Evidence map›Paper›PMID 32406924›Full record

ArticleEuropean heart journal2020

The Mediterranean diet, plasma metabolome, and cardiovascular disease risk.

Jun Li, Marta Guasch-Ferré, Wonil Chung, Miguel Ruiz-Canela, Estefanía Toledo, Dolores Corella, Shilpa N Bhupathiraju, Deirdre K Tobias, Fred K Tabung, Jie Hu and 17 more

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Article in European heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 203 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
203citing papers in PubMed, 3 pooled it
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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.

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3 · Its place in the literature

Who cites it

203 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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143 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Jun LiDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Marta Guasch-FerréDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Wonil ChungDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
Miguel Ruiz-CanelaDepartment of Preventive Medicine and Public Health, University of Navarra, Irunlarrea 1, Pamplona 31008, Spain.
Estefanía ToledoDepartment of Preventive Medicine and Public Health, University of Navarra, Irunlarrea 1, Pamplona 31008, Spain.
Dolores CorellaCIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Madrid 28029, Spain.
Shilpa N BhupathirajuDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Deirdre K TobiasDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Fred K TabungDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Jie HuDivision of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont St, 3rd floor, Boston, MA 02120, USA.
Tong ZhaoDepartment of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 4th Floor, Boston, MA 02115, USA.
Constance TurmanDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
Yen-Chen Anne FengDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
Clary B ClishMetabolomics Platform,Broad Institute of Harvard and MIT, 415 Main St, Cambridge, MA 02142, USA.
Lorelei MucciDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
A Heather EliassenDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
Karen H CostenbaderDivision of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Elizabeth W KarlsonDivision of Rheumatology, Inflammation and Immunity, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
Brian M WolpinDepartment of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
Alberto AscherioDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Eric B RimmDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
JoAnn E MansonDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.
Lu QiDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Miguel Ángel Martínez-GonzálezDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Jordi Salas-SalvadóCIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Madrid 28029, Spain.
Frank B HuDepartment of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 3rd Floor, Boston, MA 02115, USA.
Liming LiangDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building II 2nd Floor, Boston, MA 02115, USA.

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ROSNER, BERNARD A · 2000 to 2019
$77.8M
Risk Factors for Breast Cancer in Younger NursesR01CA050385 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ELIASSEN, A. HEATHER, WILLETT, WALTER C. · 1989 to 2019
$32.3M
ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Elizabeth Austen Lawson, Takara Leah Stanley · 1994 to 2026
$31.6M
Transgenic CoreP30DK046200 · NIDDK · TUFTS MEDICAL CENTER · PI CORKEY, BARBARA E. · 1992 to 2021
$25.0M
Life Course Cancer Epidemiology Cohort in WomenU01CA176726 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI ELIASSEN, A. HEATHER, WILLETT, WALTER C. · 2018 to 2025
$22.4M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Integrating lifecourse approaches, biologic and digital phenotypes in support of heart and lung disease epidemiologic researchU01HL145386 · NHLBI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI CHAVARRO, JORGE EDUARDO, MANSON, JOANN ELISABETH · 2019 to 2025
$17.8M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Life Course Cancer Epidemiology Cohort in WomenUM1CA176726 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2013 to 2017
$15.7M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8M
Dietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6M
Premonopausal Hormone Levels and Risk of Breast CancerR01CA067262 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HANKINSON, SUSAN E · 2002 to 2011
$11.9M
NCI NIH HHS P01 CA087969NCI NIH HHS R00 CA207736NCI NIH HHS R01 CA049449NCI NIH HHS R01 CA050385NCI NIH HHS R01 CA067262NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA176726NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA176726NCI NIH HHS UM1 CA186107NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL060712NHLBI NIH HHS R01 HL088521NHLBI NIH HHS R01 HL118264NHLBI NIH HHS U01 HL145386NIAMS NIH HHS R01 AR049880NIDDK NIH HHS K99 DK122128NIDDK NIH HHS P30 DK040561NIDDK NIH HHS P30 DK046200NIDDK NIH HHS R01 DK102896
6 · The paper itself

Abstract

aimsTo investigate whether metabolic signature composed of multiple plasma metabolites can be used to characterize adherence and metabolic response to the Mediterranean diet and whether such a metabolic signature is associated with cardiovascular disease (CVD) risk. METHODS AND

resultsOur primary study cohort included 1859 participants from the Spanish PREDIMED trial, and validation cohorts included 6868 participants from the US Nurses' Health Studies I and II, and Health Professionals Follow-up Study (NHS/HPFS). Adherence to the Mediterranean diet was assessed using a validated Mediterranean Diet Adherence Screener (MEDAS), and plasma metabolome was profiled by liquid chromatography-tandem mass spectrometry. We observed substantial metabolomic variation with respect to Mediterranean diet adherence, with nearly one-third of the assayed metabolites significantly associated with MEDAS (false discovery rate < 0.05). Using elastic net regularized regressions, we identified a metabolic signature, comprised of 67 metabolites, robustly correlated with Mediterranean diet adherence in both PREDIMED and NHS/HPFS (r = 0.28-0.37 between the signature and MEDAS; P = 3 × 10-35 to 4 × 10-118). In multivariable Cox regressions, the metabolic signature showed a significant inverse association with CVD incidence after adjusting for known risk factors (PREDIMED: hazard ratio [HR] per standard deviation increment in the signature = 0.71, P < 0.001; NHS/HPFS: HR = 0.85, P = 0.001), and the association persisted after further adjustment for MEDAS scores (PREDIMED: HR = 0.73, P = 0.004; NHS/HPFS: HR = 0.85, P = 0.004). Further genome-wide association analysis revealed that the metabolic signature was significantly associated with genetic loci involved in fatty acids and amino acids metabolism. Mendelian randomization analyses showed that the genetically inferred metabolic signature was significantly associated with risk of coronary heart disease (CHD) and stroke (odds ratios per SD increment in the genetically inferred metabolic signature = 0.92 for CHD and 0.91 for stroke; P < 0.001).

conclusionsWe identified a metabolic signature that robustly reflects adherence and metabolic response to a Mediterranean diet, and predicts future CVD risk independent of traditional risk factors, in Spanish and US cohorts.

Indexed as

Cardiovascular DiseasesDiet, MediterraneanFollow-Up StudiesGenome-Wide Association StudyHumansMetabolomeRisk FactorsCardiovascular diseaseDietary metabolic responseMediterranean dietMendelian randomization analysisMetabolomicsRisk prediction

Identifiers

PMID32406924
PMCPMC7377580

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