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The Adoption of Mediterranean Diet Attenuates the Development of Acute Coronary Syndromes in People with the Metabolic Syndrome

Christos Pitsavos, Demosthenes B Panagiotakos*, Christine Chrysohoou, Ioanna Papaioannou, Lambros Papadimitriou, Dimitrios Tousoulis, Christodoulos Stefanadis and Pavlos Toutouzas

Author affiliations

Cardiology Department, School of Medicine, University of Athens, Athens, Greece

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Citation and License

Nutrition Journal 2003, 2:1  doi:10.1186/1475-2891-2-1

Published: 19 March 2003



In this work we investigated the effect of the consumption of the Mediterranean diet on coronary risk, in subjects with the metabolic syndrome.


During 2000–2002, we randomly selected, from all Greek regions, 848 hospitalised patients (695 males, 58 ± 10 & 153 females, 65 ± 9 years old) with a first event of acute coronary syndrome and 1078 frequency matched, by sex, age, region controls, without any suspicious for cardiovascular disease. Nutritional habits were evaluated through a validated questionnaire, while the metabolic syndrome was defined according to the NCEP ATP III criteria. Mediterranean diet was defined according to the guidelines of the Division of Nutrition/Epidemiology, of Athens Medical School.


Of the 1926 participants, 307 (36.2%) of the patients and 198 (18.4%) of the controls (P < 0.001) met the ATP III criteria. This was related with 2fold adjusted coronary risk (odds ratio = 2.35, 95% 1.87 – 2.84) in subjects with the metabolic syndrome as compared with the rest of them. No differences were observed concerning the prevalence of the metabolic syndrome and sex of subjects, after adjustment for group of study (P > 0.1). Eighty (26%) of the patients and 70 (35%) of the controls (P < 0.01) with the metabolic syndrome were "closer" to the Mediterranean diet. Multivariate analysis revealed that the adoption of this diet is associated with a 35% (odds ratio = 0.65, 95% 0.44 – 0.95) reduction of the coronary risk in subjects with the metabolic syndrome, after adjusting for age, sex, educational and financial level and the conventional cardiovascular risk factors.


Consequently, the adoption of Mediterranean diet seems to attenuate the coronary risk in subjects with the metabolic syndrome.

metabolic syndrome; risk; coronary; Mediterranean; diet; physical activity