According to the recent study, about 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals.
A systematic review ranked the Mediterranean diet as the most likely dietary model to provide protection against coronary heart disease. Small clinical trials have uncovered plausible biologic mechanisms to explain the salutary effects of this food pattern.
The study also confirms that the diet common in southern European countries such as Greece, Spain and Italy, which involves consuming a lot of fruit, vegetables, fish and wine, and only small amounts of red meat or dairy products, offers protection against heart problems.
“The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern Europe or the United States,” the authors conclude. The risk of those on the diet having a stroke was significantly reduced, they found.
The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood pressure or diabetes drugs to lower their heart disease risk.
Compared with those eating the low-fat diet, the extra-virgin-olive-oil group showed a 30% lower risk of having a heart attack, stroke or dying of heart disease after five years, while those consuming the Mediterranean diet with more nuts showed a 28% lower risk of these outcomes.
“Really impressive,” said Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association.
“And the really important thing — the coolest thing — is that they used very meaningful endpoints. They did not look at risk factors like cholesterol or hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”
Eligible participants were men (55 to 80 years of age) and women (60 to 80 years of age) with no cardiovascular disease at enrollment, who had either type 2 diabetes mellitus or at least three of the major risk factors.
Those factors include smoking, hypertension, elevated low-density lipoprotein cholesterol levels, low high-density lipoprotein cholesterol levels, overweight or obesity, or a family history of premature coronary heart disease.
In the study, the participants in the Mediterranean diet groups agreed to replace red meat with white meat like chicken and eat three or more servings of fish each week, along with three or more servings of fruit and two or more servings of vegetables a day.
One group assigned to a Mediterranean diet was given extra-virgin olive oil each week and was instructed to use at least 4 four tablespoons a day.
The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful, writes the NY Times.
Still, the findings add to the body of evidence that suggests the Mediterranean diet can play an important role in protecting the heart, and should guide doctors and patients who want to avoid heart disease toward eating the foods that can help them the most.