Evidence map›Paper›PMID 27509006›Full record

SynthesisPloS one2016

Effects of the Mediterranean Diet on Cardiovascular Outcomes-A Systematic Review and Meta-Analysis.

Thaminda Liyanage, Toshiharu Ninomiya, Amanda Wang, Bruce Neal, Min Jun, Muh Geot Wong, Meg Jardine, Graham S Hillis, Vlado Perkovic

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 17 pooled it
24.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 17 syntheses or guidelines pooled it, 211 citations in OpenAlex.

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  4. The effectiveness of the Mediterranean Diet for primary and secondary prevention of cardiovascular disease: An umbrella review.Nutrition & dietetics : the journal of the Dietitians Association of Australia · 2025
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24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Thaminda LiyanageThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Toshiharu NinomiyaThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Amanda WangThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Bruce NealThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Min JunThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Muh Geot WongThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Meg JardineThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Graham S HillisThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
Vlado PerkovicThe George Institute for Global Health, Sydney Medical School, University of Sydney, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.
University of Sydney · AUSouth Metropolitan Health ServiceThe George Institute for Global Health · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA Mediterranean dietary pattern is widely recommended for the prevention of chronic disease. We sought to define the most likely effects of the Mediterranean diet on vascular disease and mortality.

methodsWe searched MEDLINE, EMBASE and the Cochrane Central Register without language restriction for randomized controlled trials comparing Mediterranean to control diets. Data on study design, patient characteristics, interventions, follow-up duration, outcomes and adverse events were sought. Individual study relative risks (RR) were pooled to create summary estimates.

resultsSix studies with a total of 10950 participants were included. Effects on major vascular events (n = 477), death (n = 693) and vascular deaths (n = 315) were reported for 3, 5 and 4 studies respectively. For one large study (n = 1000) there were serious concerns about the integrity of the data. When data for all studies were combined there was evidence of protection against major vascular events (RR 0.63, 95% confidence interval 0.53-0.75), coronary events (0.65, 0.50-0.85), stroke (0.65, 0.48-0.88) and heart failure (0.30, 0.17-0.56) but not for all-cause mortality (1.00, 0.86-1.15) or cardiovascular mortality (0.90, 0.72-1.11). After the study of concern was excluded the benefit for vascular events (0.69, 0.55-0.86) and stroke (0.66, 0.48-0.92) persisted but apparently positive findings for coronary events (0.73, 0.51-1.05) and heart failure (0.25, 0.05-1.17) disappeared.

conclusionThe Mediterranean diet may protect against vascular disease. However, both the quantity and quality of the available evidence is limited and highly variable. Results must be interpreted with caution.

Indexed as

Diet, MediterraneanCardiovascular DiseasesDatabases, FactualHeart FailureHumansRiskStroke

Identifiers

PMID27509006
PMCPMC4980102
OpenAlexW2494833964

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.