title: Adherence to a Mediterranean diet is associated with reduced risk of heart failure in men.
abstract: OBJECTIVE
  We examined the hypothesis that high adherence to a Mediterranean diet reduces the risk of developing heart failure (HF) as well as the risk of death from HF.
  
  
  RESULTS
  The study population comprised 37 308 men from the Cohort of Swedish Men who were free from cardiovascular disease at baseline. The modified Mediterranean diet (mMED) score was created from a self-administered food frequency questionnaire, based on consumption of presumed beneficial/detrimental foods, on a 0-8 scale. Incident HF events were ascertained by linkage to the Swedish National Patient and the Cause of Death Registers. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models. We identified 146 deaths from HF and 1269 incident HF events over a median follow-up of 10.9 years (1998-2008). The mMED score was inversely associated with risk of HF (multivariable RR for the highest vs. lowest quartile 0.69, 95% CI 0.57, 0.83); the corresponding RR of HF mortality was 0.55 (95% CI 0.31, 0.98). The multivariable RR for every two-point increment in the mMED score was 0.85 (95% CI 0.78, 0.91) for incidence of HF and 0.78 (95% CI 0.62, 0.98) for mortality from HF, respectively.
  
  
  CONCLUSIONS
  High adherence to a Mediterranean diet was associated with a lower risk of HF and mortality from HF in men. Further studies are needed to replicate these findings in other populations.
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine (IMM), Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden.
authors.forename: Thanasis G
authors.initials: TG
authors.lastname: Tektonidis
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine (IMM), Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Åkesson
authors.affiliation: Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden.|Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden.
authors.forename: Bruna
authors.initials: B
authors.lastname: Gigante
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine (IMM), Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: Unit of Nutritional Epidemiology, Institute of Environmental Medicine (IMM), Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77, Stockholm, Sweden.
authors.forename: Susanna C
authors.initials: SC
authors.lastname: Larsson
mesh_terms: D000368:Aged; D038441:Diet, Mediterranean; D006333:Heart Failure / Q000401:mortality* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012042:Registries; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013548:Sweden / Q000453:epidemiology
keywords: Heart failure; Mediterranean diet; Men; Primary prevention; Prospective studies