A healthy diet is a crucial element in preventing cardiovascular disease. A new study reveals that adhering to a Mediterranean diet can reduce a woman’s risk of cardiovascular disease and death by almost 25%.
This is the first study of its kind, published in the journal Heart.
The researchers suggest that further sex-specific research should be conducted to guide clinical practice in heart health.
Despite the cardiovascular disease being responsible for over a third of all female deaths worldwide, relevant clinical trials have mostly included limited numbers of women or have not reported results by sex, according to the researchers.
The existing recommendations on the most effective ways to reduce the risk of cardiovascular disease do not make distinctions based on gender.
In order to create a more comprehensive evidence base for developing sex-specific guidance and clinical practice, the researchers conducted a search of research databases for studies investigating the potential impact of a Mediterranean diet on the cardiovascular health and mortality risk of women.
The Mediterranean diet consists of whole grains, vegetables, fruit, legumes, nuts, and extra virgin olive oil; it is moderate in fish/shellfish, low to moderate in wine, and low in red/processed meats, dairy products, animal fat, and processed foods.
After identifying 190 relevant studies, the researchers narrowed their focus to 16 studies published between 2003 and 2021 for their pooled data analysis.
Over 700,000 women aged 18 and above were included in the studies, which were primarily conducted in the US and Europe, and their cardiovascular health was tracked for an average of 12.5 years.
The findings of the analysis indicated that adhering closely to a Mediterranean diet was linked to a 24% reduction in the risk of cardiovascular disease and a 23% reduction in the risk of all-cause mortality in women. Additionally, the risk of coronary heart disease was 25% lower in those who adhered most closely to the diet compared to those who adhered least, and while the risk of stroke was also lower, the difference was not statistically significant.
The researchers noted that their findings were robust and unaffected even when individual studies were removed from the analysis, further strengthening the evidence for a significant inverse association between higher adherence to the Mediterranean diet and incident cardiovascular disease and total mortality in women.
However, the researchers also acknowledged several limitations of their analysis. Firstly, all of the studies reviewed were observational in nature, and relied on self-reported food frequency questionnaires. Additionally, adjustments for potentially influential factors differed across the studies included in the analysis.
The researchers suggest that the observed associations between adherence to the Mediterranean diet and reduced risk of cardiovascular disease and mortality may be explained by the diet’s antioxidant and gut microbiome effects on inflammation and cardiovascular risk factors.
Additionally, the researchers propose that the various components of the Mediterranean diet, such as polyphenols, nitrates, omega-3 fatty acids, increased fiber intake, and reduced glycemic load, may each individually contribute to a better cardiovascular risk profile.
The researchers note that the mechanisms underlying the sex-specific effects of the Mediterranean diet on cardiovascular disease and mortality remain unclear, and that their findings highlight the necessity for further sex-specific research in the field of cardiology.
The researchers also state that specific cardiovascular risk factors that are unique to women, such as premature menopause, pre-eclampsia, gestational diabetes, and systemic lupus, may each independently increase the risk of cardiovascular disease.
“It is possible that preventative measures, such as a Mediterranean diet, that targets inflammation and [cardiovascular disease] risk factors, impose differing effects in women compared with men,” they conclude.
Source: 10.1136/heartjnl-2022-321930
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