November 21, 2023
3 min read
- Adults had a lower risk for CVD if they ate more foods associated with a Mediterranean diet.
- Women derived greater benefits from a Mediterranean diet compared with men.
Adults who eat more foods associated with a Mediterranean diet have lower blood pressure, BMI and reduced cardiovascular risk, according to study findings published in Nutrition, Metabolism & Cardiovascular Diseases.
“Our data support the notion that the consumption of a Mediterranean diet may be beneficial for CV health, including in non-Mediterranean settings such as the U.K.,” Sarah Gregory, PhD, a postdoctoral research fellow in the Edinburgh Dementia Prevention program at University of Edinburgh in the U.K., and colleagues wrote. “They also highlight potential sex-based differences in associations between Mediterranean diet adherence and CV health, which may have implications for the development of personalized nutritional recommendations.”
Researchers collected data from 533 adults aged 40 to 59 years from the U.K. and Ireland who were free of dementia at baseline and participated in the PREVENT dementia program (mean age, 51.25 years; 60% women). Adults self-reported food consumption through the Scottish Collaborative Group Food Frequency Questionnaire. The Mediterranean Diet Adherence Screener (MEDAS) score, the MEDAS continuous score and the Pyramid score were calculated to measure each participant’s adherence to a Mediterranean diet. Systolic BP, diastolic BP, heart rate, waist-to-hip ratio, fasted glycemia, triglycerides, HDL and LDL cholesterol were collected. Height and weight were used to calculate a BMI score for each participant. The Framingham Risk Score (FRS) and QRisk3 score were calculated to assess CV risk for each participant.
Across all three scoring systems, women had better adherence to a Mediterranean diet than men. Women also had lower BP, BMI and waist-to-hip ratio than men. Among participants with blood results available, women had lower triglycerides, higher HDL cholesterol, a lower FRS and a lower QRisk3 score than men.
Mediterranean diet improves CV health
In a fully adjusted model, adults had a lower systolic BP, diastolic BP, BMI, FRS and QRisk3 score with each 1-point increase in adherence to a Mediterranean diet with all three scoring systems. The largest effect was with BP, where each 1-point increase in the Pyramid scoring system was associated with a 1.85 mm Hg decrease in systolic BP and a 1.23 mm Hg decrease in diastolic BP (P < .001 for both). A 1-point increase in all three scoring systems was associated with an approximately 0.5-point decrease in BMI score. Each 1-point increase in Mediterranean diet as measured by the Pyramid system was associated with a 1.07-point reduction in FRS (P < .001) and a 0.45-point decrease in QRisk3 score (P = .0002). Each 1-point increase in the Pyramid score was also associated with lower waist-to-hip ratio (beta = –0.01; P = .003) and lower fasted glycemia levels (beta = –0.09; P = .01).
In sex-stratified analysis, women who had better adherence to a Mediterranean diet had lower systolic BP, diastolic BP, fasted glycemia and BMI. Men with better Mediterranean diet adherence also had a lower BMI, though the effect size was smaller compared with women. An association between a better Mediterranean diet adherence and a lower FRS was observed among women, but not men.
Olive oil, nuts linked to CV benefits
In an exploratory analysis of specific food types, consuming olive oil, drinking less than one carbonated or sweet drink per day and eating at least three portions of nuts per week were associated with lower BP and lower BMI. Adults who ate two or more portions of vegetables per day had a higher BMI, whereas those who ate three or more portions of fruit per day had a lower BMI.
“Fruit consumption has been widely associated with CV health, although the evidence generally also supports vegetable consumption and this anomaly in our dataset is not possible to explain,” the researchers wrote. “It is possible that those with higher BMIs had actually adopted healthier eating habits to modify their weight, although it is impossible to confirm this in the context of a cross-sectional analysis.”
Olive oil was associated with lower fasted glycemia, and a lower FRS. Drinking at least seven portions of wine and eating at least three portions of legumes per week were linked to higher HDL cholesterol. Nuts were associated with a lower FRS, and olive oil, nuts and dairy were associated with lower QRisk3 scores.
The researchers said future studies should further examine sex-stratified associations between Mediterranean diet adherence and CV health outcomes as well as study associations with other eating patterns.
Gregory reports receiving funding through an MRC UK Nutrition Research Partnership Collaboration Award. Please see the study for all other authors’ relevant financial disclosures.
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