Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA

Mediterranean Diet Linked to Lower Long-Term Cardiovascular Events in Women Interview with:

Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA

Dr. Mora

Samia Mora, MD, MHS
Associate Professor of Medicine
Harvard Medical School
Director, Center for Lipid Metabolomics
Brigham and Women’s Hospital
Boston, MA What is the background for this study? What are the main findings?

Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit.

Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors.

Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites. What should readers take away from your report?

Response: American women consuming a Mediterranean-type diet had up to a quarter reduction in CVD events over long-term follow-up. Modest changes in CVD risk factors account for part of the benefit of the Mediterranean diet on CVD risk and may have important downstream consequences for primary prevention. What recommendations do you have for future research as a result of this work? 

Response: Our study participants were US female healthcare professionals who might have different behaviors than men or higher risk individuals, so, future studies should also be conducted among men, other populations and other ethnic groups. There also may be additional pathways (such as improvements in vascular function or anti-arrhythmic effects) that could be improved with the Mediterranean diet that we did not measure in our study. Is there anything else you would like to add?

Response: We thank the Women’s Health Study participants, staff, collaborators and funding agencies.

Funding: The Women’s Health Study is supported by National Institutes of Health grants (CA047988, HL043851, HL080467, HL099355, and UM1 CA182913). Dr. Mora was supported by the research grants DK112940, HL134811 and HL136852, American Heart Association (0670007N) and the Molino Family Trust. Also, without additional costs, LabCorp provided the LipoProfile IV results. Dr. Shafqat Ahmad was supported through a fellowship and research support from Swedish Heart-Lung Foundation, Nutricia Research Foundation and Henning och Johan Throne-Holst stiftelse Fellowship Sweden. Dr Demler was supported by K01HL135342-02.

Disclosures: Dr. Samia Mora: Received institutional research grant support from Atherotech Diagnostics for research outside the current work, served as a consultant/scientific advisory board to Quest Diagnostics, and has a patent regarding the use of GlycA in relation to colorectal cancer risk. Dr. Paul M Ridker: Received research grant support from AstraZeneca, Novartis, Amgen, Pfizer, and NHLBI, and is listed as a coinventor on patents held by the Brigham and Women’s Hospital related to the use of inflammatory biomarkers in


Ahmad S, Moorthy MV, Demler OV, et al. Assessment of Risk Factors and Biomarkers Associated With Risk of Cardiovascular Disease Among Women Consuming a Mediterranean Diet. JAMA Netw Open.2018;1(8):e185708. doi:10.1001/jamanetworkopen.2018.5708

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Dec 10, 2018 @ 8:44 pm


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