The purpose of this study was to clarify the global relationship between the Mediterranean diet score (MDS) and country-wise incidence and mortality of ischaemic heart disease (IHD) using an international database. We used population data from a global longitudinal database covering 137 countries with a population of over one million. MDS were evaluated based on the total score of the nine foods that comprise the Mediterranean diet. The incidence and mortality of IHD by country was derived from the Global Burden of Disease (GBD) database. Average food (g/day/capita) and energy supply (kcal/day/capita) by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. Data from the GBD database were used for body mass index, current smoking rates, physical activity, years of education and percentage of the Muslim population. We identified the percentage of the population over 65 years of age (aging rate) and gross domestic product per capita (US$/capita) using the World Bank database. A linear mixed-effect model was used for evaluating the effects of MDS on incidence and mortality of IHD controlled for socioeconomic and lifestyle variables. Analysis showed that MDS was significantly associated with IHD incidence after controlling for covariates (–1.01 ± 0.27, P < 0.001). Similarly, there was a significant association between MDS and IHD-related mortality after controlling for covariates (–0.73 ± 0.34, P < 0.05). Analysis of 27 years of data suggests that a Mediterranean diet might have a preventive effect on IHD.

Objective: The aim of the present study was to clarify the global relationship between Mediterranean diet score (MDS) and the incidence of IHD by country using international statistics.Design: The incidence of IHD by country was derived from the Global Burden of Disease (GBD) database. Average supplies of food (g/d per capita) and energy (kcal/d per capita) by country, excluding loss between production and household, were obtained from the FAOSTAT database. MDS was evaluated based on the total score of nine food items that characterize the Mediterranean diet. The association between MDS and the incidence of IHD was examined in countries with a population of 1 million or greater using a general linear model controlled for socio-economic and lifestyle variables.Setting: Population data from global international databases.Participants: One hundred and thirty-two countries with a population of over 1 million.Results: MDS was inversely correlated with obesity rate, ageing rate, years of education and IHD incidence; however, no associations were found with gross domestic product, life expectancy, smoking rate, energy supply or health expenditure. In the general linear model of IHD incidence by MDS controlled for socio-economic and lifestyle variables, the β of the MDS was –26·4 (se 8·6; P<0·01).Conclusions: The results of this global international comparative study confirmed that the Mediterranean diet is inversely associated with the incidence of IHD.

The relationship between egg consumption and ischemic heart disease (IHD) remains controversial as there is still no clear answer regarding the relationship, with research limited to a few geographical regions. In the current study, we conducted a longitudinal analysis of the association between egg intake and IHD incidence (IHDi) and mortality (IHDd) using 28 years of international data from 1990 to 2018. Egg intake (g/day/capita) by country was obtained from the Global Dietary Database. Age-standard IHDi and IHDd rates per 100,000 subjects in each country were obtained from the 2019 Global Burden of Disease database. The analysis included a total of 142 countries with populations of at least one million, for which all data were available from 1990 to 2018. Eggs are consumed worldwide, and regional differences in consumption are also shown. Utilizing IHDi and IHDd as objective variables and egg intake as an explanatory variable, the analysis was conducted using linear mixed models, which controlled for inter- and intra-country variation from year to year. The results showed a significant negative association between egg intake, and IHDi (−0.253 ± 0.117, p < 0.05) and IHDd (−0.359 ± 0.137, p < 0.05). The analysis was carried out using R 4.0.5. The results suggest that adequate egg intake might suppress IHDi and IHDd on a global scale.

Purpose: Cross-sectional analysis using open data has revealed an association between the traditional Japanese diet score (TJDS) and healthy life expectancy (HALE). This study aimed to clarify the association of the TJDS with the HALE and average life expectancy (LE) via a longitudinal analysis. Methods: Data regarding the food supply and total energy were extracted from the database of the Food and Agriculture Organization of the United Nations, and data regarding HALE and LE were obtained from the Global Burden of Disease Study 2019. The supply of items consumed frequently (rice, fish, soybeans, vegetables, and eggs) and less frequently (wheat, milk, and red meat) in the Japanese diet were scored (total: −8 to 8 points) and stratified into tertiles by country. The gross domestic product, aging rates, years of education, smoking rate, physical activity, and obesity rate were used as covariates. Longitudinal analyses were conducted for 143 countries, using the HALE and LE for each country from 2010 to 2019 as dependent variables and the 2010 TJDS as an independent variable. Results: The fixed effects (standard errors) were HALE 0.424 (0.102) and LE 0.521 (0.119), indicating significance (p < 0.001). Conclusion: The nine-year longitudinal analysis using international data suggests that the traditional Japanese diet based on rice may prolong the HALE and LE.