The relation between compliance to the Mediterranean diet and the extensiveness of coronary artery disease.

OZET M related to cardiovascular (CV) disease is generally ranked among the first three orders of causes of mortality, although its ranking changes depending on geographic distribution in the world.[1] Although mortality related to cardiovascular diseases is higher in developed countries, it is found to be lower in those developed countries bordering the Mediterranean Sea such as Italy, Greece and Spain when compared to the United States.[2] In Turkey, mortality related to coronary events is in the first order with a rate of 39% according to the TEKHARF study.[3] However, the same study shows that the mortality rate related to coronary causes is lower in Turkey’s Mediterranean region compared to other regions of the country.[3] The distribution of mortality related to CV causes in Turkey and internationally suggests that geographic location may have an important role. The Mediterranean region shows a marked difference in terms of dietary habits compared to other geographic areas. The traditional Mediterranean diet (MD) pattern is characterized by high consumption of plant foods (vegetables, fruits, cereals-preferably whole grain-fruit, nuts, legumes and olives). Olive oil as the principal source of added fat, moderate consuption of eggs, poultry and dairy products (mainly cheese and yoghurt), moderate to high intake of fish and seafood, low consumption of red meat and moderate intake of wine constitute the essentials of the MD. The index of adherence with the traditional MD was first defined by Trichopoulou.[4] In studies conducted subsequently using this index and modified indices, it has been shown that compliance with the MD might have a cardioprotective effect.[4–6] It is thought that this effect is achieved by modification of the risk factors for CV diseases, which include hyperlipidemia, hypertension, obesity and insulin resistance.[7–10] Recent studies have found evidence that compliance with the MD might prevent inflammation, which plays an important role in the physiopathologies of atherosclerosis and cardiovascular disease.[11–13] In recent studies, it was shown that increased compliance with the MD might, over time, downgrade atherosclerosis in the coronary arteries.[14,15] This study aimed to investigate the relation between MD compliance and the angiographic severity and extensiveness of atherosclerosis in patients with coronary artery disease (CAD). Despite findings indicating that foods consumed may have a role in the severity of CAD, this study may be the first to investigate the relation between MD compliance and extensiveness of CAD. Hence, it is important in that it will provide a direct evaluation of the effects of diet and lifestyle changes on the extensiveness of CAD using a visual quantitative method.