Adhering to a Mediterranean diet significantly reduces the risk of cardiovascular disease and mortality by nearly a quarter in women, according to a comprehensive analysis of existing research published in the journal Heart. This groundbreaking pooled data analysis, the first of its kind, emphasizes the need for gender-specific research to inform clinical practices in heart health, given that cardiovascular disease is responsible for over a third of all female deaths globally. The importance of a healthy diet in prevention is underscored. Yet, many clinical trials to date have not focused sufficiently on women or analyzed results by gender, and current guidelines for reducing cardiovascular disease risk do not differentiate based on sex.
The study’s researchers embarked on an extensive review of research databases for studies examining the impact of the Mediterranean diet on women’s cardiovascular health and mortality risk. Characterized by a high intake of whole grains, vegetables, fruits, legumes, nuts, and extra virgin olive oil, moderate consumption of fish and shellfish, low to moderate wine consumption, and minimal intake of red or processed meats, dairy products, animal fats, and processed foods, the Mediterranean diet has long been associated with numerous health benefits. Of the 190 relevant studies initially identified, 16 studies conducted between 2003 and 2021, involving over 700,000 women aged 18 and older from primarily the US and Europe, were included in the final analysis. These studies tracked women’s cardiovascular health over an average period of 12.5 years.
The analysis revealed that strict adherence to the Mediterranean diet is linked with a 24% reduced risk of developing cardiovascular disease and a 23% lower risk of mortality from any cause among women. Moreover, the risk of coronary heart disease was decreased by 25%, and there was a non-statistically significant reduction in stroke risk among those who closely followed the diet compared to those who did not.
The consistency of these findings, even when individual studies were excluded from the analysis, underscores a robust inverse relationship between adherence to the Mediterranean diet and the incidence of cardiovascular disease and overall mortality in women. Despite these promising results, the researchers acknowledged limitations, such as the observational nature of the included studies and reliance on self-reported dietary data, which might affect the findings’ reliability.
Possible explanations for the diet’s beneficial effects include its antioxidant properties and positive impacts on gut microbiome, inflammation, and cardiovascular risk factors. The diet’s components, such as polyphenols, nitrates, omega-3 fatty acids, increased fibre intake, and reduced glycaemic load, contribute to a healthier cardiovascular risk profile. However, the mechanisms behind the diet’s gender-specific effects on cardiovascular health and mortality remain to be fully understood.
The findings highlight the urgent need for more gender-specific research in cardiology, especially considering unique or more common cardiovascular risk factors in women, such as premature menopause, pre-eclampsia, gestational diabetes, and systemic lupus. The researchers suggest that preventative measures like the Mediterranean diet, which targets inflammation and cardiovascular risk factors, might have different effects in women compared to men, reinforcing the importance of tailored dietary recommendations in promoting heart health among women.
More information: Anushriya Pant et al, Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis, Heart. DOI: 10.1136/heartjnl-2022-321930
Journal information: Heart Provided by BMJ
