A healthy quality Mediterranean-like diet partially modifies the association between obesity and cardiovascular mortality, according to a study published recently in PLOS Medicine.

Studies have suggested that other factors, including healthy dietary patterns, might modify the higher risk of CVD associated with higher BMI. In the new study, researchers studied BMI, diet and mortality among 79,003 Swedish adults enrolled in the Swedish Mammography Cohort and Cohort of Swedish Men.

Adherence to a Mediterranean-like diet (mMED) was assessed on a scale of 0 to 8, integrating information on intake of fruits and vegetables, legumes, nuts, unrefined or high-fibre grains, fish, red and processed meat, and olive oil. Over 21 years of follow-up, 30,389 (38% of participants) died. Among overweight individuals, the group with the lowest hazard ratio of all-cause mortality were those with high mMED.

Obese individuals who also had high mMED did not have a significantly higher mortality compared with those with normal weight and high mMED. For CVD mortality, which represented 12,064 of the deaths, the findings were broadly similar.

These results indicate that adherence to healthy diets such as a Mediterranean-like diet may be a more appropriate focus that avoidance of obesity for the prevention of overall mortality.