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02-02-2010 | Cardiometabolic | Article

Mediterranean diet has ‘dose-response’ link with vascular risk


Free abstract

MedWire News: Greater adherence to the Mediterranean diet is associated with favorable changes in clinical and biologic markers of atherothrombotic risk, a US population study indicates.

Analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III) found that Mediterranean Diet Scores (MedDietScores) significantly correlated with cardioprotective lipid profiles, glucose metabolism, and coagulation markers.

Charles Eaton (Alpert Medical School of Brown University, Pawtucket, Rhode Island) and team investigated the degree to which the Mediterranean diet is linked with atherothrombotic biomarkers among 33,994 participants in NHANES III, a nationally representative survey of the US population.

Using information from dietary recall interviews and food-frequency questionnaires, Eaton’s group assigned each participant a MedDietScore. This validated composite score reflects adherence to 11 dietary components – namely, nonrefined cereals and products, potatoes, fruits, vegetables, legumes, fish, red meat and products, poultry, full-fat dairy products, olive oil, and alcoholic beverages.

Correlations between tertiles of MedDietScores and atherothrombotic risk factors were observed across all age and gender groups, Eaton et al report in the journal Atherosclerosis.

For men aged less than 45 years, as MedDietScore increased, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC:HDL-C), serum insulin, and white blood cell counts decreased.

For men aged 45 years and older, as MedDietScore increased, the TC:HDL-C ratio, glycated hemoglobin (Hba1c), insulin resistance index, C-reactive protein, and fibrinogen decreased, and HDL-C levels increased.

For premenopausal women, as MedDietScore increased, the TC:HDL ratio, non-HDL cholesterol, apolipoprotein B, and Hba1c decreased, and HDL-C levels increased.

Finally, for postmenopausal women, as MedDietScore increased, the TC:HDL ratio, triglycerides, serum insulin, insulin resistance index, and homocysteine levels decreased, and HDL-C levels increased.

“Using standardized dietary assessment tools and a validated Mediterranean diet scoring methodology, we discovered dose-response relationships by gender and age between MedDietScore, biomarkers implicated in cardiovascular risk, and a validated epidemiologic coronary heart disease risk summary score,” write Eaton and co-authors.

The major limitation of the study was its cross-sectional design, meaning that causality cannot be proven.

“Prospective cohort studies that examine the effects of the Mediterranean diet on cardiovascular risk in the USA are needed,” the researchers conclude.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford