Key result
Higher Mediterranean diet adherence linked to ~11% lower risk of cardiometabolic multimorbidity per SD.
Why the study?
Poor diet is a known risk factor for a first cardiometabolic disease, but its relationship with the subsequent occurrence of cardiometabolic multimorbidity is less studied.
Does baseline adherence to the Mediterranean diet reduce the onset of cardiometabolic multimorbidity in adults free of cardiometabolic disease at baseline?
Cohort (n=21,900)
No
Does baseline adherence to the Mediterranean diet reduce the onset of cardiometabolic multimorbidity in adults free of cardiometabolic disease at baseline?
Higher baseline adherence to the Mediterranean diet is associated with a lower risk of progressing from a first cardiometabolic disease to cardiometabolic multimorbidity, particularly over shorter follow-up periods.
Supports Mediterranean diet for multimorbidity prevention in observational cohorts; leaves open causal effects and practice change pending trials.
BACKGROUND: Cardiometabolic multimorbidity (CMM), defined as the co-occurrence of 2 or more cardiometabolic diseases, including myocardial infarction (MI), stroke, and type 2 diabetes (T2D), is an increasing public health challenge. Although poor diet is a known risk factor for a first cardiometabolic disease (FCMD), the relationship with subsequent occurrence of CMM is less studied. OBJECTIVES: This study aims to investigate the prospective association between baseline adherence to the Mediterranean diet and the onset of CMM across various follow-up durations. METHODS: We used data from the European Prospective Investigation into Cancer-Norfolk cohort study of 21,900 adults, aged 40-79 free of prevalent MI, stroke, and T2D at baseline (1993-1997). A median-based Mediterranean diet score and a pyramid-based MDS (pyr-MDS) were used to measure baseline adherence to the Mediterranean diet. Multistate modeling was employed to investigate associations with the FCMD and the subsequent CMM event. RESULTS: Over the entire follow-up period of 21.4 y (median), we observed 5028 FCMD and 734 CMM events. Multistate analysis indicated that the association between baseline Mediterranean diet and the risk of CMM may be stronger in shorter follow-up durations. Particularly, baseline pyr-MDS was significantly associated with the risk of subsequent CMM transitioning from FCMD when follow-up durations were limited to 10 and 15 y, with hazard ratio (95% confidence interval) being 0.67 (0.53, 0.84) and 0.80 (0.70, 0.92) per SD increase in pyr-MDS, respectively. Additionally, we observed that the risk of CMM transitioning from FCMD was modified by social class across shorter to longer follow-ups, where the impact of baseline Mediterranean diet was only significant in nonmanual workers. CONCLUSIONS: Baseline adherence to the Mediterranean diet was potentially associated with a lower risk of CMM transitioning from FCMD, particularly during shorter follow-up periods.
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Wang et al. (2024) conducted a cohort in Cardiometabolic multimorbidity (n=21,900). Mediterranean diet vs. Lower adherence to Mediterranean diet was evaluated on Risk of cardiometabolic multimorbidity (CMM) (HR 0.89, 95% CI 0.82-0.96). Baseline adherence to the Mediterranean diet was associated with a lower risk of cardiometabolic multimorbidity, with an HR of 0.89 per standard deviation increase in diet score over a median 21.4 years.
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