The results of a trial described online on February 25, 2013 in the New England Journal of Medicine indicate a protective effect for a Mediterranean diet against the risk of experiencing heart attack, stroke or death from cardiovascular causes among older adults at high cardiovascular risk. A Mediterranean diet, which is high in fruit, vegetables, fish, legumes, nuts and olive oil, has been associated with a lower risk of cardiovascular disease and premature death in several studies of its adherents.
“In this primary prevention trial, we observed 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,” authors Ramón Estruch, MD, PhD and colleagues write. “The results support the benefits of the Mediterranean diet for the primary prevention of cardiovascular disease.”
The trial included 7,447 men and women with no cardiovascular disease upon enrollment who had at least three risk factors for the disease. Participants were randomized to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with almonds, hazelnuts and walnuts, or a low-fat control diet. The trial was concluded after a median follow-up of 4.8 years, during which myocardial infarction, stroke or death from cardiovascular disease occurred among 288 subjects. In comparison with participants who adhered to the control diet, the adjusted risk of experiencing a cardiovascular event was 29 percent lower for those who followed a Mediterranean diet plan. The findings were similar when the two Mediterranean diets were separately evaluated. Heart attack and stroke risks were 23 percent and 39 percent lower in those who consumed a Mediterranean diet, and the risk of dying from cardiovascular disease over follow-up was 17 percent less.