12 January - 20 June 2016

A Mediterranean diet may reduce cardiovascular disease and stroke risk

6 March 13

A study published in the New England Journal of Medicine by researchers from a number of Spanish universities has compared the effects of two variation of the Mediterranean diet with a standard low-fat diet.  A Mediterranean diet is typically high in olive oil, fruits, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats and sweets; and wine in moderation, consumed with meals.  Martínez-González et al. recruited 7447 participants, aged 55 to 80 years of which 57% were women.  The participants had no cardiovascular disease at baseline but were considered high risk as they either had type 2 diabetes or at least had major risk factors for cardiovascular disease, including having high blood pressure, high cholesterol  or being overweight or obese. The participants were randomly split into one of three groups: a group which was advised to follow a Mediterranean diet supplemented with extra-virgin olive oil (approximately 1 litre a week), a group advised to follow a Mediterranean diet supplement with 30g of mixed nuts per day, and a control group advised to follow a low fat diet.  All participants received dietary training at the start of the study, and the Mediterranean groups received further sessions every three months afterwards.  For the first three years the low-fat group received a leaflet explaining the low fat diet and then this group received the same intensity of dietary advice and assessment as the other two groups.  Each year the participants completed a general medical questionnaire, a food frequency questionnaire and a physical activity questionnaire.  At years one, three and five, the researchers measured certain biomarkers in random subgroups of participants in the Mediterranean diet. After an average of 4.8 years of follow-up Martínez-González et al. report that 288 people had either had a heart attack, stroke or died from cardiovascular events.  Ninety-six of these participants were in Mediterranean diet group supplemented with extra olive oil, 83 in the Mediterranean group supplemented with extra nuts and 109 in the control low fat diet group.  After making a number of adjustments for baseline risk factors, the team calculated that compared to those on a standard low fat diet, those assigned to a Mediterranean diet with extra-virgin olive oil had a 30% reduced risk of suffering a heart attack, stroke or dying from a cardiovascular event, whilst those who consumed a Mediterranean diet with nuts had a 28% reduced risk of suffering a heart attack, stroke or dying from a cardiovascular event. Martínez-González et al conclude by stating that “an energy-unrestricted Mediterranean diet supplemented with extra virgin olive oil or nuts resulted in a substantial reduction in the risk of major cardiovascular events among high risk persons.  The results support the benefits of the Mediterranean diet for the primary prevention of cardiovascular disease.”

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