A recent study published in the journal Nutrients has shed light on the potential cardiovascular health benefits of the Mediterranean diet (MD) specifically for women. Led by researchers in Australia, the study aimed to review existing evidence regarding the impact of the MD on cardiovascular outcomes in females.
Cardiovascular disease (CVD) remains the leading cause of mortality among women globally. Recognizing the pivotal role of nutrition in modifying cardiovascular risk factors, the MD stands out as one of the most recommended dietary patterns internationally. Characterized by high consumption of plant foods and mono-unsaturated fats, moderate intake of fish, seafood, and dairy, and low intake of red and processed meats, the MD has garnered attention for its potential cardioprotective effects. The study sought to examine the current understanding of how adherence to the MD influences CVD prevention in women.
Cardioprotective Benefits
Research suggests that the MD offers cardioprotective advantages, attributed to the synergistic effects of its main components. Notably, the MD has been associated with improvements in lipid profile, blood pressure, vascular function, oxidative stress, and inflammatory markers. The lipid-lowering effect of the MD is believed to stem from the higher intake of mono- and poly-unsaturated fats from plant sources and fish. Furthermore, increased consumption of phytosterols and fiber in the MD may aid in cholesterol absorption. The diet’s abundance of antioxidants, minerals, and flavonoids also contributes to its anti-inflammatory effects and reduction of oxidative stress, potentially improving blood pressure and vascular function.
Sex-Specific Nutrition Mechanisms
Understanding the interplay between diet and biological sex is crucial in comprehending cardiovascular outcomes. Although the mechanisms underlying the relationship between the MD and sex remain unclear, preliminary studies have suggested sex-dimorphic responses to the diet. For instance, a pilot study revealed that females adhering to the MD showed distinct upregulation of certain proteins compared to males. Animal studies have further underscored sex differences in gut microbiome composition, metabolism, and hormonal interactions. Evolutionary factors, including prehistoric gender roles influencing dietary behaviors and nutritional requirements, may contribute to the observed variations between sexes.
Current Evidence on Cardiovascular Health
Existing evidence indicates a reduced risk of CVD associated with higher adherence to the MD. Large prospective cohort studies, such as one involving over 74,000 women in the United States, have reported significant risk reductions in coronary heart disease with greater adherence to the MD. While some studies suggest a more pronounced effect of the MD on CVD risk reduction in males, others have highlighted significant benefits for females specifically. Moreover, the MD has demonstrated positive effects on blood pressure and has been associated with a lower risk of type 2 diabetes mellitus and improved glycemic control.
Female-Specific Risk Factors
Tailoring treatment and prevention strategies for CVD is essential, particularly in addressing female-specific risk factors such as pregnancy complications, polycystic ovarian syndrome (PCOS), and autoimmune conditions. Clinical trials have shown promising results in managing PCOS with a low-carbohydrate MD, leading to improvements in metabolic parameters. Additionally, females with gestational diabetes mellitus or hypertensive disorders during pregnancy face a heightened risk of future cardiovascular events. Nutritional interventions aimed at improving birth outcomes among women with inadequate nutrition have shown positive effects, underscoring the importance of dietary considerations during pregnancy. Autoimmune disorders, which disproportionately affect women, are also associated with increased CVD risks.
Conclusion
In conclusion, the current body of evidence supports the cardiovascular benefits of the MD, particularly for women at high risk of CVD. However, future research efforts should prioritize greater female representation and focus on elucidating sex-dimorphic and female-specific data. Furthermore, additional studies are warranted to determine whether the MD offers superior benefits compared to other dietary patterns in addressing female-specific conditions.