In a population-based cross-sectional study of 943 adults aged 35–74 in northeastern Spain, higher educational attainment correlated with meaningfully better cardiometabolic profiles — but the pattern differed sharply by sex. University-educated men showed LDL cholesterol 17.8 mg/dL lower than primary-educated counterparts (95% CI: −28.03 to −7.63), halved odds of hypercholesterolemia, reduced smoking odds (~OR 0.53), and tripled odds of high Mediterranean diet adherence (OR 3.05). Women showed a broader gradient: university education associated with 2.5 kg/m² lower BMI, 66% lower odds of overweight/obesity, and reduced hypertension odds (OR 0.44) — risk factors largely unaffected by education in men.
The sex-divergent pattern is the most clinically interesting signal here. It suggests that education-linked health behaviors operate through different pathways in men and women — possibly reflecting gendered social determinants like occupational stress, domestic labor burden, or weight-stigma exposure. The Mediterranean setting matters too: even within a region celebrated for dietary quality, educational stratification still predicts diet adherence, underscoring that food environment alone cannot eliminate socioeconomic health gradients.
Limitations are significant: this is cross-sectional and cannot establish causality; 943 participants is modest for stratified subgroup inference; and self-reported dietary adherence introduces recall bias. Still, the finding that women's cardiovascular risk is more comprehensively shaped by educational attainment — spanning adiposity, blood pressure, glycemia, and lipids — is confirmatory of global trends and argues for sex-specific health equity interventions rather than one-size-fits-all approaches.