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Mediterranean diets do work, confirms trial from Spain

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1288 (Published 27 February 2013) Cite this as: BMJ 2013;346:f1288

A new trial from Spain has confirmed that a Mediterranean diet is good for cardiovascular health. The authors tested two types of Mediterranean diet in high risk adults, one enriched with extra virgin olive oil and one enriched with nuts. Both helped reduced cardiovascular events over five years when compared with standard advice to eat less fat (fully adjusted hazard ratios 0.7 (95% CI 0.54 to 0.92) and 0.72 (0.54 to 0.96), respectively). The primary outcome was combined strokes, myocardial infarctions, and deaths from cardiovascular disease. Each Mediterranean diet prevented three events per 1000 person years.

All participants had at least three risk factors for cardiovascular disease but no history of disease. The Mediterranean diets encouraged consumption of fish, fruit and vegetables, nuts, olive oil, pulses, and wine with meals. Participants in these groups were given (free) an extra litre of olive oil a week or an extra 30 g of almonds, walnuts, and hazelnuts each day. Controls received small non-food gifts instead.

Food questionnaires and tests of biomarkers suggested good adherence with the two Mediterranean diets, although most of the benefit probably came from the extra olive oil or nuts, rather than other dietary changes, say the authors.

Both diets seemed to reduce strokes more effectively than other components of the primary outcome (extra olive oil 0.67 (0.46 to 0.98); extra nuts 0.54 (0.35 to 0.84)).

Notes

Cite this as: BMJ 2013;346:f1288