Evidence map›Paper›PMID 40000753›Full record

ArticleEuropean journal of clinical nutrition2025

Sustainable, planetary healthy dietary patterns are associated with lower 20-year incidence of cardiovascular disease: the ATTICA study (2002-2022).

Evangelia Damigou, Shauna M Downs, Christina Chrysohoou, Fotios Barkas, Costas Tsioufis, Christos Pitsavos, Evangelos Liberopoulos, Petros P Sfikakis, Demosthenes Panagiotakos

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Article in European journal of clinical nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Evangelia DamigouDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece.ORCID http://orcid.org/0009-0002-2632-9376
Shauna M DownsDepartment of Health Behavior, Society and Policy, Rutgers University, Newark, NJ, USA.
Christina ChrysohoouFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Fotios BarkasDepartment of Internal Medicine, Medical School, University of Ioannina, 45500, Ioannina, Greece.
Costas TsioufisFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Christos PitsavosFirst Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 15772, Athens, Greece.
Evangelos LiberopoulosFirst Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece.
Petros P SfikakisFirst Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece.
Demosthenes PanagiotakosDepartment of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676, Athens, Greece. dbpanag@hua.gr.ORCID http://orcid.org/0000-0001-8583-153X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesNutrition epidemiology research scarcely focuses on the relationship between dietary patterns that are beneficial for both planet and human health. This study aimed to examine the association between adherence to a sustainable, planetary-healthy dietary pattern, i.e., the EAT-Lancet Reference Diet (EAT-LD), and 20-year cardiovascular disease (CVD) incidence, in a Mediterranean population. SUBJECTS/

methodsΤhe ATTICA study is a prospective cohort study with a baseline phase in 2002 and 3 consecutive follow-ups (in 2006, 2012, 2022). The EAT-Lancet Index (EAT-LI) and the MedDietScore scales were calculated based on previously published guidelines to assess the adherence to the respective dietary pattern. The current sample consisted of 1,988 Greek adults initially free-of-CVD at baseline. The development of a cardiovascular event was assessed throughout the 20-year period (WHO-ICD-10 classification).

resultsThe 20-year incidence of CVD was 3600 cases/10,000 individuals (95%Confidence Interval-CI: 3506 to 3695/10,000). Median (interquartile range) values for EAT-LI and MedDietScore were 17 (6.2) out of possible 42 points and 27 (2.9) out of possible 55 points, respectively. Both diet scales were inversely associated with 20-year CVD incidence [Hazard Ratio-HR (95% CI) per 1 point (of possible 42 points) of EAT-LI: 0.83 (0.77-0.90) and per 1 point (of possible 55 points) of MedDietScore: 0.90 (0.84-0.93)].

conclusionOur findings highlight that diets that are good for planetary health, are also healthy for humans. Promoting diets that are culturally acceptable, economically viable, easily accessible, planet-friendly, and sustainable should be a key strategy for enhancing both public and planetary health.

Indexed as

Cardiovascular DiseasesDiet, HealthyAdultAgedDiet, MediterraneanFemaleGreeceHumansIncidenceMaleMiddle AgedProspective Studies

Identifiers

PMID40000753

What Socratic holds

Textmetadata
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Registered trials

None linked

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.