title: Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis.
abstract: BACKGROUND
  The Mediterranean diet has long been reported to be protective against the occurrence of several different health outcomes.
  
  
  OBJECTIVE
  We aimed to update our previous meta-analysis of published cohort prospective studies that investigated the effects of adherence to the Mediterranean diet on health status.
  
  
  METHODS
  We conducted a comprehensive literature search through electronic databases up to June 2010.
  
  
  RESULTS
  The updated review process showed 7 prospective studies published in the past 2 y that were not included in the previous meta-analysis (1 study for overall mortality, 3 studies for cardiovascular incidence or mortality, 1 study for cancer incidence or mortality, and 2 studies for neurodegenerative diseases). These recent studies included 2 health outcomes not previously investigated (ie, mild cognitive impairment and stroke). The meta-analysis for all studies with a random-effects model that was conducted after the inclusion of these recent studies showed that a 2-point increase in adherence to the Mediterranean diet was associated with a significant reduction of overall mortality [relative risk (RR) = 0.92; 95% CI: 0.90, 0.94], cardiovascular incidence or mortality (RR = 0.90; 95% CI: 0.87, 0.93), cancer incidence or mortality (RR = 0.94; 95% CI: 0.92, 0.96), and neurodegenerative diseases (RR = 0.87; 95% CI: 0.81, 0.94). The meta-regression analysis showed that sample size was the most significant contributor to the model because it significantly influenced the estimate of the association for overall mortality.
  
  
  CONCLUSIONS
  This updated meta-analysis confirms, in a larger number of subjects and studies, the significant and consistent protection provided by adherence to the Mediterranean diet in relation to the occurrence of major chronic degenerative diseases.
authors.affiliation: Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Florence, Italy. francescosofi@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Sofi
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 / Q000517:prevention & control; D002908:Chronic Disease / Q000517:prevention & control*; D003072:Cognition Disorders / Q000401:mortality / Q000517:prevention & control; D038441:Diet, Mediterranean; D006262:Health; D006801:Humans; D009369:Neoplasms / Q000401:mortality / Q000517:prevention & control; D019636:Neurodegenerative Diseases / Q000401:mortality / Q000517:prevention & control; D011446:Prospective Studies; D020521:Stroke / Q000401:mortality / Q000517:prevention & control