@article{3101280,
    title = "Metabolic syndrome, adherence to the Mediterranean diet and 10-year cardiovascular disease incidence: The ATTICA study",
    author = "Kastorini, C.-M. and Panagiotakos, D.B. and Chrysohoou, C. and Georgousopoulou, E. and Pitaraki, E. and Puddu, P.E. and Tousoulis, D. and Stefanadis, C. and Pitsavos, C. and Skoumas, Y. and Katinioti, N. and Papadimitriou, L. and Masoura, C. and Vellas, S. and Lentzas, Y. and Kambaxis, M. and Palliou, K. and Metaxa, V. and Ntzouvani, A. and Mpougatsas, D. and Skourlis, N. and Papanikolaou, C. and Kouli, G.-M. and Christou, A. and Zana, A. and Ntertimani, M. and Kalogeropoulou, A. and Laskaris, A. and Hatzigeorgiou, M. and Grekas, A. and Kokkou, E. and Tsetsekou, E. and Vassiliadou, C. and Dedoussis, G. and Toutouza-Giotsa, M. and Tselika, C. and Poulopoulou, S. and Toutouza, M. and The ATTICA Study Group",
    journal = "Atherosclerosis",
    year = "2016",
    volume = "246",
    pages = "87-93",
    publisher = "Elsevier Ireland Ltd",
    issn = "0021-9150",
    doi = "10.1016/j.atherosclerosis.2015.12.025",
    keywords = "C reactive protein;  glucose;  high density lipoprotein cholesterol;  interleukin 6;  lipid;  triacylglycerol;  autacoid;  biological marker;  glucose blood level;  lipid, Article;  blood pressure;  body weight;  cardiovascular disease;  cholesterol blood level;  controlled study;  dietary compliance;  female;  follow up;  human;  incidence;  major clinical study;  male;  MedDietScore;  Mediterranean diet;  metabolic syndrome X;  nutritional assessment;  principal component analysis;  priority journal;  adolescent;  adult;  aged;  blood;  Cardiovascular Diseases;  diet therapy;  glucose blood level;  Greece;  metabolic syndrome X;  metabolism;  middle aged;  multivariate analysis;  odds ratio;  patient compliance;  protection;  risk assessment;  risk factor;  risk reduction;  statistical model;  time factor;  very elderly;  weight gain;  young adult, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Biomarkers;  Blood Glucose;  Blood Pressure;  Cardiovascular Diseases;  Diet, Mediterranean;  Female;  Follow-Up Studies;  Greece;  Humans;  Incidence;  Inflammation Mediators;  Lipids;  Logistic Models;  Male;  Metabolic Syndrome X;  Middle Aged;  Multivariate Analysis;  Odds Ratio;  Patient Compliance;  Principal Component Analysis;  Protective Factors;  Risk Assessment;  Risk Factors;  Risk Reduction Behavior;  Time Factors;  Weight Gain;  Young Adult",
    abstract = "Background and aims: To better understand the metabolic syndrome (MS) spectrum through principal components analysis and further evaluate the role of the Mediterranean diet on MS presence. Methods: During 2001-2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III) definition. Adherence to the Mediterranean diet was assessed using the MedDietScore (range 0-55). Results: Five principal components were derived, explaining 73.8% of the total variation, characterized by the: a) body weight and lipid profile, b) blood pressure, c) lipid profile, d) glucose profile, e) inflammatory factors. All components were associated with higher likelihood of CVD incidence. After adjusting for various potential confounding factors, adherence to the Mediterranean dietary pattern for each 10% increase in the MedDietScore, was associated with 15% lower odds of CVD incidence (95%CI: 0.71-1.06). For the participants with low adherence to the Mediterranean diet all five components were significantly associated with increased likelihood of CVD incidence. However, for the ones following closely the Mediterranean pattern positive, yet not significant associations were observed. Conclusion: Results of the present work propose a wider MS definition, while highlighting the beneficial role of the Mediterranean dietary pattern. © 2015 Elsevier Ireland Ltd."
}