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three equal horizontal bands of cobalt blue (top), white, and cobalt blue with the national coat of arms centered in the white band; the coat of arms features a round emblem encircled by the words REPUBLICA DE EL SALVADOR EN LA AMERICA CENTRAL; the banner is based on the former blue-white-blue flag of the Federal Republic of Central America; the blue bands symbolize the Pacific Ocean and the Caribbean Sea, while the white band represents the land between the two bodies of water, as well as peace and prosperity note: similar to the flag of Nicaragua, which has a different coat of arms centered in the white band; also similar to the flag of Honduras, which has five blue stars arranged in an X pattern centered in the white band Satellite radar topography image of a portion of Central America.
Due to persistent cloud cover, obtaining conventional high-altitude photos of this region is extrordinarily difficult.
The identification of high-quality reviews that include details regarding search process, article selection criteria, and study populations would allow for a formulation of evidence-based dietary guidelines for cardiovascular health.
However, reviews evaluating the association between the Med SD and CVD risk have not been formally evaluated for compliance with the current methodologic standards.
This dietary pattern also includes daily consumption of low to moderate amounts of cheese and yogurt (low-fat and nonfat versions may be preferable), twice-weekly consumption of fish and poultry, consumption of up to 7 eggs/wk, fresh fruit as dessert, red meat consumption limited to a few times a month, and moderate consumption of wine (1 glass/d for women and 1–2 glasses/d for men) (6).
The Med SD refers to the dietary habits traditionally followed by people in countries bordering the Mediterranean Sea (4).
Thus, the Med SD has been considered a rather broad term, and to some extent, the definition of this dietary pattern varies across the current literature (4, 5).
Design: To assess compliance with current standards, we applied a modified version of the Assessment of Multiple Systematic Reviews (AMSTAR items (mean ± SD: 31.2% ± 19.4%), with those published in higher-impact journals having greater quality scores.
At a minimum, 60% of the 24 reviews did not disclose full search details or apply appropriate statistical methods to combine study findings.