Deconstruction of the MedDietScore Components for the evaluation of Acute Coronary Syndromes

V. Efthymiou, C.M. Kastorini, H. Milionis, Ε. Trichia, S. Bitsi, Κ. Kalantzi, V. Nikolaou, Κ. Vemmos, J. Goudevenos, D.B. Panagiotakos



Background: Most of the existing dietary indices are not weighted. The aim of the present work was the decomposition of the Mediterranean diet components, regarding their ability to evaluate likelihood of ACS presence and the classification of these components, in order to construct a weighted dietary index. Methods: During 2009-2010, 250 consecutive patients with a first ACS event (age: 60.24±12.18 y, 208 men) and 500 healthy selected volunteers (age: 62.43±13.39 y, 311 men), were included in the study. Adherence to the Mediterranean diet was evaluated using the dietary index MedDietScore (theoretical range: 0-55). Results: After adjusting for possible covariates, multi-adjusted analysis revealed that an increase of 1/55 unit of the MedDietScore was associated with a 6% reduction on the likelihood of ACS. Similarly, the components “fruits and juices” (OR=0.79), “vegetables and salads” (OR=0.68) and “red meat and products” (OR=0.79) were associated with decreased likelihood of ACS. Furthermore, Mediterranean diet components were classified according to the values of Wald test, from the most to the least important, as follows: 1) “vegetables and salads”, 2) “fruits and juices”, 3) “red meat and products”, 4) “potatoes”, 5) “poultry”, 6) “fish and soups”, 7) “olive oil”, 8) “alcohol drinks”, 9) “full fat dairy products”, 10) “whole grain cereals” and 11) “legumes”. Conclusions: Adherence to the Mediterranean diet was inversely associated with the presence of ACS. Construction of such a weighted dietary index could lead to a more valuable tool for evaluating ACS presence.

Keywords: Mediterranean diet, acute coronary syndrome, components, classification