Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain.
Am J Epidemiol. 2009 Dec 15;170(12):1518-29. doi: 10.1093/aje/kwp282. Epub 2009 Nov 10.
No known cohort study has investigated whether the Mediterranean diet can reduce incident coronary heart disease (CHD) events in a Mediterranean population. This study examined the relation between Mediterranean diet adherence and risk of incident CHD events in the 5 Spanish centers of the European Prospective Investigation into Cancer and Nutrition. Analysis included 41,078 participants aged 29-69 years, recruited in 1992-1996 and followed up until December 2004 (mean follow-up:10.4 years). Confirmed incident fatal and nonfatal CHD events were analyzed according to Mediterranean diet adherence, measured by using an 18-unit relative Mediterranean diet score. A total of 609 participants (79% male) had a fatal or nonfatal confirmed acute myocardial infarction (n = 468) or unstable angina requiring revascularization (n = 141). After stratification by center and age and adjustment for recognized CHD risk factors, high compared with low relative Mediterranean diet score was associated with a significant reduction in CHD risk (hazard ratio = 0.60, 95% confidence interval: 0.47, 0.77). A 1-unit increase in relative Mediterranean diet score was associated with a 6% reduced risk of CHD (95% confidence interval: 0.91, 0.97), with similar risk reductions by sex. Mediterranean diet adherence was associated with a significantly reduced CHD risk in this Mediterranean country, supporting its role in primary prevention of CHD in healthy populations.
没有已知的队列研究调查了地中海饮食是否可以减少地中海人群中冠心病（CHD）事件的发生。这项研究在欧洲癌症与营养前瞻性调查（EPIC）的 5 个西班牙中心调查了地中海饮食的坚持与冠心病事件发生风险之间的关系。分析包括 41078 名年龄在 29-69 岁的参与者，他们于 1992-1996 年招募，并随访至 2004 年 12 月（平均随访时间：10.4 年）。根据地中海饮食的坚持情况，通过使用相对地中海饮食得分的 18 个单位进行衡量，分析了已确诊的致命和非致命冠心病事件。共有 609 名参与者（79%为男性）发生致命或非致命性确诊急性心肌梗死（n = 468）或需要血管重建的不稳定型心绞痛（n = 141）。在校正中心和年龄以及公认的冠心病危险因素后，与低相对地中海饮食评分相比，高相对地中海饮食评分与冠心病风险显著降低相关（危险比=0.60，95%置信区间：0.47，0.77）。相对地中海饮食评分每增加 1 个单位，冠心病风险降低 6%（95%置信区间：0.91，0.97），且性别间的风险降低相似。在这个地中海国家，地中海饮食的坚持与冠心病风险的显著降低相关，支持其在健康人群中对冠心病一级预防的作用。
