Mediterranean-Style Diet for the Primary and Secondary Prevention of Cardiovascular Disease: A Cochrane Review
Karen Rees,
Andrea Takeda,
Nicole Martin,
Leila Ellis,
Dilini Wijesekara,
Abhinav Vepa,
Archik Das,
Louise Hartley,
Saverio Stranges
Affiliations
Karen Rees
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry
Andrea Takeda
Instiutute of Health Informatics Research, University College London, London
Nicole Martin
Instiutute of Health Informatics Research, University College London, London
Leila Ellis
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry
Dilini Wijesekara
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry
Abhinav Vepa
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry
Archik Das
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry
Louise Hartley
RTI Health Solutions, Manchester
Saverio Stranges
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, CA; Department of Population Health, Luxembourg Institute of Health, Strassen
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.
