TUESDAY, June 4, 2024 (HealthDay News) — Adherence to the Mediterranean diet is associated with a lower risk for all-cause mortality, which is partly explained by multiple cardiometabolic factors, according to a study published online May 31 in JAMA Network Open.

Shafqat Ahmad, Ph.D., from Brigham and Women’s Hospital in Boston, and colleagues examined Mediterranean diet adherence and risk for all-cause mortality to assess the relative contribution of cardiometabolic factors to this reduction in risk in a cohort study including healthy women from the Women’s Health Study. Using standard assays and nuclear magnetic resonance spectroscopy, 33 blood biomarkers were examined at baseline among 25,315 participants.

The researchers found there were 3,879 deaths during a mean of 24.7 years of follow-up. Adjusted risk reductions were seen for middle and upper versus low Mediterranean diet adherence (scores 4 to 5 and 6 to 9 versus 0 to 3), with hazard ratios of 0.84 and 0.77. The risk reductions were further attenuated after further adjustment for lifestyle factors, but they remained statistically significant (hazard ratios, 0.92 and 0.89, respectively). Small molecule metabolites and inflammatory biomarkers contributed most to the lower mortality risk, followed by triglyceride-rich lipoproteins, body mass index, and insulin resistance (explaining 14.8, 13.0, 10.2, 10.2, and 7.4 percent, respectively).

“Most of the potential benefit of adherence to the Mediterranean diet and mortality remains unexplained, and future studies should examine other pathways that could potentially mediate the Mediterranean diet-associated lower mortality as well as examine cause-specific mortality,” the authors write.

One author disclosed ties to the pharmaceutical industry and a second disclosed ties to the nutrition industry; one author reported being coinventor on a patent and on a patent application.

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