Midlife Mediterranean Diet is Associated with Subclinical Carotid Atherosclerosis in Late Midlife.

Aims: To investigate the association between dietary patterns at ages 40, 50 and 60 and subclinical carotid atherosclerosis at age 60.

Methods: Participants that were 60 years of age at the Swedish VIPVIZA (VisualiZation of asymptomatic Atherosclerotic disease) trial baseline (2013-2016) with retrospective VIP (Västerbotten Intervention Programme) dietary data at ages 40, 50, and 60 (n=1034) were included. Dietary patterns were assessed using the Mediterranean Diet Score (MDS) and Healthy Diet Score (HDS), while carotid ultrasound was used to measure carotid artery intima-media thickness (CIMT) and carotid plaque (CP). Multivariable regressions and mediation analysis investigated associations, sex differences and potential mediating factors.

Results: High (OR: 0.72, 95% CI: 0.52-0.98) or midrange (OR: 0.74, 95% CI: 0.55-0.99) cumulative MDS for ages 40, 50 and 60, as compared to low, was associated with lower CP presence at age 60. Initial sex-stratified analysis yielded similar, though non-significant, point estimates. Further analysis revealed that the relationship between plaque and MDS seem driven more by women (0.41, 95% CI: 0.237-0.703) while a significant association between CIMT and MDS was only present in men (p < 0.05). HDS during midlife did not show any significant associations with CP or CIMT at age 60.

Conclusion: Findings underscore associations of midlife Mediterranean-style diet and lower presence of subclinical carotid atherosclerosis at age 60 and confirm the significance of dietary interventions as potential means for cardiovascular disease prevention. The study enhances understanding of long-term dietary patterns and their link to subclinical atherosclerosis, supporting future interventions and further research.