Bibliographic review: The Mediterranean Diet works outside the Mediterranean


A new study has demonstrated the utility of the Mediterranean diet in the primary prevention of cardiovascular disease in the United Kingdom.


Tammy Y. N. Tong, Nicholas J. Wareham, Kay-Tee Khaw, et al. “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 Medicine201614:135 DOI: 10.1186/s12916-016-0677-4

The risk of developing cardiovascular disease is between 5% and 15% lower in healthy individuals with a light Mediterranean diet than in individuals whose adherence to the diet is less committed. The interesting element in the study is that it was carried out by researchers from the Department of Medicine at the University of Cambridge in the UK and the population sample is British and not from the Mediterranean basin. The researchers estimated that if the British were prepared to adhere to a good Mediterranean diet, new cases involving cardiovascular disease would be reduced by 4% and deaths from this cause would be reduced by 12.5%. The NICE (National Institute for Health and Care Excellence) recommends the Mediterranean diet for the secondary prevention of cardiovascular disease (the already ill), but until this study the effects were not known as a means of primary prevention (healthy patients).

The researchers analyzed the nutritional questionnaires of 23,902 healthy English people at two distinct times: first between 1993 and 1997, and later between 1998 and 2000, with an average follow-up of 12.2 years. In order to quantify the degree of adherence to the Mediterranean diet, the researchers used the MDS points system (Mediterranean Diet Score) promoted by the Foundation for the Mediterranean Diet, as well as other three point scales of measurement. 7,606 people had cardiovascular events where the result did or did not end in death, 5,660 people died during the study and 1,714 of them were due to cardiovascular causes. When cross-referencing the data from the adherence questionnaire concerning the Mediterranean diet with the incidence of cardiovascular events and cases where death was confirmed it was found that in those people with a good level of adherence to the Mediterranean diet, a reduction of 5% was observed at the time the cardiovascular disease presented; a reduction of 9% in mortality due to cardiovascular causes; and a 6% reduction in the onset of angina or infarction; and a reduction of 5% in all causes of mortality. Furthermore, the higher the level of adherence to the diet, the greater the reduction in risk. In conclusion, the authors confirmed that the Mediterranean diet – rich in fruits, vegetables, legumes, cereals, olive oil and low in red meats-, should be used in the primary prevention of cardiovascular disease in the UK and, therefore, outside the Mediterranean area.

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