The Mediterranean diet can reduce the risk of heart disease, diabetes

salad bowl with tomatoes, mozzarella and basil — The Mediterranean diet can reduce the risk of developing several cardiometabolic conditions at the same time. Image credit: Gabi Bucataru/Stocksy.

The Mediterranean diet has many known health benefits, and experts are still learning about the benefits of this dietary pattern.
One study found that following the Mediterranean diet can help lower the risk of transitioning from one to more cardiometabolic diseases, such as heart attack and stroke, especially over shorter periods of time.
People can take several steps to help lower their risk of cardiometabolic multimorbidity.

The Mediterranean diet focuses on plant-based foods, uses olive oil, and includes plenty of fruits, vegetables, and whole grains.

There has been a lot of interest in the health benefits of this diet, especially when it comes to cardiovascular health.

A recent study published in Journal of Nutrition looked at how adherence to the Mediterranean diet is associated with the risk of several cardiometabolic diseases, such as type 2 diabetes and heart attacks.

The researchers found that following the Mediterranean diet can lower the chances of someone going from a first cardiometabolic disease to cardiometabolic multimorbidity—several co-occurring conditions related to cardiovascular and metabolic health—over 10- and 15-year follow-up periods.

How the Mediterranean Diet Affects Cardiometabolic Health

As mentioned in this study, cardiometabolic diseases include conditions such as cerebrovascular accidentheart attack and type 2 diabetes. Having two or more of these conditions is called cardiometabolic multimorbidity.

This research wanted to find out whether adherence to the Mediterranean diet could decrease the risk for first cardiometabolic disease and cardiometabolic multimorbidity.

The researchers used participant data from European Prospective Investigation of Cancer (EPIC)-Norfolk cohort study.

The research included 21,900 participants who did not have a heart attack, stroke or type 2 diabetes at baseline. The researchers measured participants’ adherence to the Mediterranean diet using two scores: the pyramid-based Mediterranean diet score and the mean-based Mediterranean diet score.

The average follow-up time was 21.4 years, and the researchers looked at the incidence of heart attack, stroke, type 2 diabetes and death.

They took into account covariates such as age, education, family history of heart attack or stroke, use of certain medications, and levels of physical activity.

During the study, 5,028 participants had cardiometabolic disease, and 734 participants had cardiometabolic multimorbidity.

Overall, adherence to the Mediterranean diet has been shown to be beneficial. Analyzing both types of Mediterranean dietary scores, the researchers found that following this dietary pattern was associated with a reduced risk of cardiometabolic multimorbidity over a follow-up period of 21.4 years.

Next, the researchers focused on how the Mediterranean diet affected the transition from first cardiometabolic disease to cardiometabolic multimorbidity.

At 10 and 15 years, the Mediterranean diet was associated with a reduced risk of this transition. Further analysis suggested that this observed reduction in risk may be particularly related to having a heart attack or developing type 2 diabetes.

However, over more than 20 years, researchers have not found a statistically significant reduction in risk for this transition associated with the Mediterranean diet.

Who benefits most from a Mediterranean diet?

The researchers also performed some additional analyzes to look at how social class might have played into the association with risk.

Non-manual workers appeared to derive the most benefit from the Mediterranean diet over an average follow-up period of just over 20 years.

This group observed a reduced risk for the first cardiometabolic disease and a reduced risk for this first instance of transition to cardiometabolic multimorbidity. In contrast, manual workers do not appear to have this decrease in transition risk.

Rigved Tadwalkar, MDa board-certified consultant cardiologist and medical director of the Cardiac Rehabilitation Center at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in this research, shared his thoughts on the study’s findings with Today’s medical news.

According to Tadwalkar, “the study provides strong evidence that adherence to the Mediterranean diet can significantly reduce the risk of transition from a first cardiometabolic event, such as a heart attack or stroke, to additional cardiometabolic conditions, such as diabetes of type 2”.

Furthermore, he noted:

“The finding that this association is more evident at shorter follow-up periods (of) 10-15 years suggests that the protective effects of diet have their greatest impact at earlier stages of disease development. It also highlights how socioeconomic factors, including social class, can alter the impact of diet on health. Specifically, it (points out) that diet quality and access to Mediterranean foods may be less accessible for some populations.”

Study limitations: do the results apply to everyone?

It is also essential to understand the limitations of this research. For example, the data focused primarily on people of European heritage, which limits generalizability.

Participants were also adults aged 40 years and older, so analyzing the younger demographic may be useful in future research.

The researchers did not identify participants who had chronic coronary syndromes at baseline, which could have ultimately led to an overestimation of the effects of the Mediterranean diet. They also did not differentiate between stroke subtypes.

The researchers only measured participants’ Mediterranean adherence at baseline, which could have further affected the results.

Furthermore, participants self-reported their dietary choices and adherence, which may not match their actual diets. Other lifestyle-related information was also self-reported. In addition, scoring methods to measure adherence to the Mediterranean diet were not without risk of error.

The researchers also recognized several possible reasons why adherence to the Mediterranean diet appears to have the greatest effect on the transition from first cardiometabolic disease to cardiometabolic multimorbidity at 10- and 15-year follow-up periods.

First, baseline dietary scores may fall short in accurately reporting diet quality over time. Thus, more research may be needed to analyze the long-term effects of the Mediterranean diet on this area of health.

They also noted several reasons for the differences between manual and non-manual workers. For example, their research did not look at specific types of foods, and participants with lower socioeconomic status may have had less variety and less nutritious foods.

The results could also be due to the ways in which social class affected other risk factors, such as cardiometabolic disease management and access to preventive care.

What can you do to protect your cardiometabolic health?

Despite its limitations, the study points to one possible way people can take steps to reduce their risk of cardiometabolic multimorbidity. There are also other steps people can take to reduce their risk of cardiovascular and metabolic disease.

Dr. Christopher Berga board-certified cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in this study, explained that “cardiometabolic multimorbidity is defined as a person having two or more of the following cardiometabolic: heart attack, stroke or type 2 diabetes.”

“A simple, clear way people can take to reduce their risk of heart attack, stroke or type 2 diabetes is nicely summarized as the American Heart Association (AHA)”The essentials of life 8‘”, he emphasized.

Berg summarized these recommendations by citing:

following a healthy diet, defined by the AHA as a Mediterranean diet, including a recommendation to avoid or minimize highly processed or ultra-processed foods
engaging in physical activity, defined as more than 150 minutes/week of moderate-intensity exercise such as brisk walking
stopping tobacco use
having a healthy and quality sleep
maintaining a healthy weight
managing cholesterol levels
managing blood sugar
managing blood pressure.

People can work with their doctors and additional specialists for these purposes.

In addition, it may be important to address potential barriers to people adopting the Mediterranean diet so that more people can take advantage of this healthy food option.

See the original article on Today’s medical news