Following a Mediterranean diet can reduce the risk of cardiovascular disease in women by almost 25%, according to a new study from the University of Sydney.
Cardiovascular disease is responsible for over a third of all female deaths worldwide. It is well understood that diet is key in the prevention of cardiovascular disease, yet there have been few studies that have focused on the sex-specific effects of different diets, such as the Mediterranean diet. As well as this, most official guidelines on cardiovascular disease risk do not differentiate by sex.
In light of their findings, the researchers have called for more sex-specific research to guide clinical cardiovascular practice. The study, titled ‘Primary prevention of cardiovascular disease in women’, has been published in the journal Heart.
What is a Mediterranean diet?
The Mediterranean diet is defined as one that is rich in whole grains, 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.
The team examined research databases trying to find studies on the potential impact of a Mediterranean diet on women’s cardiovascular health and their risk of death. They found 16 studies published between 2003 and 2021 used in their pooled data analysis. Most of the studies were from the USA and Europe and contained information on over 700,000 women aged 18 and above.
The researcher’s analysis revealed that following the diet was linked to a 24% lower risk of cardiovascular disease and a 23% lower risk of death from any cause in women. They also found that the risk of coronary heart disease was 25% lower. Cases of stroke in women were also lower, but by enough to be statistically relevant.
When the researchers excluded the studies from the analysis one by one, they found that it did not materially affect the findings. This further supported the suggestion of an inverse relationship between mortality and higher Mediterranean diet adherence in women.
The research did acknowledge several limitations in their work, such as the observational nature of the studies analysed, which relied on self-reported food frequency questionnaires.
Antioxidants may be key in reducing cardiovascular disease
However, the researchers said that the presence of antioxidants and gut microbiomes in the Mediterranean diet may explain the observed associations due to their effects on inflammation and cardiovascular risk factors. They also highlighted high levels of polyphenols, nitrates, omega-3 fatty acids, and fibre in the Mediterranean diet as a possible driver of the association.
“However, mechanisms explaining the sex-specific effect of the Mediterranean diet on death remain unclear. 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,” wrote the researchers.
“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,” they concluded.
