Association of Adherence to the Mediterranean Diet with All-Cause Mortality in Subjects with Heart Failure.

Chih-Yun Chang,Chia-Lin Lee,Wei-Ju Liu,Jun-Sing Wang

doi:10.3390/nu14040842

Abstract

We investigated the associations of adherence to the Mediterranean diet with all-cause and cardiovascular mortality in patients with heart failure. We analyzed the National Health and Nutrition Examination Survey (NHANES) participants from 1999 to 2010, with their vital status confirmed through to the end of 2011. The alternate Mediterranean Diet Index (aMED) was used to assess study participants’ adherence to the Mediterranean diet according to information on dietary questionnaires. We conducted weighted Cox proportional hazards regression models to determine the associations of adherence to the Mediterranean diet (aMED ≥ median vs. <median) with all-cause and cardiovascular mortality in participants with a history of heart failure. A total of 832 participants were analyzed, and the median aMED was 3. After a median follow-up of 4.7 years, 319 participants had died. aMED ≥ 3 (vs. <3) was not associated with a lower risk of all-cause (adjusted HR 0.797, 95% CI 0.599–1.059, p = 0.116) and cardiovascular (adjusted HR 0.911, 95% CI 0.539–1.538, p = 0.724) mortality. The findings were consistent across several subgroup populations. Among the components of aMED, a lower intake of red/processed meat was associated with a higher risk of mortality (adjusted HR 1.406, 95% CI 1.011–1.955, p = 0.043). We concluded that adherence to the Mediterranean diet was not associated with a lower risk of all-cause and cardiovascular mortality in participants with a history of heart failure. The higher risk of mortality associated with a lower intake of red/processed meat deserves further investigation.

Highlights

Despite a modest decrease in the incidence of heart failure in recent decades [1,2,3], the rate of all-cause mortality remains high [3,4,5]
In this study using data from the National Health and Nutrition Examination Survey (NHANES), we investigated the association of adherence to the Mediterranean diet with all-cause and cardiovascular mortality in participants with a history of heart failure
We found that alternate Mediterranean Diet Index (aMED) ≥ 3 was not associated with a lower risk of all-cause and cardiovascular mortality (Table 2), and the findings were consistent across various subgroups (Table 3)

Summary

Introduction

Despite a modest decrease in the incidence of heart failure in recent decades [1,2,3], the rate of all-cause mortality remains high [3,4,5]. Among the patients who were admitted to hospital at the time of diagnosis [6], the 5-year survival rate was less than 40%. This disease has been reported to be as “malignant” as some kinds of cancers [4]. In addition to pharmacologic treatment, lifestyle modification and healthy dietary patterns (such as the Mediterranean diet) have been recommended to reduce cardiovascular risk [7]. In people with obesity, adopting the Mediterranean diet was effective in improving lipid values and glycemic control, as well as achieving weight reduction [8]. Adherence to the Mediterranean diet, assessed using the alternate Mediterranean Diet Index

Results

Discussion

Conclusion