“This study adds to what is already known about the cardiovascular benefits of a Mediterranean diet but further reiterates that it can be equally as beneficial in women as it is known to be in men,” said lead author Sarah Zaman, associate professor at the Westmead Applied Research Centre at the University of Sydney, in an email.
Heart disease is the number one killer of women and men worldwide, according to the World Health Organization. Coronary artery disease kills more than twice as many women as breast cancer in the United Kingdom, while in 2020, one in five deaths among women in the United States was because of heart disease.
Yet few studies on the heart have looked specifically at women, Zaman said.
“It’s long been known that eating a Mediterranean-style is good for your heart, but it’s encouraging to see this research suggest that when we look at women separately from men, the benefits remain,” said Victoria Taylor, a senior dietitian at the British Heart Foundation, in a statement. She was not involved in the study.
Behind the Mediterranean diet analysis
The analysis, published Wednesday in the journal Heart, combined studies on the Mediterranean diet, separating out details about women from men. Women were given points for a higher intake of beneficial foods such as vegetables and fruits, whole grains, legumes, nuts and seafood, and lower intake of red and processed meats, all part of the Mediterranean diet.
Women who most closely followed the Mediterranean diet had a 24% lower risk of heart disease and a 23% lower risk of early death than women who barely followed the diet, the study found. There was also a decline in deaths from stroke, but it was not statistically significant, according to the study.
“I am thrilled to finally see data on women, as these data are either not presented, or underpowered in prior studies to work as well in women and men,” said cardiologist Dr. Roxana Mehran, who was not involved in the study. Mehran, a professor of medicine, directs the Interventional Cardiovascular Research and Clinical Trials at Mount Sinai School of Medicine in New York City.
Researchers ran the number on men, and found almost the same results: “There was a 22% lower risk of heart disease and 23% lower risk of death in men,” Zaman said.
A ‘reaffirmation study’
That’s not surprising, said Dr. David Katz, a specialist in preventive and lifestyle medicine and nutrition who was not involved in the study.
“What we knew about the benefits of the Mediterranean diet before now was not sex-specific,” he said, adding that the cardiovascular benefits of a high-quality diet should be the same regardless of sex.
“Accordingly, this was a ‘reaffirmation study,’ demonstrating that the benefits observed for the Mediterranean diet in men and women remain statistically robust when exclusively women are considered as a major sub group,” he said via email.
There were limitations — all of the 16 studies were observational, which means they cannot show cause and effect, and they tended to rely on self reports of food intake, which are inevitably affected by memory recall, Taylor said.
The limitations “are acknowledged by the authors, who also recommend that we should interpret their findings with caution, but it also supports the need for more sex-specific research,” Taylor said.
“Whatever your gender, a healthy lifestyle which includes a balanced diet like the Mediterranean-style diet can help you to lower your risk of developing heart and circulatory diseases and the risk factors for them, such as type 2 diabetes, obesity, high blood pressure and high cholesterol,” she added.