title: Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study.
abstract: 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.
authors.affiliation: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Buckland
authors.forename: Carlos A
authors.initials: CA
authors.lastname: González
authors.forename: Antonio
authors.initials: A
authors.lastname: Agudo
authors.forename: Mireia
authors.initials: M
authors.lastname: Vilardell
authors.forename: Antoni
authors.initials: A
authors.lastname: Berenguer
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.forename: Larraitz
authors.initials: L
authors.lastname: Arriola
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Mikel
authors.initials: M
authors.lastname: Basterretxea
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Chirlaque
authors.forename: Lluís
authors.initials: L
authors.lastname: Cirera
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Nerea
authors.initials: N
authors.lastname: Egües
authors.forename: José María
authors.initials: JM
authors.lastname: Huerta
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
authors.forename: Pilar
authors.initials: P
authors.lastname: Marin
authors.forename: Carmen
authors.initials: C
authors.lastname: Martínez
authors.forename: Esther
authors.initials: E
authors.lastname: Molina
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Quirós
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodriguez
authors.forename: María-José
authors.initials: MJ
authors.lastname: Sanchez
authors.forename: María-José
authors.initials: MJ
authors.lastname: Tormo
authors.forename: Conchi
authors.initials: C
authors.lastname: Moreno-Iribas
mesh_terms: 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