Mediterranean diet may reduce heart attack and stroke by 30 per cent

Time to pack up and move to Tuscany.

We’ve always known that the Mediterranean diet – a diet rich in olive oil, fish, nuts, vegetables, beans and fruit – is great for you, but a new study published online this week in the New England Journal of Medicine confirms that people at high risk for cardiovascular disease can stave off heart attacks, heart disease and strokes by 30 per cent if they start eating a little more like our Italian, Spanish, Greek or Croatian friends.

"The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern Europe or the United States," write the study’s authors.

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Researchers, led by Ramon Estruch, professor of medicine at Barcelona University, spent seven years studying a test group of 7,447 people that included men between the ages of 55 and 88 and women between the ages of 60 and 80.

Though none had yet developed heart disease, all subjects had type 2 diabetes and suffered from at least three high-risk factors, such as high levels of bad cholesterol, smoking, a family history of heart disease or a weight problem.

In fact, the Globe and Mail notes that many of these people were already taking some kind of medication for blood pressure or high cholesterol.

Estruch and his team set participants up in three groups: one group that consumed a low-fat diet consisting of bread, potatoes, pasta, vegetables and fish, along with two other groups that got to enjoy a Mediterranean diet.

The study results found that the participants in the low-fat group had the highest number of heart-related problems, while the two Mediterranean groups suffered far fewer heart attacks and strokes.

Of the two Mediterranean diet groups, one group consumed at least four daily tablespoons of extra virgin olive oil, while the other was provided with an ounce of walnuts, hazelnuts and almonds each day.

Participants in the low-fat diet group were encouraged to cut out processed sweets, limit their dairy and processed meat intake and double up on fish and legumes.

As the New York Times reports, most the low-fat diet group folded quickly, resuming their North American-style preferences of soda, meat and high-sugar baked goods.

The folks in the two Mediterranean groups, on the other hand, had a much easier time, as they were not given any sort of calorie restrictions and could essentially eat any dish they wanted within the prescribed range of foods.

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Interestingly enough, the findings were so significant that Estruch and his team rolled up the study five years earlier than planned

“We think the strength of this study comes from the fact that we measured hard outcomes and not just blood pressure or changes in cholesterol levels,” says Estruch. “We really believe the Mediterranean diet lowers incidence of [heart attack], stroke and cardiovascular deaths.”

Of course, the findings haven’t been universally lauded.

The Times mentions that Dr. Caldwell Blakeman Esselstyn Jr., author of “Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure,” and a staunch anti-olive oil advocate, criticized the study’s methodology, noting that participants in the Mediterranean diet groups still had heart attacks and said all the study proved was that “the Mediterranean diet and the horrible control diet were able to create disease in people who otherwise did not have it.”

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But his voice has been drowned in an olive-oil sea of praise for Estruch’s work.

“Really impressive,” Rachel Johnson, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association, tells the paper. “And the really important thing — the coolest thing — is that they used very meaningful endpoints. They did not look at risk factors like cholesterol or hypertension or weight. They looked at heart attacks and strokes and death. At the end of the day, that is what really matters.”

It’s easy to start implementing more Mediterranean-friendly foods. Start by replacing vegetable and canola oils with extra virgin olive oil when possible and snack on walnuts or almonds instead of potato chips and fries. Cut down the burgers and start learning how to prepare delicious fish dishes (of the sustainable variety, of course).

Yet while it’s possible to mangia bene here at home, it’s still wonderful to fantasize about making all these changes while looking out at the Adriatic from your kitchen window.