Does a healthy diet counter the ill effects of obesity? –Science Daily

High body mass (BMI) was responsible for 4.0 million deaths worldwide in 2015, and more than two-thirds of these deaths were due to cardiovascular disease (CVD). Studies have suggested that other factors, including healthy dietary patterns, may moderate the higher risk of CVD associated with higher BMI. In the new study, researchers studied BMI, diet and mortality among 79,003 Swedish adults enrolled in the Swedish Mammography Cohort and the Swedish Men’s Cohort. Adherence to a Mediterranean diet (mMED) was assessed on a scale of 0 to 8, combining information on intake of fruits and vegetables, legumes, nuts, unrefined or high-fiber grains, fish, red and processed meat, and olive oil. . Data on cohort participants’ age, physical activity, smoking and socioeconomic status were also available.

Over 21 years of follow-up, 30,389 (38% of participants) died. Among overweight individuals, the group with the lowest hazard ratio (HR) for all-cause mortality was high mMED (HR 0.94; 95% CI 0.90–0.98 for normal weight and high mMED). Obese individuals who had a high mMED did not have significantly higher mortality than those with normal weight and high mMED (HR 1.03; 95% CI 0.96–1.11). Conversely, those with normal BMI but low mMED had higher mortality than those with normal weight and high mMED (HR 1.60; 95%CI 1.48–1.74). For CVD deaths, which represented 12,064 deaths, the results were broadly similar. However, although CVD risk associated with high BMI was reduced by adherence to the Mediterranean diet, it was not completely prevented. Furthermore, lower BMI does not counteract the higher CVD mortality associated with a lower mMED.

“These findings suggest that adherence to a healthy diet such as a Mediterranean-like diet may be a more appropriate focus than avoiding obesity for overall mortality prevention,” the authors said. “However, a healthy diet may not completely prevent the higher CVD mortality associated with obesity.”