The Mediterranean Diet. What is the research showing?
Over the last 60 years, eating patterns in the Mediterranean regions have been studied. Thousands of documents show the numerous benefits of following the Mediterranean diet and lifestyle. A clear link and understanding has been shown that this way of eating is a safe and an effective way to help manage cardiovascular disease and prevent major cardiac events.
MED DIET HELPS PREVENT CARDIOVASCULAR DISEASE
A landmark clinical trial of nearly 7,500 people reveals that the Mediterranean Diet may reduce the risk of cardiovascular disease by up to 30 percent and may also reduce the risk for stroke among high-risk patients. Study participants were randomly assigned to one of three groups: Mediterranean Diet with at least 4 tablespoons of olive oil daily; Mediterranean Diet with an ounce of nuts daily; and a control group receiving advice on a low-fat diet. The two Mediterranean groups had no trouble following their instructions to enjoy ﬁve servings of fruits and vegetables, ﬁsh and legumes each three or more times a week, white meat instead of red, and wine (for those who drink), while avoiding commercial cookies and cakes, dairy products, and processed meats. The low-fat group morphed into a “typical Western diet” group. The study’s results were so clear that researchers halted the study earlier than planned because it was deemed unethical to prevent the control group from switching to a Mediterranean Diet.
Revision - The New England Journal of Medicine. 2018 June 21. [Estruch, et al.]
Original paper - The New England Journal of Medicine. 2013 February 25. [Estruch, et al.]
THE MEDITERRANEAN DIET MAY HELP PREVENT HEART DISEASE
Cochrane reviews are some of the most rigorous reviews in scientiﬁc research. In this Cochrane review, researchers analyzed 30 existing randomized controlled trials (the “gold standard” of nutrition research) and 7 ongoing trials of the Mediterranean diet and its impact on heart disease risk. The study found small to moderate evidence for beneﬁts of the Mediterranean diet for preventing heart disease, but note that more research is needed to better understand the beneﬁts, particularly in patients who already have heart disease. The Cochrane Database of Systematic Reviews. 2019 Mar 13;3:CD009825. doi: 10.1002/14651858.CD009825.pub3. (Rees K et al.)
COMBINING STATINS WITH MEDITERRANEAN DIET LINKED WITH LOWER RISK OF
DEATH FROM HEART DISEASE
Statins are a type of cholesterol lowering medication often prescribed to patients with heart disease. To see how diet might impact the eﬀectiveness of statins, researchers analyzed the eating habits and health outcomes of 1,180 older adults with heart disease for 8 years. Those most closely following a Mediterranean Diet were 30% less likely to die from heart disease over the study period. However, statins only reduced heart disease death risk when taken in combination with the Mediterranean diet. Furthermore, the patients taking statins in combination with a Mediterranean diet had a 50% lower risk of dying of heart disease than those just using one approach (diet or medicine). The researchers suspect that this synergistic eﬀect may be due to the anti-inﬂammatory eﬀects of the Mediterranean Diet. International Journal of Cardiology. 2019 Feb 1;276:248-254. doi: 10.1016/j.ijcard.2018.11.117. (Bonaccio M et al.)
MED DIET LINKED WITH LESS DEATH, HEART ATTACKS IN PEOPLE WITH HISTORY OF HEART DISEASE
Even if you already have heart disease, it’s never too late to improve your health. Researchers analyzed the eating habits and health status of 3,562 adults with heart disease, to see how diﬀerent eating patterns relate to further health complications down the road (like death or heart attacks). Those most closely following a Mediterranean diet were 20% less likely to die from all causes and 22% less likely to have a cardiovascular event (like a heart attack) during the 7-year follow up. On the other hand, a “Southern Diet” (lots of added fats, fried food, eggs, organ meats, processed meats, and sweetened beverages) was linked with a higher risk of death from all causes during the 7-year follow up. Journal of the American Heart Association. 2018 Jul 12;7(14). pii: e008078. (Shikany JM et al.)
MEDITERRANEAN DIET LINKED WITH LOWER RISK OF HEART DISEASE & DEATH
FROM HEART DISEASE
Even if you don’t live in the Mediterranean, you can still beneﬁt from a Mediterranean style diet. To see how the Mediterranean diet relates to heart disease in England, European researchers analyzed the eating habits and health outcomes of 23,902 adults (age 40-79) in Eastern England. Those most closely following a Mediterranean diet were signiﬁcantly less likely to develop heart disease. Based on these data, the researchers estimate that 1-6% of all heart disease cases, and 2-14% of all stroke cases can be prevented by following a Mediterranean diet. BMC Medicine. 2016 Sep 29;14(1):135. (Tong TY et al.)
MEDITERRANEAN DIET LINKED WITH LOWER DEATH RISK IN THOSE WITH HISTORY
OF HEART DISEASE
The Mediterranean diet is well known for its role in heart disease prevention, but new research suggests that it may also be beneﬁcial for people who already have a history of heart disease. In a preliminary study, researchers followed 1197 Italian adults who had a history of heart disease and analyzed their eating patterns and health outcomes. Those most closely following a Mediterranean diet were 37% less likely to die during the 7-year study period than those not following a Mediterranean diet. In fact, each 2-point increase on the Mediterranean diet score (on a scale of 0-9) was linked with a 21% lower risk of death. Presentation at the European Society of Cardiology. Rome, Italy. August 28, 2016.
MEDITERRANEAN DIET LINKED WITH LESS PLAQUE BUILD UP IN ARTERIES
Atherosclerosis, plaque build up in the arteries, can lead to dangerous blood clots, but diet can play an important role in prevention. Researchers analyzed the eating habits and heart health markers of 4,082 adults in Spain, and identiﬁed three distinct eating patterns: the Mediterranean diet, the Western diet, and the “social-business eating pattern,” a dietary pattern with more calories, red meat, pre-made foods, alcohol, sugary drinks, snacks, and lots of eating out. Those eating a Mediterranean diet had signiﬁcantly less plaque than those eating a Western or social business eating pattern, with a social-business pattern appearing to be even worse than the typical, unhealthy Western diet (characterized by not enough fruits, veggies or whole grains, and too much red meat, desserts, and sugary beverages). Journal of the American College of Cardiology. 2016 Aug 23;68(8):805-14.
Reference: Study summaries from www.oldwayspt.org