Association between adherence to the Mediterranean diet and the prevalence of cardiovascular risk factors

Ramón-Arbués, Enrique; Martínez-Abadía, Blanca; Granada-López, José Manuel; Echániz-Serrano, Emmanuel; Huércanos-Esparza, Isabel; Antón-Solanas, Isabel

doi:10.1590/1518-8345.3904.3295

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3904.3295 copy

Association between adherence to the Mediterranean diet and the prevalence of cardiovascular risk factors

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to determine the prevalence of cardiovascular risk factors in a cohort of workers and to quantify its association with compliance with the Mediterranean diet follow-up.

Method:

a cross-sectional descriptive study was carried out on a cohort of 23,729 workers. Clinical data from annual medical examinations and the Mediterranean Diet Adherence Screener were used to assess adherence to the Mediterranean diet.

Results:

51.3% of the participants showed good adherence to the Mediterranean diet. The multivariate analysis showed an inverse and significant association between the follow-up of the Mediterranean diet and the prevalence of abdominal obesity (Odds Ratio = 0.64, 95% CI 0.56; 0.73), dyslipidemia (Odds Ratio = 0.55, 95% CI 0.42; 0.73), and metabolic syndrome (Odds Ratio = 0.76, 95% CI 0.67; 0.86).

Conclusions:

our results suggest that the Mediterranean diet is potentially effective in promoting cardiovascular health. Implementing the interventions promoting the Mediterranean diet in the working population seems justified.

Descriptors:
Diet, Mediterranean; Cardiovascular Diseases; Risk Factors; Cross-Sectional Studies; Workers; Occupational Health Nursing

Variables	Total (n=23,729)	Females (n=7,693)	Men (n=16,036)	p
Age (years old)	42.5±10.3	41.85±10.2	42.91±10.4	0.114
16-25 years old	1059 (4.5%)	362 (4.7%)	697 (4.3%)	<0.001
26-35 years old	5354 (22.6%)	1867 (24.3%)	3487 (21.7%)
36-45 years old	7954 (33.5%)	2646 (34.4%)	5308 (33.1%)
46-55 years old	6447 (27.2%)	2002 (26.0%)	4445 (27.7%)
56-65 years old	2915 (12.3%)	816 (10.6%)	2099 (13.0%)
Weight (kilograms - kg)	76.6±15.8	65.03±12.9	82.21±13.9	<0.001
BMI (kg/m²)^* * kg/m2= kilograms per square meter;	26.1±4.5	24.56±4.7	26.91±4.1	<0.001
Low weight (<18.5 kg/m²)^* * kg/m2= kilograms per square meter;	388 (1.6%)	300 (3.9%)	88 (0.5%)	<0.001
Normal weight (18.5-24.9 kg/m²)^* * kg/m2= kilograms per square meter;	9996 (42.1%)	4528 (58.9%)	5468 (34.1%)
Overweight (25-29.9 kg/m²)^* * kg/m2= kilograms per square meter;	9153 (38.6%)	1911 (24.8%)	7242 (45.2%)
Type I obesity (30-34-9 kg/m²)^* * kg/m2= kilograms per square meter;	3221 (13.6%)	671 (8.7%)	2550 (15.9%)
Type II obesity (35-39-9 kg/m²) ^* * kg/m2= kilograms per square meter;	758 (3.2%)	211 (2.7%)	547 (3.4%)
Abdominal perimeter (centimeters)	90.1±15.0	82.57±12.1	93.7±4.9	<0.05
Abdominal obesity	6020 (25.3%)	2320 (30.2%)	3700 (23.1%)	<0.001
Diastolic blood pressure (mmHg)^† * kg/m2= kilograms per square meter;	78.89±12.3	77.21±11.8	79.26±11.9	<0.001
Systolic blood pressure (mmHg)^† * kg/m2= kilograms per square meter;	133.16±17.6	127.23±16.7	135.41±17.8	<0.001
Arterial hypertension	4773 (20.1%)	1163 (15.1%)	3610 (22.5%)	<0.001
Total cholesterol (mg/dl)^‡ ‡ mg/dl = milligrams per deciliter	191.6±36.0	188.77±34.0	193.0±36.8	<0.001
HDL cholesterol (mg/dl)^‡ ‡ mg/dl = milligrams per deciliter	60.9±15.5	70.68±15.5	56.33±13.2	<0.001
LDL cholesterol (mg/dl)^‡ ‡ mg/dl = milligrams per deciliter	108.2±31.1	101.00±29.2	111.74±31.4	<0.001
Triglycerides (mg/dl)^‡ ‡ mg/dl = milligrams per deciliter	113.9±82.2	85.59±42.5	127.56±92.5	<0.001
Total cholesterol/HDL cholesterol	3.31±0.9	2.77±0.6	3.57±0.97	<0.001
Dyslipidemia	7430 (31.3%)	1707 (22.2%)	5723 (35.7%)	<0.001
Glycaemia (mg/dl)^‡ ‡ mg/dl = milligrams per deciliter	89.1±17.1	85.17±12.7	91.08±18.5	<0.001
Diabetes Mellitus	1824 (7.6%)	598 (7.0%)	1226 (7.6%)	0.729
Metabolic syndrome	1795 (7.5%)	533 (6.9%)	1262 (7.9%)	<0.05
Risky alcohol consumption	233 (1.0%)	49 (0.6%)	184 (1.1%)	<0.001
Smoking	7488 (31.5%)	2083 (27.1%)	5405 (33.7%)	<0.001
Physical inactivity	13425 (56.5%)	3978 (51.7%)	9447 (58.9%)	<0.001

Criterion	Total (n=23,729)	Females (n=7,693)	Men (n=16,036)	p
Using olive oil as the main source for cooking fats	20882 (88.0%)	7023 (91.3%)	13859 (86.4%)	<0.001
Daily consumption of 2 or more tablespoons of olive oil	15423 (64.9%)	5062 (65.8%)	10361 (64.6%)	0.072
Daily consumption of 2 or more servings of vegetables	13787 (58.1%)	4477 (58.2%)	9310 (58.0%)	0.839
Daily consumption of 3 or more pieces of fruit (includes natural juice)	10986 (46.3%)	3558 (46.2%)	7428 (46.3%)	0.918
Daily consumption less than 1 serving of red meats, sausages or cold meats	13194 (55.6%)	4292 (55.8%)	8902 (55.5%)	0.686
Daily consumption less than 1 serving of butter, margarine or cream	12625 (53.2%)	4392 (57.1%)	8233 (51.3%)	<0.001
Daily consumption less than 1 carbonated and/or sugary drink	12123 (51.1%)	4084 (53.0%)	8039 (50.1%)	<0.001
Weekly consumption of 3 or more glasses of red wine	4366 (18.3%)	623 (8.1%)	3743 (23.3%)	<0.001
Weekly consumption of 3 or more servings of legumes	5601 (23.6%)	1869 (24.3%)	3732 (23.2%)	0.083
Weekly consumption of 3 or more servings of fish	8946 (37.7%)	3085 (40.1%)	5861 (36.5%)	<0.001
Weekly consumption less than 3 servings of commercial pastries	7461 (31.4%)	2492 (32.4%)	4969 (31.0%)	<0.05
Weekly consumption of 1 or more servings of nuts	5434 (22.9%)	1654 (21.5%)	3780 (23.5%)	<0.001
Preferred consumption of white over red meat	13739 (57.9%)	4501 (58.5%)	9238 (57.6%)	0.189
Weekly consumption of 2 or more dishes garnished with vegetable sauce and olive oil	12718 (53.6%)	4161 (54.1%)	8557 (53.3%)	0.293
Final score ≥9 points^† † Final score. Compliance with the criterion equals 1 point and non-compliance equals 0	12178 (51.3%)	3992 (51.9%)	8186 (51.0%)	0.224
Final Score. Mean±Standard Deviation^† † Final score. Compliance with the criterion equals 1 point and non-compliance equals 0	9.10±3.98	9.18±4.09	9.06±3.92	<0.05

	Total (n=23,729)	Women (n=7,693)	Men (n=16,036)
Overweight/Obesity^† † Model adjusted for age, gender, smoking, level of physical activity - PA - and alcohol consumption;	0.96 (0.88; 1.05)	0.93 (0.85; 1.02)	0.98 (0.91; 1.06)
Central obesity^† † Model adjusted for age, gender, smoking, level of physical activity - PA - and alcohol consumption;	0.64 (0.56; 0.73)^§ § p<0.05	0.61 (0.51; 0.72)^§ § p<0.05	0.65 (0.55; 0.76)^§ § p<0.05
Diabetes^‡ ‡ Model adjusted for age, gender, smoking, PA level, alcohol consumption, overweight/obesity and central obesity;	0.93 (0.84; 1.03)	0.91 (0.78; 1.06)	0.88 (0.71; 1.09)
Hypertension^‡ ‡ Model adjusted for age, gender, smoking, PA level, alcohol consumption, overweight/obesity and central obesity;	0.89 (0.78; 1.02)	0.91 (0.8; 1.04)	0.89 (0.77; 1.01)
Dyslipidemia^‡ ‡ Model adjusted for age, gender, smoking, PA level, alcohol consumption, overweight/obesity and central obesity;	0.55 (0.42; 0.73)^§ § p<0.05	0.78 (0.69; 0.87)^§ § p<0.05	0.82 (0.72; 0.93)^§ § p<0.05
Metabolic syndrome^‡ ‡ Model adjusted for age, gender, smoking, PA level, alcohol consumption, overweight/obesity and central obesity;	0.76 (0.67; 0.86)^§ § p<0.05	0.73 (0.59; 0.91)^§ § p<0.05	0.78 (0.67; 0.90)^§ § p<0.05

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[1] Corresponding author: Enrique Ramón-Arbués E-mail: eramon@usj.es https://orcid.org/0000-0002-7911-9949