Mediterranean diet: Eating our way to cardiovascular health

Naji Hamdan, M.D. Naji Hamdan, M.D.
Cardiologist, Providence Heart and Vascular Institute
Northwest Cardiologists

Published June 2013

More evidence is emerging about the health benefits of a Mediterranean-style diet, particularly its role in preventing cardiovascular disease. Recently released results of the PREDIMED study found that the diet, supplemented with extra-virgin olive oil or nuts, lowered the risk of heart attack, stroke or cardiovascular death by as much as 30 percent.

Mediterranean diets call for a higher volume of vegetables, fruit, nuts, legumes and olive oil; included are moderate amounts of fish, poultry and even wine. They discourage sugar, trans fats, and refined or processed foods.

During nearly five years, the multicenter trial followed 7,447 participants between the ages of 55 and 80. Enrollees had no coronary artery disease, but they did have risk factors, such as Type 2 diabetes, smoking, obesity, hyperlipidemia, hypertension or family history.

Low-fat vs. Mediterranean diets graph

They were randomized into one of three groups:

  • Group A: Standard low-fat diet of fruits, vegetables, fish, lean meats, low-salt and low-sugar drinks
  • Group B: Mediterranean diet with at least three servings of fish and legumes weekly and supplemented by at least 4 tablespoons of extra-virgin olive oil a day.
  • Group C: Mediterranean diet similar to Group B, but supplemented instead by a mix of walnuts, almonds and hazelnuts.

All groups received nutritional counseling and education.

The study’s primary end point was a composite of heart attack, stroke or death from a cardiovascular cause. Those in the Mediterranean diet groups had significantly lower rates of stroke than those in control group A. They also had fewer incidents of heart attack and cardiovascular deaths.

The trial was terminated after nearly five years because of the significant findings in the Mediterranean diet groups.

The results of this trial follow the earlier Lyon Diet Heart Study, which found that a Mediterranean-style diet lowered the recurrence of heart attack for people who had already had one. Other literature has shown benefits for diabetes, cancer and dementia.

We should discuss the findings of this trial with our patients and stress the importance of diet in maintaining cardiovascular health. We also should be on the lookout for future trials that measure the benefit of this diet with exercise.

Patient resource
“A Whole Food Mediterranean Diet in a Nutshell,” Miles Hassell, M.D., and Mea Hassell