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Mediterranean diet, women & heart disease

Executive Summary

* A widely reported study claimed that adherence to 'the Mediterranean diet' would reduce the risk of early death in women by a quarter.

* The researchers didn't study the Mediterranean diet. They studied the fictitious Mediterranean diet, which academia has constructed. The real Mediterranean diet is based on animal foods, vegetables and some fruit. The starchy carbs consumed are white, rather than wholemeal. The fictitious Mediterranean diet is based on whole grains, legumes, vegetables, fruits and olive oil, with little meat and dairy.

* The researchers reviewed 16 population studies to reach their conclusions. No controlled trials were available for review for women only.

* Approximately 700,000 women were included in the 16 population studies. Cardiovascular disease (CVD) was the focus of the review.

* The CVD incident rate was 4% during 12.5 years of follow-up. That made the incident rate a fraction of one percent in any one year of the study. Applying the "quarter" difference to this small incident rate gave an absolute risk difference of 6 in 10,000 in any 1 year. That's inconsequential.

* This incident rate was also before the 16 studies were adjusted for the many differences that impact CVD other than diet: smoking, age, alcohol, exercise, income, education, diabetes, HRT etc. An examination of the 16 studies found that many important factors were not adjusted for. The whole basis of the review was thus compromised.

* Thanks to global headlines, women might think that if they consume this made-up Mediterranean diet, they might be far less likely to die early than those who don't eat in this way. That is not the case.


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