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Reaction to the first meta-analysis studying the effect of a Mediterranean diet on women's cardiovascular health and mortality

A review of studies of more than 700,000 women has estimated that those who follow a Mediterranean diet faithfully have about a 25% lower risk of cardiovascular disease and death. This effect is greater than had been found in other studies, many of which included a majority of men and did not differentiate results by sex. According to the authors, the study underscores the need for this type of targeted analysis. The results are published in the journal Heart.

14/03/2023 - 23:30 CET
Mediterranean diet in women

The Mediterranean diet is also beneficial in women. / Adobe Stock.

Expert reactions

Corella - Dieta Mujeres (EN)

Dolores Corella

Professor of Preventive Medicine and Public Health at the Faculty of Medicine of the University of Valencia and researcher at the CIBER Obesity and Nutrition (CIBEROBN)

Science Media Centre Spain

The authors have conducted a meta-analysis. This means that they have not conducted any new studies, but have analysed data from previous published studies. Methodologically as a meta-analysis it is a correct study, but the main limitation of meta-analyses is that they have to analyse the results of original studies previously conducted by other researchers. This is both the main limitation and the novelty of the study.  

In general, the original studies have mostly been conducted by analysing men and women together. Therefore, the risk estimate they have provided is pooled and it is not known whether men and women respond equally. Some of the original studies, on the other hand, did provide results broken down by men and women in their publications, and it is precisely these studies that have been included in the meta-analysis. The limitation is that they have only been able to include the original studies that have previously presented results by men and women [all of them observational]. 

The study does not provide much new information on the effects of the Mediterranean diet. It has simply carried out a meta-analysis of the results of previous studies, focusing the statistical analyses on women. Overall, I find the study interesting in highlighting the need for more separate studies in men and women. 

More well-designed original studies are needed to prove that the effect of the Mediterranean diet is greater in women. Although some results are meta-analysed by sex, in general the gender perspective has not yet been well incorporated in nutritional epidemiology research and there is a need for better questionnaires to measure diet in men and women and to include other confounding variables such as pregnancy, menopause, etc. in women. 

In summary, the interest of the study is that it highlights the need for better studies stratified by sex. The application of the gender perspective in biomedical research has been promoted for several years now due to the previous scarcity of this approach.

The author has not responded to our request to declare conflicts of interest
Primary prevention of cardiovascular disease in women with a Mediterranean diet: systematic review and meta-analysis
  • Research article
  • Peer reviewed
  • Observational study
  • People
  • Meta-analysis
Publication date

Pant et al.

Study types:
  • Research article
  • Peer reviewed
  • Observational study
  • People
  • Meta-analysis
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