Written by Marcia J. Egles, MD. Study concluded that those who followed a Mediterranean diet demonstrated less risk of heart dysfunction and fewer major recurrences in the two years following a heart attack or unstable angina.
A recent observational study (1) from Athens, Greece reported benefits of the Mediterranean diet to patients who were recovering from heart attacks or heart-related chest pains (unstable angina). The associated benefits included better heart pumping function and overall more favorable outcomes after two years of follow-up in heart patients whose diets most closely approximated a Mediterranean style diet.
The Mediterranean diet is rich in fruit, vegetables, nuts, legumes, whole grains, fish and low-fat dairy products with olive oil as its main source of fat. Red wine is consumed in small to moderate quantities. Meat and eggs are eaten in minimal amounts (2). Several studies and clinical trials during the past decades have associated the Mediterranean diet with a lower incidence of heart disease and some types of cancer (3-7). The new study examines whether a Mediterranean diet might improve a patient’s outcome even after having a heart attack.
The study was conducted from May, 2006 until May, 2009 on 1,000 of 1257 patients who were hospitalized at Athens University Hospital cardiology unit for heart attacks or unstable angina. The 257 not in the study includes both those who chose not to participate and those who did not survive the first 48 hours. The enrolled patients included 79% men with an average age of 63 years. The average age of the women was 69. The patients all had been diagnosed with clinical, laboratory, and EKG evidence of acute myocardial infarction (heart attack) or severe unstable angina.
The patients’ heart function was evaluated by ultrasound (echocardiogram) at entry to the study, prior to hospital discharge, at three months, and at two years. About 75% of the patients completed the study to the full two years. The ultrasound provided data known as the “ejection fraction”, a measure of the percentage of blood the heart is able to pump with each beat. Left ventricular systolic dysfunction (a type of heart failure) is defined in this study as an ejection fraction less than 40%.
While hospitalized, the patients were interviewed concerning their typical diets over the past one year. A “Mediterranean Diet Score” was calculated for each patient. A higher score was given to those whose eating habits were more consistent with a Mediterranean diet. The third of the patients with the highest scores were then compared with the third with the lowest scores.
The patients in the highest third of scores had ejection fractions 18% higher during hospitalization than those in the lower third of Mediterranean diet scores. The highest third compared to the lowest third had a lower risk of in-hospital death ( zero compared to 2%; p equal to .009). They also had a 31% lower risk of adverse heart events during the first month after hospitalization. At one and two years later, they had a 47% and 37% lower risk of recurrent heart attacks than those in the lowest third (p less than .001).
The study concluded that the Mediterranean diet pattern is associated with less risk of left ventricular systolic dysfunction and fewer major recurrences in the two years following a heart attack or unstable angina. These associations appeared independent of risk factors such as high blood pressure, high cholesterol or diabetes. The authors of this study expressed that a Mediterranean diet might be of significant help to the health of many heart patients.
Source: Chrysohoou, Christina, et al. “The Mediterranean diet contributes to the preservation of left ventricular systolic function and to the long-term favorable prognosis of patients who have had an acute coronary event.” The American journal of clinical nutrition 92.1 (2010): 47-54.
© 2010 American Society for Nutrition
Posted August 16, 2010
References:
- Christina Chrysohoou et al. The Mediterranean diet contributes to the preservation of left ventricular systolic function and to the long-term favorable prognosis of patients who have had an acute coronary event. Am J Clin Nutr 2010;92 47-54.
- Willett WC; Sacks, F; Trichopoulou, A; Drescher, G; Ferro-Luzzi, A; Helsing, E; Trichopoulos, D (June 1, 1995). “Mediterranean diet pyramid: a cultural model for healthy eating”. American Journal of Clinical Nutrition 61 (6): 1402S–6S. PMID 7754995.
- Panagiotakos DB, Arapi S, Pitsavos C, et al. The relationship between adherence to the Mediterranean diet and the severity and short-term prognosis of acute coronary syndromes (ACS): The Greek Study of ACS (The GREECS). Nutrition 2006;22:722–30.
- Panagiotakos DB, Pitsavos C, Polychronopoulos E, Chrysohoou C, Zampelas A, Trichopoulou A. Can a Mediterranean diet moderate the development and clinical progression of coronary heart disease? A systematic review. Med Sci Monit 2004;10:RA193–8.
- Keys A, Menotti A, Karvonen MJ, et al. The diet and 15-year death rate in the Seven Countries Study. Am J Epidemiol 1986;124:903–15.
- Assmann G, de Backer G, Bagnara S, et al. International consensus statement on olive oil and the Mediterranean diet: implications for health in Europe. Eur J Cancer Prev 1997;6:418–21.
- De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999;99:779–85.
- Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003;348:2599–608.
