Abstract Background and aims: The Mediterranean Diet (MedD) is considered a very healthy
diet useful in the prevention of cardiovascular disease. The present study aims to evaluate adherence
to MedD in unselected premenopausal women and its relation with ankle-brachial index
(ABI), an index of preclinical atherosclerosis.
Methods and results: A group of 425 patients (age range 45e54 years) was investigated. They
were enrolled only if they were asymptomatic for cardiovascular disease. Nutritional parameters
were assessed by a self-administered food frequency validated questionnaire (116 items)
completed by an interviewer administered 24 h diet recall. They all underwent ABI measurement.
The mean MedD Score was 32.2 6.1 (Q1eQ3 range 26e37) comparing with data from
Italian population (46 8.3) was significantly lower. Intake of food categories sources of antioxidants
was higher in patients with a greater adherence to Med D and was mainly related to fruit
and vegetables. Patients were categorized in quartile according to MedD Score and we evaluate
the distribution of ABI index within quartile. 31.4% of women in Q1 (lower adherence to MedD)
had an ABI lower than 0.9 compared to 18.3% of women in Q4 (higher adherence to MedD):
p < 0.01. Obesity was more frequent in Q1 compared to Q4 and in women with lower ABI.
Conclusions: Women with a low MedD Score were more obese and showed instrumental sign of
preclinical peripheral atherosclerosis. MedD rich in antioxidants from fruit, vegetables and nuts
influenced the development of atherosclerosis and was associated with a lower incidence of
asymptomatic atherosclerosis
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