Objective: The objective of this trial was to compare the effects of a Mediterranean diet and a low fat diet on risk of cardiovascular disease in subjects over 5 years.
Methods: 7,447 subjects at high risk of developing cardiovascular disease were randomized into one of 3 diet groups: A Mediterranean diet supplemented with olive oil, a Mediterranean diet supplemented with nuts, and a low fat diet. The subjects were followed for 4.8 years and the primary endpoints were myocardial infarction, stroke, or death from cardiovascular causes.
Results: The Mediterranean group supplemented with nuts had a 30% lower risk of cardiovascular disease when compared to the low fat group. The Mediterranean group supplemented with olive oil had a 28% lower risk of cardiovascular disease when compared to the low fat group. The trial was stopped early because it was no longer considered ethical to keep the low fat group on a diet that could be increasing their risk of cardiovascular disease.
Discussion: This is a beautifully designed study in an elite research journal. A 30% reduction in risk of cardiovascular disease in only 5 years is an impressive difference. The authors believed that the benefit of the Mediterranean diet was due to favorable changes in blood lipids, insulin sensitivity, and resistance to oxidation, inflammation, and vasoreactivity.
Take Home Message: This study provides further evidence that a low fat diet is not the way to go. In fact, this study is so big and so well done, that it very well may be the final nail in the coffin for low fat diet proponents. If you want to reduce your risk of cardiovascular disease, the number one killer in the U.S., follow a Mediterranean approach; which features olive oil, nuts, fruits and vegetables, legumes, lean protein and limits sugar sweetened beverages, breads, sweets, butter, and red meat.