Mediterranean diet for cardiovascular disease: an evidence mapping study

Area of Science:

• Cardiovascular disease research
• Nutritional epidemiology
• Evidence-based medicine

Background:

• Cardiovascular disease (CVD) is a leading global cause of mortality.
• While meta-analyses suggest the Mediterranean diet (MD) is effective for CVD, methodological variations limit conclusions.
• Existing reviews vary in scope, quality, and outcome measures, necessitating a quality assessment.

Purpose of the Study:

• To evaluate the methodological quality of meta-analyses on the Mediterranean diet (MD) for cardiovascular disease (CVD).
• To assess the quality of evidence for outcome indicators related to MD's therapeutic efficacy in CVD.
• To provide an updated overview of the evidence concerning MD and CVD.

Main Methods:

• Comprehensive literature searches of PubMed, Cochrane Library, and Embase databases.
• Assessment of meta-analysis quality using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist.
• Evaluation of evidence quality for significant outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Main Results:

• 54.55% of meta-analyses were high quality, 9.09% low quality, and 36.36% critically low quality.
• Moderate evidence supports a positive correlation between MD and reduced risk of various CVD outcomes.
• Included studies comprised 5 randomized trials and 12 non-randomized studies with 716,318 participants.

Conclusions:

• The methodological quality of meta-analyses on the Mediterranean diet for CVD is often suboptimal.
• Evidence quality for outcome indicators related to MD's efficacy in CVD management is currently unsatisfactory.
• While promising, definitive conclusions on the Mediterranean diet's therapeutic role in CVD require higher quality evidence and methodology.