AbstractIntroductionHeart failure (HF) is one of the most common cardiovascular disorders, and its prevalence is increased due to age, genetics, and lifestyle factors. Emerging evidence suggests that the Mediterranean Diet (Med Diet) is linked to lower all-cause mortality in patients with increased cardiovascular disease risk, such as those with HF.ObjectiveTo conduct a systematic review and meta-analysis of observational studies into the relationship between the Med Diet on HF risk.DesignSeveral databases (PubMed, Scopus, Web of Science and Cochrane Library) until the 01st of May 2023 were searched.

摘要引言心力衰竭（HF）是最常见的心血管疾病之一，由于年龄，遗传和生活方式因素，其患病率增加。新出现的证据表明，地中海饮食（Med Diet）与心血管疾病风险增加的患者（如HF患者）的全因死亡率降低有关。目的对观察性研究进行系统评价和荟萃分析，探讨地中海饮食对HF风险的影响。设计搜索了截至2023年5月1日的几个数据库（PubMed，Scopus，Web of Science和Cochrane Library）。

Our research was conducted based on the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were reported as risk ratios (RRs) with their 95% confidence intervals (CIs) as results of multivariate or univariate analyses.ResultsFrom the original 1206 studies collected, six observational prospective studies were included, with a total of 216,385 European participants without evidence of HF at baseline.

我们的研究是根据更新的2020年系统评价和荟萃分析首选报告项目（PRISMA）指南进行的。数据报告为风险比（RR），其95%置信区间（CI）为多变量或单变量分析的结果。结果从最初收集的1206项研究中，纳入了6项观察性前瞻性研究，共有216385名欧洲参与者在基线时没有HF证据。

Over a mean period of 11 years of follow-up, a 1-point increase in the Med Diet score was associated with a significantly lower risk of HF (RR = 0.940; 95% CI: 0.912–0.969, p < 0.0001; I2 = 42.9%). Categorised by sex, a higher adherence to Med Diet was associated with a significantly lower incidence of HF in women (RR = 0.942; 95% CI: 0.912-0.973, p = 0.001; I2 = 41.8%), but not in men.

在平均11年的随访期间，Med饮食评分增加1分与HF风险显着降低相关（RR=0.940；95%可信区间：0.912-0.969，p<0.0001；I2=42.9%）。按性别分类，更高的Med饮食依从性与女性HF发生率显着降低相关（RR=0.942；95%可信区间：0.912-0.973，p=0.001；I2=41.8%），但男性则不然。

The overall quality of included studies was good.ConclusionsHigher adherence to Med Diet across European countries is associated with lower risk of HF, particularly in women..

纳入研究的总体质量良好。结论欧洲国家坚持地中海饮食与HF风险降低相关，尤其是女性。。

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Download referencesAuthor informationAuthors and AffiliationsDepartment of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, “G. D’Alessandro”-PROMISE-University of Palermo, Palermo, ItalyNicola Veronese, Francesco Saverio Ragusa, Ligia J. Dominguez & Mario BarbagalloConsiglio Nazionale delle Ricerche, Neuroscience Institute, Padova, ItalyStefania MaggiFaculty of Life Sciences and Medicine, Centre for Human and Applied Physiological Sciences, King’s College London, London, UKOliver C.

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WitardCentre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UKLee SmithFaculty of Medicine and Surgery, University of Enna “Kore”, 94100, Enna, ItalyLigia J. DominguezDepartment of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UKMasoud Isanejad & Konstantinos ProkopidisAuthorsNicola VeroneseView author publicationsYou can also search for this author in.

安格里亚·罗斯金大学健康表现与幸福中心，剑桥，英国李·史密斯恩纳大学医学与外科学院，94100，恩纳，意大利利加·J·多明格斯，利物浦大学生命过程与医学科学研究所肌肉骨骼与衰老科学系，利物浦，UKMasoud Isanejad＆Konstantinos ProkopidisAuthorsNicola VeroneseView作者出版物你也可以在中搜索这位作者。

PubMed Google ScholarFrancesco Saverio RagusaView author publicationsYou can also search for this author in

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PubMed Google ScholarStefania MaggiView author publicationsYou can also search for this author in

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PubMed Google ScholarOliver C. WitardView author publicationsYou can also search for this author in

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PubMed Google ScholarMario BarbagalloView author publicationsYou can also search for this author in

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PubMed Google ScholarKonstantinos ProkopidisView作者出版物您也可以在

PubMed Google ScholarContributionsVeronese, Ragusa, Witard: wrote the first draft of the manuscript; Veronese, Prokopidis: data analysis, methodology; Maggi, Barbagallo, Dominguez, Smith: critical revision of the work; Isanjead, Ragusa: data collection.Corresponding authorCorrespondence to.

PubMed Google ScholarContributionsVeronese，Ragusa，Witard：撰写了手稿的初稿；Veronese，Prokopidis：数据分析，方法论；Maggi，Barbagallo，Dominguez，Smith：对工作的批判性修订；拉古萨Isanjead：数据收集。对应作者对应。

Nicola Veronese.Ethics declarations

尼古拉·维罗内塞。道德宣言

Competing interests

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The authors declare no competing interests.

作者声明没有利益冲突。

Additional informationPublisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Supplementary informationAssociation between increase in one point in Med Diet score and incidence of heart failure in men and women.Association between higher adherence to Med Diet score, in original categories, and incidence of heart failure.Full search strategy protocol based on title, abstract, and keywords in the literature search.Excluded references with reason.Descriptive characteristics of the included studies.Risk of bias evaluation using the Newcastle Ottawa Scale.Rights and permissionsSpringer Nature or its licensor (e.g.

Additional informationPublisher的注释Springer Nature在已发布地图和机构隶属关系中的管辖权主张方面保持中立。补充信息Med饮食评分增加一分与男性和女性心力衰竭发生率之间的关联。原始类别中更高的Med饮食评分依从性与心力衰竭发生率之间的关联。基于文献检索中标题、摘要和关键词的完整搜索策略协议。排除有原因的引用。纳入研究的描述性特征。使用纽卡斯尔-渥太华量表进行偏倚评估的风险。权利和许可Pringer Nature或其许可人（例如。

a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.Reprints and permissionsAbout this articleCite this articleVeronese, N., Ragusa, F.S., Maggi, S.

协会或其他合作伙伴）根据与作者或其他权利持有人的出版协议对本文拥有专有权；本文接受稿件版本的作者自行存档仅受此类出版协议和适用法律的条款管辖。转载和许可本文引用本文Veronese，N.，Ragusa，F.S.，Maggi，S。

et al. Effect of the Mediterranean diet on incidence of heart failure in European countries: a systematic review and meta-analysis of cohort studies..

地中海饮食对欧洲国家心力衰竭发病率的影响：队列研究的系统综述和荟萃分析。。

Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01519-4Download citationReceived: 02 June 2024Revised: 21 September 2024Accepted: 25 September 2024Published: 01 October 2024DOI: https://doi.org/10.1038/s41430-024-01519-4Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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