A randomized, multicenter trial conducted in Spain found that a Mediterranean diet resulted in a reduction in the incidence of major cardiovascular (CV) events and a 30 percent relative risk reduction in major CV events over a 4.8-year follow-up period.

Additional Resources Full Study  PREDIMED Clinical Trial Summary  CardioSmart for Your Patients: About the Mediterranean Diet

The trial results were published on Feb. 25 in The New England Journal of Medicine. The PREDIMED (Preventión con Dieta Mediterránea) trial compared the consumption of a Mediterranean diet supplemented with either extra-virgin olive oil or nuts vs. a control diet among 7,447 individuals at high risk of CV disease (CVD) but with no CVD at enrollment. Individuals in the trial had either type 2 diabetes or at least three of seven major CV risk factors — smoking, hypertension, elevated low-density lipoprotein cholesterol levels, low high-density lipoprotein cholesterol levels, were overweight or obese, or had a family history of premature coronary heart disease.

Results showed the group of participants assigned to a Mediterranean diet supplemented with olive oil had 96 primary endpoint events (a composite of myocardial infarction, stroke and death from cardiovascular causes), those assigned to a Mediterranean diet supplemented by mixed nuts (walnuts, almonds and hazelnuts) had 83 events and the control group had 109 events (p = 0.015). The Mediterranean diets resulted in an absolute risk reduction of three major CV events per 1,000 person-years.

A traditional Mediterranean diet consists of high amounts of olive oil, fruit, vegetables, nuts and cereals; moderate amounts of fish and poultry; and low amounts of dairy products, sweets, red meats and processed meats. Participants assigned to the Mediterranean diet groups significantly increased weekly servings of fish and legumes, as well as olive oil and nuts, depending on the group they were in.

According to the study authors, the results of the trial might explain, in part, CV mortality rates among Mediterranean countries compared with mortality rates in northern European countries and the U.S. They note that the dietary supplements of extra-virgin olive oil and nuts were possibly responsible for most of the observed benefits of the Mediterranean diets.

Keywords: Overweight, Diabetes Mellitus, Type 2, Coronary Disease, Risk Factors, Poultry, Diet, Mediterranean, Cholesterol, Fruit, Plant Oils, Vegetables, Spain, Cardiovascular Diseases, Obesity, Hypertension, Myocardial Infarction, Stroke, Fabaceae, Risk Reduction Behavior, New England, Smoking, Lipoproteins, LDL, Dairy Products, Dietary Supplements, Corylus, Edible Grain, Nuts, Prunus, Lipoproteins, HDL

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