Several studies have shown that a Mediterranean diet is good for your heart. This massive study looked at the Mediterranean diet and a Western diet in people who had coronary heart disease that had been stabilized. . . . 

The study was very large: it included 15,482 people from thirty-nine countries. Points went up on the Mediterranean diet score for increasing amounts of whole grains, fruit, vegetables, legumes, fish and alcohol in the diet, and went down for increasing amounts of meat. Western diet scores went up with increasing amounts of refined grains, sweets and desserts, sugar sweetened drinks and deep fried foods in the diet. The question was, How would diet effect major cardiovascular events?

After following the people and their diets for an average of 3.7 years, the researchers found that only 7.3% of the people who most closely followed a Mediterranean diet (score of 15 or more) suffered a major cardiovascular event. 10.5% of those who scored 13-14 did, and 10.8% of those who scored 12 or less did. Major cardiovascular events went up a significant 7% for each point above 12: that is, the more a person followed the Mediterranean diet, the less likely the person was to suffer a major cardiovascular event (like heart attack, stroke or death). The Western diet, however, had no effect.

This study shows that Mediterranean diets protect against heart disease but that the standard North American diet does not.

The researchers suggest that their study shows that eating healthy foods may be more important than just avoiding unhealthy foods. However, it is also possible that the standard North American diet did not alter their risk because they were already on the standard North American diet: that is, the risk didn’t change because the diet didn’t change.

It would also be interesting to see if the Mediterranean diet would be even more protective if scores didn’t go up as alcohol consumption went up. Increasing consumption of alcohol would increase Mediterranean diet scores, but large amounts of alcohol are detrimental to health. The study may have been better designed if it only increased Mediterranean diet scores up until moderate alcohol consumption or didn’t increase it for alcohol at all.



European Heart Journal. doi:10.1093/eurheartj/ehw125

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