By TAP Integrative

The Mediterranean diet refers to the traditional diet of the Mediterranean region. The diet relies heavily on fruits, vegetables, legumes, olive oil and whole grains with modest amounts of fermented dairy, fish, poultry and wine.

Data from 2 randomized, controlled trials support the role of the Mediterranean diet in both primary prevention (the PREDIMED trial in Spain) and secondary prevention (the Lyon Diet Heart Study in France) of cardiovascular disease (CVD). In addition, a recent study conducted in 215,782 US multiethnic adults (the Dietary Patterns Methods Project) reported that adherence to the Mediterranean diet was associated with significantly lower cardiovascular mortality. Studies conducted in Mediterranean cohorts repeatedly demonstrate cardiovascular benefits of the diet, but studies conducted in non-Mediterranean populations have produced less consistent results.

To assess the association between the Mediterranean diet and CVD in the United Kingdom, Tong and colleagues evaluated data from the EPIC-Norfolk study. In this prospective study, 23,902 participants were followed for an average of 12-17 years. Dietary patterns were assessed at baseline and during follow up using food frequency questionnaires. Dietary patterns were scored for adherence to the Mediterranean diet pyramid and the literature-based Mediterranean diet. The primary outcome was incident CVD, and secondary outcomes were CVD mortality and all-cause mortality.

A total of 7,606 participants developed primary incident CVD, and 5,660 died during the follow-up period. Greater adherence to the Mediterranean diet was significantly associated with lower incidence of CVD and all-cause mortality. In this cohort, low adherence to the Mediterranean diet was estimated to account for 3.9% of total CVD incidence, equating to 9.7 preventable cases per 1,000 people over 10 years. In addition, low adherence to the Mediterranean diet accounted for an estimated 8.5% of ischemic heart disease or stroke incidence and 12.5% of CVD mortality.

The authors of the study conclude that the Mediterranean diet may contribute to the overall strategy for the primary prevention of CVD in a non-Mediterranean population.


Tong TY, Wareham NJ, Khaw KT, Imamura F, Forouhi NG. Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC-Norfolk study. BMC Med. 2016;14(1):135.


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