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STABILITY: Patients with CHD can reduce risk for MI, stroke with Mediterranean diet
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The Mediterranean diet is associated with lower risk for MI and stroke in patients with CHD, according to a diet substudy of the STABILITY trial published in the European Heart Journal.
“After adjusting for other factors that might affect the results, we found that every one-unit increase in the Mediterranean diet score was associated with a 7% reduction in the risk of [MI], strokes or death from [CV] or other causes in patients with existing disease,” Ralph Stewart, MBChB (Otago), FRACP, FCSANZ, MD, from Auckland City Hospital, University of Auckland, New Zealand, said in a press release. “In contrast, greater consumption of foods thought to be less healthy and more typical of Western diets was not associated with an increase in these adverse events, which we had not expected.”
Participants in the original STABILITY trial had stable CHD and had at least one other CV risk factor, including diabetes requiring pharmacotherapy, current or previous smoking and renal dysfunction. Lifestyle questionnaires that included information on diet were completed at baseline by 15,482 participants. The primary endpoint for the substudy was first occurrence of major adverse CV events during a median follow-up of 3.7 years.
According to the results, major adverse CV events occurred in 1,588 participants. No association was found between an increase in the Western diet score and major adverse CV events, even after adjusting for potential confounders (adjusted HR for +1 increase = 0.99; 95% CI, 0.97-1.01). However, an increase in Mediterranean diet score greater than 12 was associated with lower risk for major adverse CV events (unadjusted HR for +1 increase = 0.93; P < .0001; adjusted HR for for +1 increase = 0.95; 95% CI, 0.91-0.98).
In unadjusted models, increase in Mediterranean diet score greater than 12 conferred reduction in risk for CV death, MI, stroke and all-cause death, but only the relationship with stroke remained significant after adjustment for confounders.
“The research suggests we should place more emphasis on encouraging people with heart disease to eat [healthier] foods, and perhaps focus less on avoiding unhealthy foods,” Stewart said.
One of the limitations of the study was that the researchers did not specify what a serving meant to make the questionnaire easier to complete.
“This is a limitation because the estimates of foods eaten are relatively crude and imprecise, but also a strength because we were able to show that even though diet is very complex, a few simple questions can identify a dietary pattern associated with a lower risk of recurrent [MI] or strokes,” Stewart said in the release. – by Tracey Romero
Disclosure: The STABILITY trial and the diet substudy were funded by GlaxoSmithKline. Stewart reports receiving research funding from GlaxoSmithKline. Please see the full study for a list of the other researchers’ relevant financial disclosures.
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