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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.

Citation

Mamas. (2023). Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis. Heart, https://doi.org/10.1136/heartjnl-2022-321930

Acceptance Date Feb 2, 2023
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