Adherence to the Mediterranean diet and incident cardiovascular outcomes among older adults

Aim: The present study examined the prospective associations between adherence to the Mediterranean (MED) diet, its individual components, and incident cardiovascular disease (CVD) among community-dwelling older adults. Methods: Data were obtained from the English Longitudinal Study of Ageing (ELSA). Participants aged ≥65 years without hypertension at baseline (Wave 9, 2018–2019) were followed through Wave 11 (2023–2024). Adherence to the MED diet was assessed using the Medi-Lite score. Incident hypertension, myocardial infarction, and stroke were identified through self-reported physician diagnoses. Logistic regression analyses were performed to examine the prospective associations between MED diet adherence, individual dietary components, and cardiovascular outcomes, adjusting for age, sex, and caloric intake. Results: A total of 338 participants (74.6 ± 6.2 years; 56.6% women) were included. During follow-up, the incidence of hypertension, myocardial infarction, and stroke was 12.4%, 2.6%, and 2.6%, respectively. No statistically significant associations were detected between overall MED diet adherence and incident hypertension (OR = 0.992, 95% CI = 0.586–1.679), myocardial infarction (OR = 1.422, 95% CI = 0.381–5.302), or stroke (OR = 0.808, 95% CI = 0.360–1.811). Likewise, none of the individual MED diet components was significantly associated with incident CVD outcomes. Conclusion: In conclusion, no statistically significant associations were detected between adherence to the MED diet and incident CVD among community-dwelling older adults in England. However, given the relatively low number of cardiovascular events, particularly myocardial infarction and stroke, these findings should be interpreted with caution. Further studies with longer follow-up periods and larger numbers of CVD events are warranted to provide more precise estimates and further clarify these associations.