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

Alberto Firenze, Alice Mannocci, Fabrizio Bert, Aldo Marsico, Rosella Saulle, Sara Cimino, Vittoria Colamesta, Valentina Bonanno, Annalisa Rosso, Francesco Cicogna, Valentina Petronilli, Renata Gili, Clara Ferrara, Francesca Di Murro, Sandro Provenzano, Massimiliano Chiarini, Mariacarmela Ferraro, Fabio Ferrante, Gerardo De Carolis, Aldo MarsicoAldo Marsico, Roberta Siliquini, Massimo Maurici, Francesco Barillà, Giuseppe La Torre, Luciano Agati, Fabio Ferrante, Fiorella Barilla', Marianna Maurici, Sybilla Cimino

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13 Citazioni (Scopus)


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.
Lingua originaleEnglish
pagine (da-a)e0193360-
Numero di pagine13
RivistaPLoS One
Stato di pubblicazionePublished - 2018

All Science Journal Classification (ASJC) codes

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