Mediterranean diet protects against development of subclinical atherosclerotic disease

The researchers found that higher adherence to a Mediterranean diet is related to fewer atherosclerotic plaques.

The consumption of caloric diets high in total and saturated fat and sodium, smoking and a sedentary lifestyle have been identified as the main modifiable risk factors for CVD (cardiovascular disease). Subclinical atherosclerotic disease is defined as signs of atherosclerotic cardiovascular disease (ACD) at early stages. It is commonly revealed by the presence of atherosclerotic plaque(s) in the aortic, carotid, or iliofemoral territories. SAD, in general, is considered a risk factor for CVD that is not usually detected in current clinical practice.

Accumulating evidence indicates that healthy dietary patterns, particularly adherence to the Mediterranean Diet, have been reported as protective against CVD and the development of atherosclerotic plaques (AP). However, current research on the association between dietary patterns and SDA is limited, and published results often consist of small population sizes and are inconsistent.

To fill this knowledge gap, Marina Idalia Rojo-López, and the team from Spain aimed to evaluate the association between the Mediterranean diet and subclinical atherosclerotic disease in a large cohort of Mediterranean population with low-to-moderate cardiovascular risk.

The researchers' team performed a cross-sectional study comprising 8116 subjects from the ILERVAS cohort. Atherosclerotic plaque presence was assessed by ultrasound examination.

Adherence to the MDiet was determined using the 14-item Mediterranean Diet Adherence Score (MEDAS). Subjects with at least one cardiovascular risk factor were included. Exclusion criteria were a clinical history of chronic kidney disease, diabetes, or a prior cardiovascular event.

The authors reported the following findings:

• Compared with subjects without SAD, participants with SAD were older and had a higher frequency of smoking habits, hypertension, HbA1c, dyslipidemia, and waist circumference.
• The adjusted multivariable analysis showed that a higher MEDAS was associated with a lower risk of AP (incidence rate ratios [IRR] 0.97).
• Moderate or high adherence to the MDiet was associated with a lower number of AP compared with a low MDiet adherence (IRR 0.90).
• In both models, female sex was associated with a lower risk of AP.

"In the present study, we found that better adherence to the Mediterranean was associated with lower number and frequency of subclinical atherosclerosis in a large cohort of adult Mediterranean individuals with low-to-moderate CVD risk," the researchers wrote.

"Further studies are required to establish a causal relationship between both variables," they concluded.

Reference:

Rojo-López, M. I., Bermúdez-López, M., Castro, E., Farràs, C., Torres, G., Pamplona, R., Lecube, A., Valdivielso, J. M., Fernández, E., Julve, J., Castelblanco, E., Franch-Nadal, J., Alonso, N., Granado-Casas, M., & Mauricio, D. (2023). Low adherence to the Mediterranean diet is associated with increased prevalence and number of atherosclerotic plaques in the ILERVAS cohort. Atherosclerosis, 380, 117191. https://doi.org/10.1016/j.atherosclerosis.2023.117191