Study: Mediterranean diet and mortality: a second meta -analysis

Reference

Sofi F, Abbate R, Gensini GF, Casini A. Collecting evidence of the health benefits of compliance with the Mediterranean diet: an updated systematic review and meta -analysis. am j Clin nutr . 2010; 92 (5): 1189-1196.

study design

This latest study by Francesco Sofi added data from seven prospective studies published in the past two years to form an earlier meta -analysis from 2008. The statistical analysis of the compiled data correlated the compliance with a Mediterranean diet with the relative risk of various diseases and the overall risk risk. These newcomers included 1 study on the overall mortality, 3 studies on cardiovascular incidence or mortality, 1 study on cancer incidence or mortality and 2 studies on neurodegenerative diseases.

participant

The number of subjects whose data has been compiled varied depending on the disease. With regard to the incidence and mortality of cardiovascular diseases, a total of 534,064 subjects were recorded with 8,739 events for analysis. There were 1,006,410 subjects and 11,378 events for cancer incidence and mortality. For neurodegenerative diseases there were 136,235 subjects and 1,074 cases from which conclusions could be drawn. The earlier meta -analysis of 2008 used data from 12 qualifying studies that were published between 1966 and 2008 with a total of 1,574,299 subjects.

Study intervention

Compliance with a Mediterranean diet was defined using values ​​that assessed the correspondence of the subject of the subject of the subject with the traditional Mediterranean nutritional pattern. Values ​​of zero or 1 were assigned to the 7 to 9 different nutritional features, with the median of the consumption of the study participants serving as dividers. People whose consumption was typical of a Mediterranean diet (vegetables, fruit, beans, cereals, fish, olive oil and moderate consumption of red wine with meals) was given 1 point for each feature in which they were above average. Those whose consumption was below the median received a zero point number. People whose consumption patterns of components that are not part of a Mediterranean diet (red and processed meat, poultry, eggs or dairy products), were also above the median value, also received a zero, while those who were above the median value or were below received 1 point for this category. Various studies differed in the total number of food categories rated. While the lowest score was always zero, the highest possible score between 7 and 9 points varied for the greatest adherence.

primary result dimensions

The study calculated changes in the relative risk for the occurrence or mortality due to cardiovascular diseases, cancer or neurodegenerative diseases that are associated with a greater compliance with a Mediterranean diet. In addition, the relative risk of total mortality was calculated.

most important knowledge

This paper is an update of Sofi et al. 2008 and adds data from newly published studies. The increased amount of data had no significant influence on the original findings of sofi. This new meta -analysis showed that a two percentage points higher compliance with the Mediterranean diet was associated with a significant reduction in the overall mortality [relative risk (RR) = 0.92; 95 %CI: 0.90, 0.94] Cardiovascular incidence or mortality (rr = 0.90; 95 %-KI: 0.87; 0.93), cancer incidence or mortality (RR = 0.94; 95 %-KI: 0.92; 0.96) and neurodegenerative diseases (RR = 0.87; %-Ki: 0.81). , 0.94).

effects on practice

The exact definition of the Mediterranean diet is frustratingly vague. It is more of a concept than a defined intervention. It is clear that this diet contains elements that are health -promoting. It is also clear that neither accuracy is required nor large dietary changes are required to achieve a benefit. In order to achieve the minimal increase in adherence assessment by 2 points that is necessary to achieve significant benefits, only an improvement in 2 out of 7 or 9 different categories was required. In order to achieve an increase in compliance by two points, for example, one might only have to increase fish consumption over the mean in the cohort of the test subjects in the study and reduce the consumption of red meat below the average of the cohort.