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Mediterranean diet (MD) is considered a model for healthy eating. However, prospective evidence in Turkey evaluating the relationship between MD and cardiovascular events is scarce. We surveyed the adherence of Turkish population to MD and its association with cardiovascular disease (CVD).
Followed-up 900 participants (52 percent women) initially free of cardiovascular disease (CVD) during 5.1 years. The general dietary habits of study population were detected with a food frequency quetionnaire. Data obtained from that questionnaire were tested with Mediterranean diet score in order to find out the relevance to Mediterranean diet. A MD score (scale 0–8) was computed reflecting high ratio of monounsaturated to saturated fat; high intake of alcohol, legumes, cereals, vegetables, and fruits; low intakes of meat and it's products, milk and dairy products. Scoring <5 was defined as Low-MD consuming, while 5+ as High-MD consuming. We observed 25 incident cases of CVD. Consumption of High-MD was 21% in men and 19% in women. The risk for myocardial infarction, coronary bypass, angioplasty, and any cardiovascular disease in men increased by 1.3 (p=0.02), 1.4 (p=0.03), 1.5 (p=0.01), and 1.3 (p=0.02), respectively, for each MD score decrease. In women, the risk for myocardial infarction and angioplasty increased by 1.3 (p=0.02) and 1.5 (p=0.01), respectively, for each MD score decrease. The risk for coronary bypass, and any cardiovascular disease in women, crude odds ratios ranged from 1.1 to 1.3 but were not statistically significant.
The current rate of MD in Turkey is fairly low. There is an inverse association between adherence to MD and the incidence of fatal and non-fatal CVD in initially healthy adults.
|Age (years) a||43||42|
|Physically active (%)||22||15|
|Alcohol consumption (%,≥1 glass per month)||42||10|
|Alcohol (gram/day)a||18 (3–29)||1 (0–4)|
|Energy intake (kcal/day)a||1770 (1127–2399)||1250 (925–2264)|
|Vegetables (gram/day)a||210 (151–258)||198 (126–247)|
|Fruit (gram/day)a||187 (92–223)||154 (86–218)|
|Legumes (gram/day)a||20 (12–27)||17 (9–25)|
|Nuts (gram/day)a||4 (0–11)||2 (0–8)|
|Grains (gram/day)a||180 (126–338)||174 (132–294)|
|Fish and seafood (gram/day)a||3 (0–10)||2 (0–8)|
|Unsaturated fatty acids (gram/day)a||39 (27–51)||34 (26–44)|
|Saturated fatty acids (gram/day)a||62 (46–81)||55 (38–69)|
|Dairy and dairy products (gram/day)a||321 (193–524)||314 (190–488)|
|Meat products (gram/day)a||124 (108–155)||93 (61–112)|
|Fatal CVD (n)||3||2|
|Incident CVD (n)||15||10|
Participants’ characteristics at baseline and CVD incidence aNumbers are given as mean (sd) or as median (interquartile range); bCigarette, cigar or hookah; CVD = cardiovascular diseases, MI = myocardial infarction.