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

A Mediterranean lifestyle may prevent and mitigate cardiometabolic disorders. We explored whether adherence to a Mediterranean lifestyle was prospectively associated with risk of metabolic syndrome (MetS) among coronary heart disease (CHD) patients.The 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 Mediterranean lifestyle at baseline, and after five 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 Mediterranean lifestyle. Multivariable logistic regression models were used to determine the association between MEDLIFE adherence and the risk of MetS development or reversal.During the five-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, p0.01) and a higher likelihood of reversing pre-existing 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, p0.01) and a 21% higher likelihood of reversing pre-existing MetS (OR 1.21 CI 95% 1.04-1.41, p = 0.01).Our results showed that greater adherence to a Mediterranean lifestyle reduced the risk of subsequent MetS development and increased the likelihood of reversing pre-existing MetS among patients with CHD at baseline. This article is protected by copyright. All rights reserved.