Show simple item record

dc.contributor.authorTong, YINen
dc.contributor.authorWareham, Nicholasen
dc.contributor.authorKhaw, Kay-Teeen
dc.contributor.authorImamura, Fumiakien
dc.contributor.authorForouhi, Nitaen
dc.date.accessioned2016-11-10T11:52:02Z
dc.date.available2016-11-10T11:52:02Z
dc.date.issued2016-09-29en
dc.identifier.issn1741-7015
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/261118
dc.description.abstractBACKGROUND: Despite convincing evidence in the Mediterranean region, the cardiovascular benefit of the Mediterranean diet is not well established in non-Mediterranean countries and the optimal criteria for defining adherence are unclear. The population attributable fraction (PAF) of adherence to this diet is also unknown. METHODS: In the UK-based EPIC-Norfolk prospective cohort, we evaluated habitual diets assessed at baseline (1993-1997) and during follow-up (1998-2000) using food-frequency questionnaires (n = 23,902). We estimated a Mediterranean diet score (MDS) using cut-points projected from the Mediterranean dietary pyramid, and also three other pre-existing MDSs. Using multivariable-adjusted Cox regression with repeated measures of MDS and covariates, we examined prospective associations between each MDS with incident cardiovascular diseases (CVD) by 2009 and mortality by 2013, and estimated PAF for each outcome attributable to low MDS. RESULTS: We observed 7606 incident CVD events (2818/100,000 person-years) and 1714 CVD deaths (448/100,000). The MDS based on the Mediterranean dietary pyramid was significantly associated with lower incidence of the cardiovascular outcomes, with hazard ratios (95 % confidence intervals) of 0.95 (0.92-0.97) per one standard deviation for incident CVD and 0.91 (0.87-0.96) for CVD mortality. Associations were similar for composite incident ischaemic heart disease and all-cause mortality. Other pre-existing MDSs showed similar, but more modest associations. PAF due to low dietary pyramid based MDS (<95th percentile) was 3.9 % (1.3-6.5 %) for total incident CVD and 12.5 % (4.5-20.6 %) for CVD mortality. CONCLUSIONS: Greater adherence to the Mediterranean diet was associated with lower CVD incidence and mortality in the UK. This diet has an important population health impact for the prevention of CVD.
dc.description.sponsorshipThe EPIC-Norfolk study was supported by grants from the Medical Research Council and Cancer Research UK. Funders had no role in study design or interpretation of the findings.
dc.languageENGen
dc.language.isoenen
dc.publisherBioMed Central
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.titleProspective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC-Norfolk study.en
dc.typeArticle
prism.endingPage11
prism.issueIdentifier135en
prism.publicationDate2016en
prism.publicationNameBMC Medicineen
prism.startingPage1
prism.volume14en
dc.identifier.doi10.17863/CAM.6288
dcterms.dateAccepted2016-08-17en
rioxxterms.versionofrecord10.1186/s12916-016-0677-4en
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/en
rioxxterms.licenseref.startdate2016-09-29en
dc.contributor.orcidWareham, Nicholas [0000-0003-1422-2993]
dc.contributor.orcidKhaw, Kay-Tee [0000-0002-8802-2903]
dc.contributor.orcidImamura, Fumiaki [0000-0002-6841-8396]
dc.contributor.orcidForouhi, Nita [0000-0002-5041-248X]
dc.identifier.eissn1741-7015
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idMRC (MC_UU_12015/5)
pubs.funder-project-idMRC (MC_UU_12015/1)
pubs.funder-project-idMEDICAL RESEARCH COUNCIL (MR/N003284/1)
pubs.funder-project-idMRC (G1000143)
pubs.funder-project-idMRC (G0401527)
cam.orpheus.successThu Jan 30 12:57:02 GMT 2020 - The item has an open VoR version.*
rioxxterms.freetoread.startdate2100-01-01


Files in this item

Thumbnail
Thumbnail
Thumbnail
Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record

Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International