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European Journal of Nutrition

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01-02-2019 | Original Contribution

Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies

Authors: Valentina Rosato, Norman J. Temple, Carlo La Vecchia, Giorgio Castellan, Alessandra Tavani, Valentina Guercio

Published in: European Journal of Nutrition | Issue 1/2019

Abstract

Purpose

To provide evidence of the relationship of Mediterranean diet (MD) on incidence/mortality for cardiovascular disease (CVD), coronary/ischemic heart disease (CHD)/acute myocardial infarction (AMI) and stroke (ischemic/hemorrhagic) by sex, geographic region, study design and type of MD score (MDS).

Methods

We performed a systematic review and meta-analysis of observational studies. Pooled relative risks (RRs) were calculated using random-effects models.

Results

We identified 29 articles. The RR for the highest versus the lowest category of the MDS was 0.81 (95% CI 0.74–0.88) for the 11 studies that considered unspecified CVD, consistent across all strata. The corresponding pooled RR for CHD/AMI risk was 0.70 (95% CI 0.62–0.80), based on 11 studies. The inverse relationship was consistent across strata of study design, end point (incidence and mortality), sex, geographic area, and the MDS used. The overall RR for the six studies that considered unspecified stroke was 0.73 (95% CI 0.59–0.91) for the highest versus the lowest category of the MDS. The corresponding values were 0.82 (95% CI 0.73–0.92) for ischemic (five studies) and 1.01 (95% CI 0.74–1.37) for hemorrhagic stroke (four studies).

Conclusions

Our findings indicate and further quantify that MD exerts a protective effect on the risk of CVD. This inverse association includes CHD and ischemic stroke, but apparently not hemorrhagic stroke.

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Title: Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies
Authors: Valentina Rosato
Norman J. Temple
Carlo La Vecchia
Giorgio Castellan
Alessandra Tavani
Valentina Guercio
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 1/2019
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-017-1582-0

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