Abstract
Background:Diet plays a major role in cardiovascular disease (CVD) risk.Objectives:To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD.Methods:We searched for randomised controlled trials (RCTs) of Mediterranean-style diets in healthy adults and those at increased risk of CVD (primary prevention) and with established CVD (secondary prevention).Results:Thirty RCTs were included, 22 in primary prevention and eight in secondary prevention. Clinical endpoints were reported in two trials where there was moderate quality evidence for a reduction in strokes for primary prevention, and low quality evidence for a reduction in total and CVD mortality in secondary prevention. We found moderate quality evidence of improvement in CVD risk factors for primary prevention and low quality evidence of little or no effect in secondary prevention.Conclusions:There is still some uncertainty regarding the effects of a Mediterranean-style diet in CVD prevention.
Highlights
Cardiovascular disease (CVD) is currently the leading cause of mortality worldwide, causing one-third of deaths globally [1]
Clinical endpoints were measured in only one large primary prevention trial (PREDIMED) [51], where following retraction and reanalysis of the data due to methodological concerns, there was low quality evidence of little or no effect of the intervention on total or cardiovascular disease (CVD) mortality or myocardial infarction but moderate quality evi
Despite the large number of trials included in the review there is still uncertainty regarding the effects of a Mediterranean-style diet on clinical endpoints and cardiovascular disease (CVD) risk factors for both primary and secondary prevention from current clinical trial evidence
Summary
Cardiovascular disease (CVD) is currently the leading cause of mortality worldwide, causing one-third of deaths globally [1]. Objectives: To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD. Methods: We searched for randomised controlled trials (RCTs) of Mediterranean-style diets in healthy adults and those at increased risk of CVD (primary prevention) and with established CVD (secondary prevention). Clinical endpoints were reported in two trials where there was moderate quality evidence for a reduction in strokes for primary prevention, and low quality evidence for a reduction in total and CVD mortality in secondary prevention. We found moderate quality evidence of improvement in CVD risk factors for primary prevention and low quality evidence of little or no effect in secondary prevention. Conclusions: There is still some uncertainty regarding the effects of a Mediterranean-style diet in CVD prevention
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