University of Navarra, Emergency Department, Clínica Universidad de Navarra, Pamplona, Spain.
University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Department of Environmental Health, Harvard T.H Chan School of Public Health, Boston, MA, USA.
Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1728-1737. doi: 10.1016/j.numecd.2021.02.022. Epub 2021 Feb 27.
A healthy lifestyle is essential to prevent cardiovascular disease (CVD). However, beyond dietary habits, there is a scarcity of studies comprehensively assessing the typical traditional Mediterranean lifestyle with a multi-dimensional index. We assessed the association between the Mediterranean lifestyle (measured with the MEDLIFE index including diet, physical activity, and other lifestyle factors) and the incidence of CVD.
The "Seguimiento Universidad de Navarra" (SUN) project is a prospective, dynamic and multipurpose cohort of Spanish university graduates. We calculated a MEDLIFE score, composed of 28 items on food consumption, dietary habits, physical activity, rest, social habits, and conviviality, for 18,631 participants by assigning 1 point for each typical Mediterranean lifestyle factor achieved, for a theoretically possible final score ranging from 0 to 28 points. During an average follow-up of 11.5 years, 172 CVD cases (myocardial infarction, stroke or cardiovascular death) were observed. An inverse association between the MEDLIFE score and the risk of primary cardiovascular events was observed, with multivariable-adjusted hazard ratio (HR) = 0.50; (95% confidence interval, 0.31-0.81) for the highest MEDLIFE scores (14-23 points) compared to the lowest scores (0-9 points), p (trend) = 0.004.
A higher level of adherence to the Mediterranean lifestyle was significantly associated with a lower risk of CVD in a Spanish cohort. Public health strategies should promote the Mediterranean lifestyle to preserve cardiovascular health.
健康的生活方式对于预防心血管疾病（CVD）至关重要。然而，除了饮食习惯之外，很少有研究综合评估典型的地中海生活方式，也缺乏多维指数的评估。我们评估了地中海生活方式（通过包括饮食、体力活动和其他生活方式因素在内的 MEDLIFE 指数来衡量）与 CVD 发病之间的关联。
“纳瓦拉大学随访研究（SUN）”是一项前瞻性、动态和多用途的西班牙大学毕业生队列研究。我们为 18631 名参与者计算了 MEDLIFE 评分，该评分由 28 个关于食物摄入、饮食习惯、体力活动、休息、社会习惯和社交活动的项目组成，每个典型的地中海生活方式因素得 1 分，理论上的最高得分为 28 分。在平均 11.5 年的随访期间，观察到 172 例 CVD 病例（心肌梗死、中风或心血管死亡）。MEDLIFE 评分与主要心血管事件风险呈负相关，多变量调整后的风险比（HR）为 0.50；（95%置信区间，0.31-0.81）对于最高 MEDLIFE 评分（14-23 分）与最低评分（0-9 分）相比，p（趋势）=0.004。
在西班牙队列中，更高水平的地中海生活方式依从性与 CVD 风险降低显著相关。公共卫生策略应促进地中海生活方式，以维护心血管健康。
