ArticleCardiovascular diabetology2021
Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain.
Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06601478 (Development and Implementation of a Tool for the Evaluation and Monitorization of Mediterranean Lifestyle at Clinical Settings), which is not on this map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Development and Implementation of a Tool for the Evaluation and Monitorization of Mediterranean Lifestyle at Clinical Settings: MEDLIFE Index, a Proof of Concept Study
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Lifestyle scores and their potential to estimate the risk of multiple non-communicable disease-related endpoints: a systematic review.BMC public health · 2025Pooled it
- Lifestyle behaviors and risk of cardiovascular disease and prognosis among individuals with cardiovascular disease: a systematic review and meta-analysis of 71 prospective cohort studies.The international journal of behavioral nutrition and physical activity · 2024Pooled it
- Pooled it
- Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial.Nutrition & diabetes · 2024Trial
- Yearly attained adherence to Mediterranean diet and incidence of diabetes in a large randomized trial.Cardiovascular diabetology · 2023Trial
- Effect of Dietary and Lifestyle Interventions on the Amelioration of NAFLD in Patients with Metabolic Syndrome: The FLIPAN Study.Nutrients · 2022Trial
- Sleep Characteristics and Insomnia Severity in Relation to Mediterranean Lifestyle Adherence and Psychosocial Wellbeing: Findings from the MEDIET4ALL International Survey.European journal of investigation in health, psychology and education · 2026Article
- Effects of Traditional Mediterranean Physical Activity on Physical and Mental Health: A Systematic Review.American journal of lifestyle medicine · 2026Review
- Mediterranean Lifestyle Adherence Reflects Coherent Behavioural Patterns Based on the MEDLIFE Index.Nutrients · 2026Observational
- Association of healthy lifestyle, depression with all-cause or cardiovascular mortality modified by metabolic syndrome among individuals: evidence from US NHANES and UK biobank cohort studies.Nutrition & metabolism · 2026Article
- Associations between the Mediterranean lifestyle and incident age-related eye diseases: a longitudinal analysis from the UK Biobank.Journal of global health · 2026Article
- A narrative review of dietary patterns in cardiovascular-kidney-metabolic syndrome.Frontiers in nutrition · 2026Review
- Integrated metabolomics reveals lipid mediators and food-associated chemicals associated with metabolic syndrome.Frontiers in nutrition · 2026Article
- Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers.Cureus · 2026Article
- Mediterranean diet adherence, body composition, and recovery outcomes in hospitalised COVID-19 patients: a mixed-methods study.Frontiers in nutrition · 2026Article
- Prevalence and determinants of food addiction among Palestinian university students: a cross-sectional study.Eating and weight disorders : EWD · 2025Article
- Translational Lifestyle Medicine Approaches to Cardiovascular-Kidney-Metabolic Syndrome.Healthcare (Basel, Switzerland) · 2025Review
- Article
- Adherence to combined healthy lifestyle and odds of metabolic syndrome in Iranian adults: the PERSIAN Dena cohort study.Scientific reports · 2025Article
- Association of Mediterranean Diet with Cardiovascular Risk Factors and with Metabolic Syndrome in Subjects with Long COVID: BioICOPER Study.Nutrients · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain.
methodsData were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008-2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence).
resultsCompared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality.
conclusionsThe Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.