(9), 7863-7888. https://doi.org/10.3390/nu7095367