Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain
EntityUAM. Departamento de Medicina Preventiva y Salud Pública y Microbiología
PublisherBiomed Central Ltd.
CitationCardiovascular Diabetology 20.1 (2021): 5
Funded byThis work was supported by FIS grants 16/609, 16/1512, 18/287, 19/319 and PI20/00896 (Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE), the Salamander Project (JPI-A Healthy Diet for a Healthy Life, State Secretary of R+D+I PCIN-2016-145), and the Cátedra de Epidemiología y Control del Riesgo Cardiovascular at UAM (#820024). Mercedes Sotos Prieto holds a Ramón y Cajal contract (RYC-2018-025069-I) from the Ministry of Science, Innovation and Universities and FEDER/FSE. The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation or in the decision to submit this manuscript for publication
SubjectsMediterranean lifestyle; Cardiovascular risk factors; Metabolic syndrome mortality; Cohort; Medicina
NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
Rights© The Author(s) 2021
Esta obra está bajo una Licencia Creative Commons Atribución 4.0 Internacional.
Background: Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all‑cause and cardiovascular mortality in Spain. Methods: Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18 + years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed‑up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27‑item MEDLIFE index (with higher score representing better adherence). Results: Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable‑adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL‑cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA‑IR and highly‑sensitivity C‑reactive protein (P‑trend < 0.001). During a mean follow‑up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable‑adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions: The Mediterranean lifestyle was associated with lower frequency of MS and reduced all‑cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin
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Google Scholar:Sotos Prieto, Mercedes - Ortola Vidal, María Del Rosario - Ruiz-Canela, Miguel - García García-Esquinas, Esther - Martínez Gómez, David - López García, Esther - Martínez-González, Miguel Ángel - Rodríguez Artalejo, Fernando
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