Mediterranean diet may cut heart disease in women by 25%, study suggests

Women can cut their risk of heart disease and death by nearly one-quarter by sticking closely to a Mediterranean diet, a study suggests.

Adhering to a Mediterranean diet was associated with a 24 per cent lower risk of cardiovascular disease, and a 23 per cent lower risk of death from any cause in women, the analysis by Australian researchers found.

The risk of coronary heart disease was 25 per cent lower, while that of stroke was also lower, although not statistically significant, in those who most closely followed this diet of nuts, seafood, whole grains and vegetables, compared with those who did so the least.

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Cardiovascular disease accounts for more than a third of all deaths in women. While a healthy diet is a key plank of prevention, most relevant clinical trials have included relatively few women or haven’t reported the results by sex, according to the researchers. Current guidelines on how best to lower cardiovascular disease risk – including HSE guidelines – don’t differentiate by sex.

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Their findings, published in Heart journal, are based on the results of 16 studies published between 2003 and 2021, involving more than 700,000 women, mostly in Europe and the US.

The Mediterranean diet is rich in wholegrains, vegetables, fruit, legumes, nuts, and extra virgin olive oil; moderate in fish/shellfish; low to moderate in wine; and low in red/processed meats, dairy products, animal fat, and processed foods.

One limitation to the findings is that the studies are observational, relying on self-reported eating behaviours. Adjustments for potentially influential factors varied across the different studies.

The researchers believe the Mediterranean diet’s antioxidant and gut microbiome effects on inflammation and cardiovascular risk factors are among the possible explanations for the observed associations.

The diet’s various components, such as polyphenols, nitrates, omega-3 fatty acids, increased fibre intake and reduced glycaemic load, may all separately contribute to a better cardiovascular risk profile, they suggest.

The mechanisms explaining the effect of the diet specifically on women remain unclear and reinforce the need for more sex-specific research in cardiology, the authors say.

“Female specific cardiovascular risk factors, including premature menopause, pre-eclampsia and gestational diabetes, or female predominant risk factors, such as systemic lupus, can all independently increase [cardiovascular disease] risk.

“It is possible that preventative measures, such as a Mediterranean diet, that targets inflammation and [cardiovascular disease] risk factors, impose differing effects in women compared with men.”