title: Adherence to Mediterranean diet and health status: meta-analysis.
abstract: OBJECTIVE
  To systematically review all the prospective cohort studies that have analysed the relation between adherence to a Mediterranean diet, mortality, and incidence of chronic diseases in a primary prevention setting.
  
  
  METHODS
  Meta-analysis of prospective cohort studies.
  
  
  METHODS
  English and non-English publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials from 1966 to 30 June 2008. Studies reviewed Studies that analysed prospectively the association between adherence to a Mediterranean diet, mortality, and incidence of diseases; 12 studies, with a total of 1 574,299 subjects followed for a time ranging from three to 18 years were included.
  
  
  RESULTS
  The cumulative analysis among eight cohorts (514,816 subjects and 33,576 deaths) evaluating overall mortality in relation to adherence to a Mediterranean diet showed that a two point increase in the adherence score was significantly associated with a reduced risk of mortality (pooled relative risk 0.91, 95% confidence interval 0.89 to 0.94). Likewise, the analyses showed a beneficial role for greater adherence to a Mediterranean diet on cardiovascular mortality (pooled relative risk 0.91, 0.87 to 0.95), incidence of or mortality from cancer (0.94, 0.92 to 0.96), and incidence of Parkinson's disease and Alzheimer's disease (0.87, 0.80 to 0.96).
  
  
  CONCLUSIONS
  Greater adherence to a Mediterranean diet is associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson's disease and Alzheimer's disease (13%). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of major chronic diseases.
authors.affiliation: Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. francescosofi@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Sofi
authors.forename: Francesca
authors.initials: F
authors.lastname: Cesari
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Casini
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D002908:Chronic Disease; D015331:Cohort Studies; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D019636:Neurodegenerative Diseases / Q000401:mortality*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D018570:Risk Assessment; D040242:Risk Reduction Behavior
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