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      Definitions and potential health benefits of the Mediterranean diet: views from experts around the world

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          Abstract

          The Mediterranean diet has been linked to a number of health benefits, including reduced mortality risk and lower incidence of cardiovascular disease. Definitions of the Mediterranean diet vary across some settings, and scores are increasingly being employed to define Mediterranean diet adherence in epidemiological studies. Some components of the Mediterranean diet overlap with other healthy dietary patterns, whereas other aspects are unique to the Mediterranean diet. In this forum article, we asked clinicians and researchers with an interest in the effect of diet on health to describe what constitutes a Mediterranean diet in different geographical settings, and how we can study the health benefits of this dietary pattern.

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          Stephen S Lim, Theo Vos, Abraham D. Flaxman … (2012)
          The Lancet, 380(9859), 2224-2260
          Article 0 comments Cited 3873 times – based on 0 reviews     Review now
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            The effect of fruit and vegetable intake on risk for coronary heart disease.

            Kaumudi Joshipura, Frank Hu, JoAnn Manson … (2001)
            Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease are sparse. To evaluate the association of fruit and vegetable consumption with risk for coronary heart disease. Prospective cohort study. The Nurses' Health Study and the Health Professionals' Follow-Up Study. 84 251 women 34 to 59 years of age who were followed for 14 years and 42 148 men 40 to 75 years who were followed for 8 years. All were free of diagnosed cardiovascular disease, cancer, and diabetes at baseline. The main outcome measure was incidence of nonfatal myocardial infarction or fatal coronary heart disease (1127 cases in women and 1063 cases in men). Diet was assessed by using food-frequency questionnaires. After adjustment for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake had a relative risk for coronary heart disease of 0.80 (95% CI, 0.69 to 0.93) compared with those in the lowest quintile of intake. Each 1-serving/d increase in intake of fruits or vegetables was associated with a 4% lower risk for coronary heart disease (relative risk, 0.96 [CI, 0.94 to 0.99]; P = 0.01, test for trend). Green leafy vegetables (relative risk with 1-serving/d increase, 0.77 [CI, 0.64 to 0.93]), and vitamin C-rich fruits and vegetables (relative risk with 1-serving/d increase, 0.94 [CI, 0.88 to 0.99]) contributed most to the apparent protective effect of total fruit and vegetable intake. Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a protective effect against coronary heart disease.
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              THE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY

              B. S. DJORDJEVIC, A. DONTAS, Flaminio Fidanza … (1986)
              In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-59 years and "healthy" at entry, 2,288 died in 15 years. Death rates differed among cohorts. Differences in mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart disease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weight, fatness, and physical activity. The cohorts differed in average diets. Death rates were related positively to average percentage of dietary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smoking habits as independent variables accounted for 85% of variance in rates of deaths from all causes, 96% coronary heart disease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all differences in monounsaturates among cohorts. All-cause and coronary heart disease death rates were low in cohorts with olive oil as the main fat. Causal relationships are not claimed but consideration of characteristics of populations as well as of individuals within populations is urged in evaluating risks.
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                Author and article information

                Contributors
                Antonia Trichopoulou
                Miguel A Martínez-González
                Tammy YN Tong
                Nita G Forouhi
                Shweta Khandelwal
                Dorairaj Prabhakaran
                Dariush Mozaffarian
                Michel de Lorgeril
                Journal
                Journal ID (nlm-ta): BMC Med
                Journal ID (iso-abbrev): BMC Med
                Title: BMC Medicine
                Publisher: BioMed Central
                ISSN (Electronic): 1741-7015
                Publication date Collection: 2014
                Publication date (Electronic): 24 July 2014
                Volume: 12
                Page: 112
                Affiliations
                [1 ]Department of Hygiene and Epidemiology, School of Medicine, University of Athens, Greece; Hellenic Health Foundation, Athens, Greece
                [2 ]Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
                [3 ]CIBER-OBN, Instituto de Salud Carlos III, Madrid, Spain
                [4 ]MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
                [5 ]Public Health Foundation of India (PHFI), New Delhi; Centre for Chronic Disease Control (CCDC), New Delhi, India
                [6 ]Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
                [7 ]Laboratoire TIMC-IMAG, CNRS UMR 5525, PRETA Cœur & Nutrition, and Faculté de Médecine, Université Joseph Fourier, Grenoble, France
                Article
                Publisher ID: 1741-7015-12-112
                DOI: 10.1186/1741-7015-12-112
                PMC ID: 4222885
                PubMed ID: 25055810
                SO-VID: 765ee3ee-30a5-46a1-ac7e-72c54bbfbff2
                Copyright © Copyright © 2014 Trichopoulou et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 10 June 2014
                Date accepted : 10 June 2014
                Categories
                Subject: Forum

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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