Written by Jessica Patella, ND. Use of the Mediterranean Diet was associated with reduced risks; 39% for stroke, 17% for death from cardiovascular disease and 11% for deaths from all causes.
Heart disease affects an estimated 26.5 million Americans and is the number one cause of death in the U.S. (1). Observational studies have shown an association between eating a Mediterranean diet and reducing the risk of cardiovascular disease (1). For the first time, a randomized research study has confirmed that a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the number of major cardiovascular events, such as heart attack or stroke (1).
The Mediterranean diet is defined as a high intake of olive oil, fruit, nuts, vegetables and cereals, with a moderate intake of fish and poultry and a low intake of dairy products, red meat, processed meats and sweets. The diet also includes drinking wine in moderation with meals.
The recent research included men (55-80 years of age) and women (60-80 years of age) without any cardiovascular disease but with high cardiovascular risk factors at the beginning of the study. The participants did have either type 2 diabetes or at least 3 major risk factors for cardiovascular disease: smoking, hypertension (high blood pressure), elevated LDL cholesterol (“bad cholesterol’), low HDL cholesterol (“good cholesterol”), overweight or obesity, or a family history of early heart disease (1).
A total of 7447 participants were randomly assigned to one of three groups: a Mediterranean diet supplemented with extra-virgin olive oil (1 liter/week), a Mediterranean diet supplemented with nuts (30g mixed/day: 15g walnuts, 7.5g hazelnuts, 7.5g almonds) or a control low-fat diet (1). Participants in the two Mediterranean groups received dietary training at the beginning of the study and again every three months. For the first three years of the study, the control group only had yearly meetings, but this was observed to be a possible limitation and meetings were then held every three months at the same frequency as the Mediterranean groups (1).
Participants were followed for an average of 4.8 years. Participants in both of the Mediterranean diet groups had a reduced the risk of major cardiovascular events (heart attack, stroke, or death) by 30% compared to the control group (1).
When comparing the combined Mediterranean diets (both with nuts and with extra-virgin olive oil) to the control diet the results are as follows: Stroke incidence (95%CI (Hazard ratio 0.61 (0.44-0.86) (p=0.005)), heart attack or myocardial infarction incidence (95%CI (Hazard ratio 0.77 (0.52-1.15) (p=0.20)), death from cardiovascular causes (95%CI (Hazard ratio 0.83 (0.54-1.29) (p=0.41)), and death from any cause (95%CI (Hazard ratio 0.89 (0.71-1.12) (p=0.32)) (1).
In conclusion, a Mediterranean diet supplemented with extra-virgin olive oil or nuts, resulted in a 30% reduction in the risk of major cardiovascular events in high-risk participants (1). The results support consuming a Mediterranean diet for prevention of cardiovascular disease(1). Because the study was conducted in the Mediterranean in Spain, the researchers suggest further research in other cultural groups to confirm results.
Source: Estruch, Ramón, et al. “Primary prevention of cardiovascular disease with a Mediterranean diet.” New England Journal of Medicine 368.14 (2013): 1279-1290.
Copyright © 2017 Massachusetts Medical Society. All rights reserved.
Posted March 26, 2013.
Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com.
References:
- Heart Disease FastStats. Centers for Disease Control and Prevention.
- Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. 2013 NEJM. DOI:10.1056/NEJMoa200303.
