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Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis

Consuming a Mediterranean-style diet (MED) is helpful for primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, few studies have compared mortality in ASCVD subjects with different degrees of adherence to the MED diet or have evaluated the contributions of individual diet co...

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Autores principales: Liang, Kae-Woei, Lee, Chia-Lin, Liu, Wei-Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370677/
https://www.ncbi.nlm.nih.gov/pubmed/35956379
http://dx.doi.org/10.3390/nu14153203
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author Liang, Kae-Woei
Lee, Chia-Lin
Liu, Wei-Ju
author_facet Liang, Kae-Woei
Lee, Chia-Lin
Liu, Wei-Ju
author_sort Liang, Kae-Woei
collection PubMed
description Consuming a Mediterranean-style diet (MED) is helpful for primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, few studies have compared mortality in ASCVD subjects with different degrees of adherence to the MED diet or have evaluated the contributions of individual diet components. We analyzed National Health and Nutrition Examination Survey (NHANES) participants with a history of coronary heart disease (CHD) or stroke (N = 2052) in a period from 1999 to 2010. Their individual vital status was linked to the National Death Index till the end of 2011. The level of adherence to the MED diet was quantified using a 9-point evaluation score (aMED score). Cox regression models were used to compare the different levels of adherence to the MED diet, and contributions of individual components of the MED diet on cardiovascular, cancer, and all-cause mortality. Among the 2052 subjects with CHD or stroke, 29.0% (596 of 2052) died after a median follow-up of 5.6 years. In Cox regression analysis, higher absolute aMED score (HR 0.798, p = 0.0079) or above median aMED score (score 4–9) (HR 0.646, p = 0.0013) was negatively associated with all-cause mortality. Among various components of the MED diet, intake of more whole grains or nuts was significantly associated with a lower all-cause mortality. In contrast, a higher aMED score was not associated with less cardiovascular mortality. In a secondary analysis that excluded deaths within 2 years of the NHANES study entry, the above median aMED score (score 4–9) was negatively associated with both all-cause and cardiovascular mortality. In conclusion, subjects with a history of CHD or stroke adhering better to the MED diet in the NHANES study had a lower all-cause mortality during follow-ups. Consuming more whole grains or nuts had a lower all-cause mortality. The protective effect of adherence to the MED diet on decreasing cardiovascular mortality was seen only after excluding those who died within first two years of the NHANES study entry.
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spelling pubmed-93706772022-08-12 Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis Liang, Kae-Woei Lee, Chia-Lin Liu, Wei-Ju Nutrients Article Consuming a Mediterranean-style diet (MED) is helpful for primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, few studies have compared mortality in ASCVD subjects with different degrees of adherence to the MED diet or have evaluated the contributions of individual diet components. We analyzed National Health and Nutrition Examination Survey (NHANES) participants with a history of coronary heart disease (CHD) or stroke (N = 2052) in a period from 1999 to 2010. Their individual vital status was linked to the National Death Index till the end of 2011. The level of adherence to the MED diet was quantified using a 9-point evaluation score (aMED score). Cox regression models were used to compare the different levels of adherence to the MED diet, and contributions of individual components of the MED diet on cardiovascular, cancer, and all-cause mortality. Among the 2052 subjects with CHD or stroke, 29.0% (596 of 2052) died after a median follow-up of 5.6 years. In Cox regression analysis, higher absolute aMED score (HR 0.798, p = 0.0079) or above median aMED score (score 4–9) (HR 0.646, p = 0.0013) was negatively associated with all-cause mortality. Among various components of the MED diet, intake of more whole grains or nuts was significantly associated with a lower all-cause mortality. In contrast, a higher aMED score was not associated with less cardiovascular mortality. In a secondary analysis that excluded deaths within 2 years of the NHANES study entry, the above median aMED score (score 4–9) was negatively associated with both all-cause and cardiovascular mortality. In conclusion, subjects with a history of CHD or stroke adhering better to the MED diet in the NHANES study had a lower all-cause mortality during follow-ups. Consuming more whole grains or nuts had a lower all-cause mortality. The protective effect of adherence to the MED diet on decreasing cardiovascular mortality was seen only after excluding those who died within first two years of the NHANES study entry. MDPI 2022-08-05 /pmc/articles/PMC9370677/ /pubmed/35956379 http://dx.doi.org/10.3390/nu14153203 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liang, Kae-Woei
Lee, Chia-Lin
Liu, Wei-Ju
Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title_full Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title_fullStr Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title_full_unstemmed Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title_short Lower All-Cause Mortality for Coronary Heart or Stroke Patients Who Adhere Better to Mediterranean Diet-An NHANES Analysis
title_sort lower all-cause mortality for coronary heart or stroke patients who adhere better to mediterranean diet-an nhanes analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9370677/
https://www.ncbi.nlm.nih.gov/pubmed/35956379
http://dx.doi.org/10.3390/nu14153203
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