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Multicenter Study
. 2018 Mar 15;13(3):e0193360.
doi: 10.1371/journal.pone.0193360. eCollection 2018.

Mediterranean diet adherence and synergy with acute myocardial infarction and its determinants: A multicenter case-control study in Italy

Giuseppe La Torre  1 , Rosella Saulle  1 , Francesca Di Murro  1 , Roberta Siliquini  2 , Alberto Firenze  3 , Massimo Maurici  4 , Alice Mannocci  1 , Vittoria Colamesta  1 , Francesco Barillà  5 , Fabio Ferrante  6 , Luciano Agati  6 ; Collaborative group
Affiliations
Multicenter Study

Mediterranean diet adherence and synergy with acute myocardial infarction and its determinants: A multicenter case-control study in Italy

Giuseppe La Torre et al. PLoS One. .

Abstract

Background: Cardiovascular diseases are the leading causes of mortality and morbidity in Western countries. The possible synergistic effect of poor adherence to a Mediterranean diet (MD) and other risk factors for acute myocardial infarction (AMI) such as hypertension, cholesterol, ever smoker, BMI> 25, diabetes, has not been deeply studied.

Design: Case-control study.

Methods: Patients with first AMI and controls from four tertiary referral Italian centers were screened for enrolment. Dietary information was collected through a questionnaire and a MD adherence score was calculated. Physical activity and smoking habits were also registered. The Synergy Index was calculated according to Rothman.

Results: 127 cases and 173 controls were enrolled. The analysis was conducted using a dichotomous variable for the MD score with values ≥7 representing good adherence. Multivariate analysis showed the following variables associated to AMI: ever smoker (OR = 2.08), diabetes (OR = 1.42), hypertension (OR = 2.08), hypercholesterolemia (OR = 2.47), BMI> 25 (OR = 1.99), while a protective effect emerged both in subjects scoring > 7 on the MD score (OR = 0.55) and in subjects resident of Southern Italy (OR = 0.38). A synergistic effect does exist between poor adherence to the MD and the following risk factors: hypertension, hypercholesterolemia, BMI >25, diabetes and being a resident in central and northern Italy.

Conclusion: Synergy between heart disease risk factors and MD underlines the need to enlarge the list of known modifiable cardiovascular risk factors to include and promote adherence to Mediterranean dietary habits.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The receiver operating characteristic curve of the Mediterranean diet score.
See this image and copyright information in PMC

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