Mamas Mamas m.mamas@keele.ac.uk
Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis.
Mamas
Authors
Abstract
BACKGROUND: Dietary modification is a cornerstone of cardiovascular disease (CVD) prevention. A Mediterranean diet has been associated with a lower risk of CVD but no systematic reviews have evaluated this relationship specifically in women. OBJECTIVE: To determine the association between higher versus lower adherence to a Mediterranean diet and incident CVD and total mortality in women. METHODS: A systematic search of Medline, Embase, CINAHL, Scopus, and Web of Science (2003-21) was performed. Randomised controlled trials and prospective cohort studies with participants without previous CVD were included. Studies were eligible if they reported a Mediterranean diet score and comprised either all female participants or stratified outcomes by sex. The primary outcome was CVD and/or total mortality. A random effects meta-analysis was conducted to calculate pooled hazard ratios (HRs) and confidence intervals (CIs). RESULTS: Sixteen prospective cohort studies were included in the meta-analysis (n=7 22?495 female participants). In women, higher adherence to a Mediterranean diet was associated with a lower CVD incidence (HR 0.76, 95% CI 0.72 to 0.81; I2=39%, p test for heterogeneity=0.07), total mortality (HR 0.77, 95% CI 0.74 to 0.80; I2=21%, p test for heterogeneity=0.28), and coronary heart disease (HR 0.75, 95% CI 0.65 to 0.87; I2=21%, p test for heterogeneity=0.28). Stroke incidence was lower in women with higher Mediterranean diet adherence (HR 0.87, 95% CI 0.76 to 1.01; I2=0%, p test for heterogeneity=0.89), but this result was not statistically significant. CONCLUSION: This study supports a beneficial effect of the Mediterranean diet on primary prevention of CVD and death in women, and is an important step in enabling sex specific guidelines.
Acceptance Date | Feb 2, 2023 |
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Publication Date | Mar 14, 2023 |
Journal | Heart |
Print ISSN | 1355-6037 |
Publisher | BMJ Publishing Group |
DOI | https://doi.org/10.1136/heartjnl-2022-321930 |
Publisher URL | https://heart.bmj.com/content/early/2023/02/14/heartjnl-2022-321930 |
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