Damigou Evangelia, Anastasiou Costas, Chrysohoou Christina, Barkas Fotios, Tsioufis Costas, Pitsavos Christos, Liberopoulos Evangelos, Sfikakis Petros P, Panagiotakos Demosthenes
Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece.
First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, 15772, Athens, Greece.
Nutr Metab Cardiovasc Dis. 2025 May;35(5):103777. doi: 10.1016/j.numecd.2024.10.015. Epub 2024 Oct 28.
Cardiovascular disease (CVD) and its related co-morbidities, i.e., type 2 diabetes mellitus (T2DM), hypertension and hypercholesterolemia, have an enormous burden on population health and healthcare systems. Mediterranean diet can reduce this burden; quantifying this reduction via the calculation of the Prevented Fraction for the Population (PFP) could offer positive-framed messages to encourage adherence to this healthful dietary pattern. Hence, the aim of this study was to calculate PFP of CVD, T2DM, hypertension, and hypercholesterolemia by long-term adherence to the Mediterranean type of diet, during a 20-year period, in a Mediterranean population.
The sample consisted of adult participants, initially free-of-CVD, from the ATTICA prospective cohort study (2002-2022). At all evaluations (2002, 2006, 2012, 2022), CVD, T2DM, hypertension, and hypercholesterolemia were assessed according to WHO-ICD-10, and Mediterranean diet adherence was assessed via MedDietScore. PFP by Mediterranean diet was computed for each outcome in different population groups. It was found that approximately 30 % of CVD, T2DM, hypertension and hypercholesterolemia cases were prevented due to the high long-term adherence to the Mediterranean diet. Concerning different population groups, it was observed that due to their decreased adherence and PFPs, male participants, older participants and participants with comorbidities might benefit more from following the Mediterranean diet during a long-term period.
The study findings suggest that future public health strategies should aim to make the Mediterranean diet a long-term lifestyle change rather than a short-term diet intervention, while shedding light on which population groups should be targeted first.
心血管疾病（CVD）及其相关合并症，即2型糖尿病（T2DM）、高血压和高胆固醇血症，给人群健康和医疗系统带来了巨大负担。地中海饮食可以减轻这种负担；通过计算人群预防分数（PFP）来量化这种减轻程度，可为鼓励坚持这种健康饮食模式提供积极的信息。因此，本研究的目的是计算地中海人群在20年期间长期坚持地中海式饮食对心血管疾病、2型糖尿病、高血压和高胆固醇血症的预防分数。
样本来自阿提卡前瞻性队列研究（2002 - 2022年）中最初无心血管疾病的成年参与者。在所有评估（2002年、2006年、2012年、2022年）中，根据世界卫生组织国际疾病分类第10版（WHO - ICD - 10）评估心血管疾病、2型糖尿病、高血压和高胆固醇血症，并通过地中海饮食评分（MedDietScore）评估地中海饮食依从性。计算了不同人群组中每种结局通过地中海饮食的预防分数。结果发现，由于长期高度坚持地中海饮食，约30%的心血管疾病、2型糖尿病、高血压和高胆固醇血症病例得到预防。关于不同人群组，观察到由于男性参与者、老年参与者和患有合并症的参与者依从性降低和预防分数较低，他们可能从长期遵循地中海饮食中获益更多。
研究结果表明，未来的公共卫生策略应旨在使地中海饮食成为一种长期的生活方式改变，而不是短期的饮食干预，同时明确应首先针对哪些人群。
