TY - JOUR
T1 - Mediterranean diet and all-causes mortality after myocardial infarction
T2 - Results from the GISSI-Prevenzione trial
AU - Barzi, F.
AU - Woodward, M.
AU - Marfisi, R. M.
AU - Tavazzi, L.
AU - Valagussa, F.
AU - Marchioli, R.
N1 - Funding Information:
GISSI is endorsed by Associazione Nazionale Medici Cardio-logi Ospedalieri (ANMCO), Firenze, Italy and by Istituto di Ricerche Farmacologiche Mario Negri, Consorzio Mario Negri Sud, Santa Maria Imbaro, Italy. GISSI-Prevenzione was supported by Bristol-Myers Squibb, Pharmacia-Upjohn, Societá Prodotti Antibiotici, Pfizer and Bracco. We thank C Pera, B Ferri, A Flamminio, A Polidoro and R Zama for invaluable secretarial help during the course of the study. Federica Barzi was the recipient of a research fellowship from Instituto di Ricerche Farmacologiche M. Negri, Milano, Italy.
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Objective: To ascertain whether simple dietary advice to increase the consumption of Mediterranean foods, given in a clinical setting, leads to reduced mortality after a myocardial infarction. Design: Data were used from the GISSI-Prevenzione clinical trial, analysed as a cohort study with adjustment for treatment allocation. Setting: A total of 172 centres in Italy. Subjects: A total of 11323 men and women with myocardial infarction. All subjects received advice to increase their consumption of fish, fruit, raw and cooked vegetables and olive oil. Measurements: The intakes of the five foods were assessed at baseline, 6, 18 and 42 months. Associations of food intakes, a combined dietary score, and the risk of death over 6.5 y were estimated adjusting for several non-dietary variables, using pooled logistic regression. Results: Subjects generally improved their diet according to the advice given. All foods were associated with a significant reduction in risk of death. Compared with people in the worst dietary score quarter, the odds ratio for those in the best score quarter was 0.51 (95% CI 0.44-0.59). A good diet had a protective effect in sub-groups defined by age, sex, smoking, randomized treatment and concomitant drug therapy. Conclusions: Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment prescribed, clinicians should routinely advise patients with myocardial infarction to increase their frequency of consumption of Mediterranean foods.
AB - Objective: To ascertain whether simple dietary advice to increase the consumption of Mediterranean foods, given in a clinical setting, leads to reduced mortality after a myocardial infarction. Design: Data were used from the GISSI-Prevenzione clinical trial, analysed as a cohort study with adjustment for treatment allocation. Setting: A total of 172 centres in Italy. Subjects: A total of 11323 men and women with myocardial infarction. All subjects received advice to increase their consumption of fish, fruit, raw and cooked vegetables and olive oil. Measurements: The intakes of the five foods were assessed at baseline, 6, 18 and 42 months. Associations of food intakes, a combined dietary score, and the risk of death over 6.5 y were estimated adjusting for several non-dietary variables, using pooled logistic regression. Results: Subjects generally improved their diet according to the advice given. All foods were associated with a significant reduction in risk of death. Compared with people in the worst dietary score quarter, the odds ratio for those in the best score quarter was 0.51 (95% CI 0.44-0.59). A good diet had a protective effect in sub-groups defined by age, sex, smoking, randomized treatment and concomitant drug therapy. Conclusions: Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment prescribed, clinicians should routinely advise patients with myocardial infarction to increase their frequency of consumption of Mediterranean foods.
KW - Antioxidants
KW - Mediterranean diet
KW - Mortality
KW - Repeated measurements
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U2 - 10.1038/sj.ejcn.1601575
DO - 10.1038/sj.ejcn.1601575
M3 - Article
C2 - 12700623
AN - SCOPUS:0038558117
SN - 0954-3007
VL - 57
SP - 604
EP - 611
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
IS - 4
ER -