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Mediterranean Diet Reduces Risk of Heart Attack and Stroke

Randomized controlled trials, in which people are randomly assigned to a particular treatment and then monitored over time, are considered by many to be the “gold standard” of nutrition research. In this randomized controlled trial, 1,002 Spanish adults (average age 59) with heart disease were randomly assigned to a Mediterranean diet or a control diet (which differed by emphasizing lean meats and fish and low-fat dairy, and restricting fatty fish, nuts and olive oil) and followed for 7 years. Those eating a Mediterranean diet were 25-29% less likely to have a major cardiovascular event (such as a heart attack or stroke) than those eating the control diet, with the relationship being especially strong in men. These findings are consistent with previous research noting the cardioprotective benefits of a Mediterranean diet. 
Lancet. 2022 May 4;S0140-6736(22)00122-2. doi: 10.1016/S0140-6736(22)00122-2. (Delgado-Lista J et al.)

Mediterranean Diet Can Slow Progression of Atherosclerosis

Atherosclerosis, the build up of fatty plaque in arteries, can be a risk factor for heart disease down the road. In a randomized controlled trial of more than 900 people with heart disease, those assigned to a Mediterranean diet improved their atherosclerosis (as measured by reduced thickness of both carotid arteries) over 5 years and maintained their baseline artery thickness at 7 years. Those assigned to a low-fat diet did not have any significant improvements in atherosclerosis.
Stroke. 2021 Aug 10;STROKEAHA120033214. doi: 10.1161/STROKEAHA.120.033214. (Jimenez-Torres J et al.)

Mediterranean Diet Linked with Better Blood Vessel Function in Adults with Heart Disease

The endothelium lines the heart and blood vessels, and when not working properly, can be an indicator of atherosclerosis (dangerous buildup of fatty plaques in arteries). In this study, researchers randomly assigned 805 adults with coronary heart disease to a Mediterranean diet or a low-fat control diet and measured their endothelial function. After 1 year on their respective diets, those following a Mediterranean diet were more likely to have improved endothelial function and better homeostasis of their blood vessels, even in patients with severe endothelial dysfunction.
PLoS Medicine. 2020 Sep 9;17(9):e1003282. doi: 10.1371/journal.pmed.1003282. eCollection 2020 Sep. (Yubero-Serrano EM et al.)

Olive Oil Linked with Lower Risk of Heart Disease

Not all fats are created equal. Olive oil is a source of heart-healthy monounsaturated fats and polyphenols, while butter is a source of saturated fats. In this study, researchers followed more than 90,000 people for 24 years. Those eating more than ½ tablespoon of olive oil per day had a 14-17% lower risk of heart disease compared with people who didn’t eat olive oil. The scientists also found that replacing 5g/day of butter, margarine, mayonnaise, or dairy fat with the equivalent amount of olive oil was also linked with a 5-7% lower risk of heart disease.
J Am Coll Cardiol. 2020 Apr 21;75(15):1729-1739. doi: 10.1016/j.jacc.2020.02.036. Epub 2020 Mar 5. (Guasch-Ferré M et al.)

Mediterranean Diet Linked with Better Brain Function in Men with Heart Disease

The Mediterranean diet is well-known for its links to brain health, and new research demonstrates that these ties hold up in populations with heart disease as well. In this study, researchers analyzed the diets of 200 men (average age 57), then assessed their brain health 14 and 20 years later. Not following a Mediterranean Diet was linked with a greater decline in overall cognitive performance and visual spatial functions.
Nutritional Neuroscience. 2020 Jan 22:1-9. doi: 10.1080/1028415X.2020.1715049. (Lutski M et al.)

Chili Pepper Linked with Longevity in Italian Adults

Chili pepper is an underappreciated aspect of a Mediterranean diet. To see how it relates to longevity in a Mediterranean population, researchers analyzed the diets of 22,811 Italian adults and monitored their health outcomes for 8 years. Those eating chili pepper at least 4 times per week were 23% less likely to die from all causes and 34% less likely to die from heart disease over the study period, even after controlling for the benefits of a Mediterranean diet. The relationship seems to be strongest in people without high blood pressure.
Journal of the American College of Cardiology. 2019 Dec 24;74(25):3139-3149. doi: 10.1016/j.jacc.2019.09.068. (Bonaccio M et al.)

Mediterranean Diet Linked with Improvements in Cardiodiabesity

“Cardiodiabesity” is an umbrella term which refers to the relationship between obesity, cardiovascular disease, metabolic syndrome, and type 2 diabetes. Researchers analyzed over 50 studies to answer several key questions about the impact of the Mediterranean diet on cardiodiabesity. The researchers found strong evidence that following the Mediterranean diet reduces obesity, blood pressure, and the risk of cardiovascular disease in healthy and at-risk people. They also found moderate evidence that the Mediterranean diet reduces the risk of developing metabolic syndrome and type 2 diabetes, and can reduce the symptoms of type 2 diabetes in diabetics.
Nutrients. 2019 Mar 18;11(3). pii: E655. doi: 10.3390/nu11030655. (Franquesa M. et al)

Mediterranean Diet Has Long History of Health Benefits

Mediterranean diet first rose to prominence in the 1950’s and since that time has become one of the most-studied diets in the world. In this study, researchers summarize the Mediterranean diet’s scientific history and key takeaways, including its benefits for weight loss and the prevention of heart disease and type II diabetes. The Mediterranean diet has also been linked with the possible prevention of certain types of cancer and neurodegenerative diseases such as Alzheimer’s. The authors note that the erosion of tradition threatens the Mediterranean diet in its place of birth, and that more populations could benefit from adopting a more Mediterranean inspired diet.
International Journal of Environmental Research and Public Health. 2019 Mar 15;16(6). pii:E942. doi: 10.3390/ijerph16060942. (Lăcătușu C-M et al.)

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.)

Frequent Olive Oil Consumption May Be Linked with Making Blood Less Likely to Clot

Olive oil is a well-known heart healthy food, and new research sheds light on a potential explanation behind this benefit. In this study, researchers analyzed the eating habits of 63 obese but otherwise healthy adults, and also analyzed the platelet activity in their blood. (Platelets are the building blocks of blood clots when they stick together.) Those eating olive oil at least once per week had significantly lower platelet activation, indicating that their blood may be less likely to clot. (Note that findings presented at meetings are considered preliminary until published in a peer-reviewed journal.)
Presentation at American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions. Houston, TX. March 7, 2019 (Heffron SP 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.)

Mediterranean Diet Linked with ¼ Lower Heart Disease Risk in Women

The Mediterranean diet is closely linked with heart health, and researchers want to learn more about the underlying mechanisms behind this connection. In this study researchers analyzed the diet and health outcomes of 25,994 women for 12 years. Those most closely following a Mediterranean diet were 28% less likely to develop heart disease than those not following a Mediterranean diet. Even those who were only moderately following a Mediterranean diet had a 23% lower risk of heart disease, indicating that even small lifestyle changes can have a meaningful impact on health. The researchers suspect that part of the heart health benefits may be related to lower inflammation, as women most closely following the Mediterranean diet had significantly lower levels of biomarkers of inflammation. Other factors shown to affect the relationship between the Mediterranean diet and heart health are the Mediterranean diet’s links to blood sugar management, BMI, blood pressure, and cholesterol.
JAMA Network Open. 2018 Dec 7;1(8):e185708. doi:10.1001/jamanetworkopen.2018.5708 (Ahmad S et al.)

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