ArticleThe Journal of nutrition2024
Prospective Association of the Mediterranean Diet with the Onset of Cardiometabolic Multimorbidity in a UK-Based Cohort: The EPIC-Norfolk Study.
Article in The Journal of nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Dietary Patterns and Cardiovascular Diseases in Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Observational Studies.Advances in nutrition (Bethesda, Md.) · 2026Pooled it
- Adherence to Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-analysis.Advances in nutrition (Bethesda, Md.) · 2025Pooled it
- Sleep duration, sleep quality, and daytime napping in relation to incident cardiometabolic multimorbidity across three national aging cohorts: a prospective, interpretable machine learning study.Frontiers in nutrition · 2026Article
- Comparative predictive values of anthropometric indices for cardiometabolic multimorbidity in middle-aged and older adults: a prospective study from the CHARLS study.BMC public health · 2025Article
- Study on the association between dietary patterns and cardiovascular metabolic comorbidities among adults.Journal of health, population, and nutrition · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundCardiometabolic multimorbidity (CMM), defined as the co-occurrence of 2 or more cardiometabolic diseases, including myocardial infarction (MI), stroke, and type 2 diabetes (T2D), is an increasing public health challenge. Although poor diet is a known risk factor for a first cardiometabolic disease (FCMD), the relationship with subsequent occurrence of CMM is less studied.
objectivesThis study aims to investigate the prospective association between baseline adherence to the Mediterranean diet and the onset of CMM across various follow-up durations.
methodsWe used data from the European Prospective Investigation into Cancer-Norfolk cohort study of 21,900 adults, aged 40-79 free of prevalent MI, stroke, and T2D at baseline (1993-1997). A median-based Mediterranean diet score and a pyramid-based MDS (pyr-MDS) were used to measure baseline adherence to the Mediterranean diet. Multistate modeling was employed to investigate associations with the FCMD and the subsequent CMM event.
resultsOver the entire follow-up period of 21.4 y (median), we observed 5028 FCMD and 734 CMM events. Multistate analysis indicated that the association between baseline Mediterranean diet and the risk of CMM may be stronger in shorter follow-up durations. Particularly, baseline pyr-MDS was significantly associated with the risk of subsequent CMM transitioning from FCMD when follow-up durations were limited to 10 and 15 y, with hazard ratio (95% confidence interval) being 0.67 (0.53, 0.84) and 0.80 (0.70, 0.92) per SD increase in pyr-MDS, respectively. Additionally, we observed that the risk of CMM transitioning from FCMD was modified by social class across shorter to longer follow-ups, where the impact of baseline Mediterranean diet was only significant in nonmanual workers.
conclusionsBaseline adherence to the Mediterranean diet was potentially associated with a lower risk of CMM transitioning from FCMD, particularly during shorter follow-up periods.
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