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. 2023 May;293(5):574-588.
doi: 10.1111/joim.13602. Epub 2023 Jan 11.

Adherence to a Mediterranean lifestyle improves metabolic status in coronary heart disease patients: A prospective analysis from the CORDIOPREV study

Juan Luis Romero-Cabrera  1   2   3 , Antonio García-Ríos  1   2 , Mercedes Sotos-Prieto  3   4   5 , Gracia Quintana-Navarro  1   2 , Juan Francisco Alcalá-Díaz  1   2 , Laura Martín-Piedra  1   2 , José David Torres-Peña  1   2 , Raúl M Luque  2   6 , Elena María Yubero-Serrano  1   2 , Javier Delgado-Lista  1   2 , Niki Katsiki  7   8 , Stefanos N Kales  3   9 , José López-Miranda  1   2 , Pablo Pérez-Martínez  1   2
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Free article

Adherence to a Mediterranean lifestyle improves metabolic status in coronary heart disease patients: A prospective analysis from the CORDIOPREV study

Juan Luis Romero-Cabrera et al. J Intern Med. 2023 May.
Free article

Abstract

Background and objectives: A Mediterranean lifestyle may prevent and mitigate cardiometabolic disorders. We explored whether adherence to a Mediterranean lifestyle was prospectively associated with the risk of metabolic syndrome (MetS) among coronary heart disease (CHD) patients.

Methods: The Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention (CORDIOPREV) study was an interventional diet study to compare a Mediterranean diet with a low-fat diet, in 1002 CHD patients. The Mediterranean lifestyle (MEDLIFE) index was used to assess adherence to a MEDLIFE at baseline, and after 5 years, in 851 participants from the CORDIOPREV study. Subjects were classified as having high (>13 points), moderate (12-13 points), and low (<12 points) adherence to the MEDLIFE. Multivariable logistic regression models were used to determine the association between MEDLIFE adherence and the risk of MetS development or reversal.

Results: During the 5-year follow-up, CORDIOPREV participants with high adherence to MEDLIFE had a lower risk of MetS development (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19-0.75, p < 0.01) and a higher likelihood of reversing preexisting MetS (OR 2.08 CI 95% 1.11-3.91, p = 0.02) compared with participants in the low MEDLIFE adherence group. Each additional one-point increment in the MEDLIFE index was associated with a 24% lower risk of MetS development (OR 0.76, 95% CI 0.64-0.90, p < 0.01) and a 21% higher likelihood of reversing preexisting MetS (OR 1.21 CI 95% 1.04-1.41, p = 0.01).

Conclusions: Our results showed that greater adherence to a MEDLIFE reduced the risk of subsequent MetS development and increased the likelihood of reversing preexisting MetS among patients with CHD at baseline.

Keywords: Mediterranean lifestyle; coronary heart disease; metabolic syndrome; secondary prevention.

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