The Mediterranean diet could cut the risk of cardiovascular disease in women by 24%, according to a study

• Following the Mediterranean diet has been linked to a 24% lower risk of cardiovascular disease in women.
• Cardiovascular disease is the leading cause of death for women.
• Little sex-specific research has been done and the study is the first of its kind.

Following the Mediterranean diet has been linked to a 24% lower risk of cardiovascular disease in women in a study.

The researchers behind the analysis of 16 studies conducted between 2003 and 2021, published in the journal Heart, said their findings suggest more sex-specific research into cardiovascular disease is needed, given the majority either include relatively few women or don't differentiate between sexes.

Cardiovascular disease, the term used for conditions of the heart or blood vessels, is the leading cause of death in women. Despite this, the study is the first of its kind to look into the effect of the Mediterranean diet on women's heart health.

The studies included more than 700,000 adult women, mostly in the US and Europe, whose heart health was tracked for an average of 12.5 years.

The researchers found that those who followed the Mediterranean diet most closely had a 24% lower risk of cardiovascular disease, as well as a 23% lower risk of death from any cause.

The Mediterranean diet prioritizes vegetables, whole grains, oily fish, legumes, nuts, olive oil, and fruit, and also includes alcohol in moderation. It encourages minimal consumption of fried and processed foods, refined carbs, added sugars, and dairy products. 

It's believed that the Mediterranean diet is so good for heart health because it's high in antioxidants, polyphenols, nitrates, omega-3 fatty acids, and fiber, and limits refined carbs.

The study cannot prove cause and effect

The researchers acknowledged the limitations of their findings, such as the fact that all the studies relied on participants reporting on their own behaviors.

Observational studies can be misleading because they don't show causation — social factors and behavior can play a big role in the results, George Davey Smith, professor of clinical epidemiology at the University of Bristol, UK, who was not involved in the study, told the Science Media Centre.

Victoria Taylor, senior dietitian at the charity British Heart Foundation, who was also not involved in the study, highlighted the need for sex-specific research.

"Heart disease is often seen as a male problem, but coronary heart disease kills more than twice as many women as breast cancer in the UK each year," she said. "Sex-specific research like this is vital for reducing the heart disease gender gap and improving women's care."

The study authors agreed and wrote: "Female specific cardiovascular risk factors, including premature menopause, pre-eclampsia and gestational diabetes, or female predominant risk factors, such as systemic lupus, can all independently increase CVD risk."

"It is possible that preventative measures, such as a Mediterranean diet, that targets inflammation and CVD risk factors, impose differing effects in women compared with men," they said.

While the researchers grouped participants by ethnicity, they didn't assess whether or not women were pre- or post-menopausal, using hormonal replacement therapy or the oral contraceptive pill, or had a history of gestational diabetes, professor Nita Forouh from the MRC Epidemiology Unit that works to improve global health at the University of Cambridge, who also didn't work on the study, said.