In a new study, researchers found a healthy quality Mediterranean-like diet could change the link between obesity and heart-disease-related death.
The research was conducted by a team at Uppsala University, Sweden.
Higher body mass (BMI) accounted for 4.0 million deaths globally in 2015 and more than two-thirds of those deaths were due to cardiovascular disease (CVD).
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, the team examined BMI, diet, and mortality among 79,003 Swedish adults.
Adherence to a Mediterranean-like diet was assessed on a scale of 0 to 8, integrating information on intake of fruits and vegetables, legumes, nuts, unrefined or high-fiber grains, fish, red and processed meat, and olive oil.
Over 21 years of follow-up, the found 30,389 (38% of participants) died.
Among overweight people, the group with the lowest death risk were those with high adherence to a Mediterranean-like diet.
Obese people who also had high adherence to a Mediterranean-like diet did not have a much higher death risk compared with those with normal weight and high adherence to a Mediterranean-like diet.
Conversely, people with a normal BMI but low adherence to a Mediterranean-like diet had a higher death risk than those with normal weight and high adherence to a Mediterranean-like diet.
For CVD death risk, which represented 12,064 of the deaths, the findings were broadly similar.
However, while CVD death linked to high BMI was reduced by adherence to a Mediterranean diet, it was not fully countered.
These results suggest 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
One author of the study is Karl Michaëlsson.
The study is published in PLOS Medicine.
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