TY - JOUR AU - Liyanage T. AU - Wong M. AU - Ninomiya T. AU - Jun M. AU - Hillis G. AU - Jardine M AU - Wang A. AU - Perkovic Vlado AU - Neal Bruce AB -

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.

AD - The George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Armadale Kelmscott Memorial Hospital, South Metropolitan Health Service, Armadale, WA, 6112, Australia.
Department of Medicine, Division of Nephrology, University of Calgary, Calgary, Alberta, Canada.
Concord Repatriation General Hospital, Hospital Road, Concord, Sydney, NSW, 2139, Australia. AN - 27509006 BT - PLoS OnePLoS ONEPLoS ONE CN - [IF]: 3.234 DP - NLM ET - 2016/08/11 LA - eng LB - AUS
R&M
FP
FY17 M1 - 8 N1 - Liyanage, Thaminda
Ninomiya, Toshiharu
Wang, Amanda
Neal, Bruce
Jun, Min
Wong, Muh Geot
Jardine, Meg
Hillis, Graham S
Perkovic, Vlado
United States
PLoS One. 2016 Aug 10;11(8):e0159252. doi: 10.1371/journal.pone.0159252. eCollection 2016. N2 -

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.

PY - 2016 SN - 1932-6203 (Electronic)
1932-6203 (Linking) EP - e0159252 T2 - PLoS OnePLoS ONEPLoS ONE TI - Effects of the Mediterranean Diet on Cardiovascular Outcomes-A Systematic Review and Meta-Analysis VL - 11 Y2 - FY17 ER -