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Mediterranean diet effective for primary prevention of CVD

A Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts lowered the risk of CVD in high-risk patients, according to research published in the New England Journal of Medicine.

“Increasing adherence to the Mediterranean diet has been consistently associated with lower cardiovascular risk,” Ramon Estruch, MD, PhD, from the Instituto de Salud Carlos III, Madrid, and colleagues wrote.

Estruch and colleagues conducted a randomized trial to determine whether a Mediterranean diet supplemented with extra-virgin olive oil or nuts is effective for primary prevention of CVD compared with a control diet.

The researchers enrolled 7,447 participants aged between 55 and 80 years (57% women) who had a high cardiovascular risk but no CVD at baseline. High cardiovascular risk was defined as having type 2 diabetes or at least three major risk factors, including smoking, hypertension, elevated LDL cholesterol levels, low HDL cholesterol levels, overweight or obesity or a family history of premature coronary heart disease.

Participants followed either a Mediterranean diet supplemented with extra-virgin olive oil (4 tbsp per day of extra-virgin olive oil; n = 2,543), a Mediterranean diet supplemented with mixed nuts (15 g of walnuts, 7.5 g of hazelnuts and 7.5 g of almonds; n = 2,454) or a control diet (advice on a low-fat diet; n = 2,450).

During a median follow-up of 4.8 years, 288 participants experienced a major cardiovascular event, such as myocardial infarction, stroke or cardiovascular-related death. Of these events, 96 occurred in the group that followed the Mediterranean diet with extra-virgin olive oil, 83 occurred in the group that followed the Mediterranean diet with nuts and 109 occurred in the control group.

Adjusting for baseline characteristics and propensity scores showed that participants following a Mediterranean diet with extra-virgin olive oil (HR = 0.69; 95% CI, 0.53-0.91) or nuts (HR = 0.72; 95% CI, 0.54-0.95) had an approximately 30% lower risk of a major cardiovascular event compared with those following the control diet. Results remained consistent after omitting 1,588 participants who departed from their diet.

“Our findings support a beneficial effect of the Mediterranean diet for the primary prevention of CVD,” Estruch and colleagues concluded. – by Alaina Tedesco

Disclosure: Please see study for complete list of all other authors’ relevant financial disclosures.