Mediterranean Diet Supplemented With Nuts or Extra-virgin Olive Oil Delays Onset of Heart Disease

Highlights:

Mediterranean diet to which nuts or extra-virgin olive oil is added reduces the risk of serious heart diseases such as stroke and heart attack in persons who are considered high risk for developing heart disease
According to the World Health Organization (WHO), each year close to 18 million people die of heart disease across the world, accounting for more than 30 percent of global deaths
The risk factors for developing heart disease include smoking, unhealthy dietary habits, lack of physical activity along with poorly controlled blood pressure, blood sugar, high levels of low-density lipoprotein (LDL) cholesterol or bad cholesterol and being overweight

Consuming a Mediterranean diet supplemented with extra-virgin oil or nuts can reduce the risk of developing heart disease in high-risk patients, according to a recent report published in the reputed journal New England Journal of Medicine (NEJM).

Heart Attack - Overview
Heart attack is the death of the heart muscle due to loss of blood supply. Heart disease is the leading cause of death in the United States. Other names for heart attack include acute myocardial infarction, coronary thrombosis, and coronary occlusion.

‘Persons at increased risk of developing heart disease can reduce their risk of heart attack or stroke by following a Mediterranean diet supplemented with either extra-virgin olive oil or nuts.’

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Details of Study

The study was conducted across several centers in Spain. Over 7000 participants between the ages of 55 to 80 years (57% female) participated in the study, which began in 2009
All the participants were healthy at the time of enrollment. However, they had risk factors for developing heart disease such as

Type 2 diabetes mellitus or any three of the following major risk factors namely
High blood pressure
Smoking history
Being overweight or obese
Elevated low-density lipoprotein cholesterol levels
Low high-density lipoprotein cholesterol levels, or a
Family history of an early onset coronary artery disease

Participants were assigned to one of three diet groups namely –

A Mediterranean diet group along with extra-virgin olive oil daily (study group)
A Mediterranean diet along with mixed nuts (walnuts, hazelnuts and almonds) (study group), or
A control group diet where the members were instructed to follow a low-fat diet

After 4.8 years the participants were followed up for occurrence of serious heart diseases such as heart attack and stroke

Mediterranean Diet - Benefits - Components - Olive Oil - FAQs
Mediterranean diet has long been considered one of the healthiest diets on the planet. This diet plan discourages the use of saturated fats and hydrogenated oils while cooking meals.

Findings of the Study

A total of 288 cases of serious heart disease was reported among the participants in all the three diet groups
Of the 288 cases of serious heart disease, there were

96 cases (3.8%) in the Mediterranean diet group supplemented with extra-virgin oil
83 cases (3.4%) in the Mediterranean diet group supplemented with mixed nuts and
109 (4.4%) cases in the control group who followed a low fat diet

The results were first published in 2013 in the NEJM but due to the identification of certain departures from the protocol of conducting a randomized controlled trial (a clinical study where participants are randomly assigned to either study or control groups to compare the effects of a specific treatment or intervention), this report was withdrawn
Following reanalysis of data after excluding the 1588 participants whose assignment to the Mediterranean diet study group was suspected to have departed from trial protocol the report was once again republished in 2018
The results of the reanalysis revealed similar results as shown in the 2013 report

Thus the study suggests that the incidence of serious heart diseases such as heart attack and stroke was lower among high-risk individuals who were assigned to a Mediterranean diet along with either extra-virgin olive oil or nuts than among those assigned to a low-fat diet.

Why is Olive Oil used extensively in the Mediterranean Diet?
Olive oil is a good source of monounsaturated fat. Olive oil contains antioxidants that discourage artery clogging and chronic diseases, including cancer.

Results of Previous Studies on Mediterranean Diet

In earlier population based studiesas well as the Lyon Diet Heart Study which assessed the benefits of a Mediterranean diet in reducing the risk of a second occurrence of heart disease in persons who already had an initial episode of heart disease (secondary prevention), it has been shown that consuming a Mediterranean diet has been consistently associated with lower heart disease risk.

The Mediterranean diet has been rated by a systematic review as the most probable dietary model to offer protection against heart disease.

Inspired by the findings of these earlier studies the authors of the current study designed their trial to assess the role of the Mediterranean diet in reducing the risk of onset of heart disease in healthy persons (primary prevention).

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What is the Mediterranean Diet?

The Mediterranean diet consists of consuming a high proportion of olive oil, unrefined cereals, legumes and plenty of fruits, and vegetables, moderate to high amounts of fish, low quantities of dairy products, processed meats, sweets and red meat; and wine in moderation, consumed with meals and low quantities of non-fish meat products.

The Mediterranean diet is based primarily on the eating habits of Southern Italy, Greece and Spain during the 1940s and 1950s.

There is evidence in the published literature that adhering to a Mediterranean diet has a beneficial effect in preventing heart disease, believed mainly to be due to the beneficial effects of olive oil

References:

Cardiovascular disease - (http://www.who.int/cardiovascular_diseases/en/)
Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts - (https://www.nejm.org/doi/full/10.1056/NEJMoa1800389)

Source-Medindia