Adherence to the Mediterranean Diet in Spanish Population and Its Relationship with Early Vascular Aging according to Sex and Age: EVA Study

Nutrients. 2020 Apr 8;12(4):1025. doi: 10.3390/nu12041025.

Abstract

The objective of this study is to analyze the influence of adherence to the Mediterranean diet (MDA) and its components on early vascular aging (EVA) in a Spanish population sample free of cardiovascular disease and to analyze the differences by sex.

Methods: We recruited 501 individuals aged 35-75 without cardiovascular disease by random sampling (55.90 ± 14.24 years, 49.70% men). EVA was defined in two steps: Step 1: subjects with vascular damage in carotid arteries or peripheral artery disease were classified as EVA. Step 2: subjects at the percentile of the combined Vascular Aging Index (VAI) were classified; ≥ p90 was considered EVA and < p90 was considered normal vascular aging (NVA), estimated using the following formula (VAI = (log (1.09) × 10 cIMT + log (1.14) cfPWV) × 39.1 + 4.76 by age and sex. Carotid-femoral pulse wave velocity (cfPWV) was measured by SphigmoCor System® and carotid intima-media thickness by Sonosite Micromax® ultrasound and classified thus: values ≥ Percentile 90 were considered EVA and those < Percentile 90 as NVA, with population percentiles analyzed. The principal result variable was assessed using the 14-item MEDAS questionnaire, developed and validated by the PREDIMED group, comprising 12 questions about the frequency of food consumption and two questions regarding the Spanish population's typical eating habits.

Results: MDA was observed by 25% (17% men and 34% women). EVA was present in 17% (29% men and 4% women). The adjusted logistic regression models showed that an increase in MDA decreases the probability of EVA in the global analysis (OR = 0.36; 95% CI: 0.16-0.82). In the analysis by sex, this association was only seen in men (OR = 0.33; 95% CI: 0.12-0.86), but not in women (OR = 0.31; 95% CI: 0.04-2.50).

Conclusion: The results of this study suggest that a greater adherence to the Mediterranean diet decreases the probability of presenting EVA. In the analysis by sex, this association applies only to men.

Keywords: Mediterranean diet; early vascular aging; general population; normal vascular aging.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aging
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Diseases / complications
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / diet therapy*
  • Cross-Sectional Studies
  • Diet, Mediterranean*
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / diagnostic imaging
  • Peripheral Arterial Disease / diet therapy*
  • Pulse Wave Analysis
  • Sex Factors
  • Spain
  • Ultrasonography