Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study.
No known cohort study has investigated whether the Mediterranean diet can reduce incident coronary heart disease (CHD) events in a Mediterranean population. This study examined the relation between Mediterranean diet adherence and risk of incident CHD events in the 5 Spanish centers of the European Prospective Investigation into Cancer and Nutrition. Analysis included 41,078 participants aged 29-69 years, recruited in 1992-1996 and followed up until December 2004 (mean follow-up:10.4 years). Confirmed incident fatal and nonfatal CHD events were analyzed according to Mediterranean diet adherence, measured by using an 18-unit relative Mediterranean diet score. A total of 609 participants (79% male) had a fatal or nonfatal confirmed acute myocardial infarction (n = 468) or unstable angina requiring revascularization (n = 141). After stratification by center and age and adjustment for recognized CHD risk factors, high compared with low relative Mediterranean diet score was associated with a significant reduction in CHD risk (hazard ratio = 0.60, 95% confidence interval: 0.47, 0.77). A 1-unit increase in relative Mediterranean diet score was associated with a 6% reduced risk of CHD (95% confidence interval: 0.91, 0.97), with similar risk reductions by sex. Mediterranean diet adherence was associated with a significantly reduced CHD risk in this Mediterranean country, supporting its role in primary prevention of CHD in healthy populations.
Buckland
Genevieve
G
Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain.
González
Carlos A
CA
Agudo
Antonio
A
Vilardell
Mireia
M
Berenguer
Antoni
A
Amiano
Pilar
P
Ardanaz
Eva
E
Arriola
Larraitz
L
Barricarte
Aurelio
A
Basterretxea
Mikel
M
Chirlaque
María Dolores
MD
Cirera
Lluís
L
Dorronsoro
Miren
M
Egües
Nerea
N
Huerta
José María
JM
Larrañaga
Nerea
N
Marin
Pilar
P
Martínez
Carmen
C
Molina
Esther
E
Navarro
Carmen
C
Quirós
José Ramón
JR
Rodriguez
Laudina
L
Sanchez
María-José
MJ
Tormo
María-José
MJ
Moreno-Iribas
Conchi
C
D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D003327:Coronary Disease / Q000453:epidemiology*; D038441:Diet, Mediterranean; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology