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PLoS One. 2016 Aug 10;11(8):e0159252. doi: 10.1371/journal.pone.0159252. eCollection 2016.

Effects of the Mediterranean Diet on Cardiovascular Outcomes-A Systematic Review and Meta-Analysis.

Author information

1
The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
2
Armadale Kelmscott Memorial Hospital, South Metropolitan Health Service, Armadale, WA, 6112, Australia.
3
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, Alberta, Canada.
4
Concord Repatriation General Hospital, Hospital Road, Concord, Sydney, NSW, 2139, Australia.

Abstract

BACKGROUND:

A Mediterranean dietary pattern is widely recommended for the prevention of chronic disease. We sought to define the most likely effects of the Mediterranean diet on vascular disease and mortality.

METHODS:

We searched MEDLINE, EMBASE and the Cochrane Central Register without language restriction for randomized controlled trials comparing Mediterranean to control diets. Data on study design, patient characteristics, interventions, follow-up duration, outcomes and adverse events were sought. Individual study relative risks (RR) were pooled to create summary estimates.

RESULTS:

Six studies with a total of 10950 participants were included. Effects on major vascular events (n = 477), death (n = 693) and vascular deaths (n = 315) were reported for 3, 5 and 4 studies respectively. For one large study (n = 1000) there were serious concerns about the integrity of the data. When data for all studies were combined there was evidence of protection against major vascular events (RR 0.63, 95% confidence interval 0.53-0.75), coronary events (0.65, 0.50-0.85), stroke (0.65, 0.48-0.88) and heart failure (0.30, 0.17-0.56) but not for all-cause mortality (1.00, 0.86-1.15) or cardiovascular mortality (0.90, 0.72-1.11). After the study of concern was excluded the benefit for vascular events (0.69, 0.55-0.86) and stroke (0.66, 0.48-0.92) persisted but apparently positive findings for coronary events (0.73, 0.51-1.05) and heart failure (0.25, 0.05-1.17) disappeared.

CONCLUSION:

The Mediterranean diet may protect against vascular disease. However, both the quantity and quality of the available evidence is limited and highly variable. Results must be interpreted with caution.

PMID:
27509006
PMCID:
PMC4980102
DOI:
10.1371/journal.pone.0159252
[Indexed for MEDLINE]
Free PMC Article

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