Dietary modification is a cornerstone of cardiovascular disease (CVD) prevention. A Mediterranean (MED) diet has been associated with a lower risk of CVD but no systematic reviews have evaluated this relationship specifically in women. As CVD is the number 1 cause of death in women, any progress in the prevention of CVD has huge benefits and must be taught and implemented.
While an all-plant (whole-food plant-based diet) has been shown to halt and prevent heart disease, not everyone is willing to adopt that plan. The MED diet is adopted by many but can it prevent CVD in women?
STUDY GOALS
To determine the association between higher versus lower adherence to a MED diet and incident CVD and total mortality in women, a search of all prior studies was performed and published.
STUDY DIET
A search of randomized controlled trials and prospective cohort studies with participants without previous CVD were included.
Studies were eligible if they reported a Mediterranean diet score and comprised either all female participants or stratified outcomes by sex. The primary outcome was CVD and/or total mortality.
STUDY RESULTS
Sixteen prospective cohort studies were included in the analysis (n=722 ,495 female participants).
In women, higher adherence to a Mediterranean diet was associated with a lower CVD incidence (risk 24% less), total mortality (risk 23% less), and coronary heart disease (risk 25% less).
Stroke incidence was lower in women with higher Mediterranean diet adherence (13%) but this was not statistically significant. It would appear to be clinically important, however.
STUDY CONCLUSIONS
This study supports the beneficial effect of the MED diet on the primary prevention of CVD and death in women and is an important step in enabling sex-specific guidelines.
Women should be taught right away to reduce or drop all dairy, red meat, and processed foods. Increasing fruit and vegetable, legume, whole grain, and extra-virgin olive oil intake is advised. Added sugars should be reduced or eliminated. Red wine is optional but is a standard part of the traditional MED diet along with eating in a relaxed and social setting.
