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Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials.
Crit Rev Food Sci Nutr. 2020; 60(7):1207-1227.CR

Abstract

To update the clinical practice guidelines for nutrition therapy of the European Association for the Study of Diabetes, we conducted a systematic review and meta-analysis of prospective cohort studies and randomized clinical trials (RCTs) to evaluate the effect of the Mediterranean diet (MedDiet) on the prevention of cardiovascular disease (CVD) incidence and mortality. We searched Medline, EMBASE (through April 20, 2018) and Cochrane (through May 7, 2018) databases. Pooled relative risks (RRs) and 95% confidence interval (CI) were calculated by the generic inverse variance method. A total of 41 reports (3 RCTs and 38 cohorts) were included. Meta-analyses of RCTs revealed a beneficial effect of the MedDiet on total CVD incidence (RR: 0.62; 95% CI: 0.50, 0.78) and total myocardial infarction (MI) incidence (RR: 0.65; 95% CI: 0.49, 0.88). Meta-analyses of prospective cohort studies, which compared the highest versus lowest categories of MedDiet adherence, revealed an inverse association with total CVD mortality (RR: 0.79; 95% CI: 0.77, 0.82), coronary heart disease (CHD) incidence (RR: 0.73; 95% CI: 0.62, 0.86), CHD mortality (RR: 0.83; 95% CI: 0.75, 0.92), stroke incidence (RR: 0.80; 95% CI: 0.71, 0.90), stroke mortality (RR: 0.87; 95% CI: 0.80, 0.96) and MI incidence (RR: 0.73; 95% CI: 0.61, 0.88). The present study suggests that MedDiet has a beneficial role on CVD prevention in populations inclusive of individuals with diabetes.

Authors+Show Affiliations

Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain.Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Physicians Committee for Responsible Medicine, Washington, DC, USA.Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava University Hospital, Zagreb, Croatia. School of Medicine, University of Zagreb, Zagreb, Croatia.Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain. Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30676058

Citation

Becerra-Tomás, Nerea, et al. "Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: a Systematic Review and Meta-analysis of Prospective Cohort Studies and Randomized Clinical Trials." Critical Reviews in Food Science and Nutrition, vol. 60, no. 7, 2020, pp. 1207-1227.
Becerra-Tomás N, Blanco Mejía S, Viguiliouk E, et al. Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. Crit Rev Food Sci Nutr. 2020;60(7):1207-1227.
Becerra-Tomás, N., Blanco Mejía, S., Viguiliouk, E., Khan, T., Kendall, C. W. C., Kahleova, H., Rahelić, D., Sievenpiper, J. L., & Salas-Salvadó, J. (2020). Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. Critical Reviews in Food Science and Nutrition, 60(7), 1207-1227. https://doi.org/10.1080/10408398.2019.1565281
Becerra-Tomás N, et al. Mediterranean Diet, Cardiovascular Disease and Mortality in Diabetes: a Systematic Review and Meta-analysis of Prospective Cohort Studies and Randomized Clinical Trials. Crit Rev Food Sci Nutr. 2020;60(7):1207-1227. PubMed PMID: 30676058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. AU - Becerra-Tomás,Nerea, AU - Blanco Mejía,Sonia, AU - Viguiliouk,Effie, AU - Khan,Tauseef, AU - Kendall,Cyril W C, AU - Kahleova,Hana, AU - Rahelić,Dario, AU - Sievenpiper,John L, AU - Salas-Salvadó,Jordi, Y1 - 2019/01/24/ PY - 2019/1/25/pubmed PY - 2020/3/31/medline PY - 2019/1/25/entrez KW - Mediterranean diet KW - cardiovascular disease KW - cardiovascular mortality KW - diabetes KW - meta-analysis SP - 1207 EP - 1227 JF - Critical reviews in food science and nutrition JO - Crit Rev Food Sci Nutr VL - 60 IS - 7 N2 - To update the clinical practice guidelines for nutrition therapy of the European Association for the Study of Diabetes, we conducted a systematic review and meta-analysis of prospective cohort studies and randomized clinical trials (RCTs) to evaluate the effect of the Mediterranean diet (MedDiet) on the prevention of cardiovascular disease (CVD) incidence and mortality. We searched Medline, EMBASE (through April 20, 2018) and Cochrane (through May 7, 2018) databases. Pooled relative risks (RRs) and 95% confidence interval (CI) were calculated by the generic inverse variance method. A total of 41 reports (3 RCTs and 38 cohorts) were included. Meta-analyses of RCTs revealed a beneficial effect of the MedDiet on total CVD incidence (RR: 0.62; 95% CI: 0.50, 0.78) and total myocardial infarction (MI) incidence (RR: 0.65; 95% CI: 0.49, 0.88). Meta-analyses of prospective cohort studies, which compared the highest versus lowest categories of MedDiet adherence, revealed an inverse association with total CVD mortality (RR: 0.79; 95% CI: 0.77, 0.82), coronary heart disease (CHD) incidence (RR: 0.73; 95% CI: 0.62, 0.86), CHD mortality (RR: 0.83; 95% CI: 0.75, 0.92), stroke incidence (RR: 0.80; 95% CI: 0.71, 0.90), stroke mortality (RR: 0.87; 95% CI: 0.80, 0.96) and MI incidence (RR: 0.73; 95% CI: 0.61, 0.88). The present study suggests that MedDiet has a beneficial role on CVD prevention in populations inclusive of individuals with diabetes. SN - 1549-7852 UR - https://www.unboundmedicine.com/medline/citation/30676058/Mediterranean_diet_cardiovascular_disease_and_mortality_in_diabetes:_A_systematic_review_and_meta_analysis_of_prospective_cohort_studies_and_randomized_clinical_trials_ L2 - https://www.tandfonline.com/doi/full/10.1080/10408398.2019.1565281 DB - PRIME DP - Unbound Medicine ER -