Med Diet Reduces Risk of Major Cardiac Events

The Mediterranean diet (MedDiet) is based on ample con­sump­tion of healthy foods such as veg­eta­bles, fruits, legumes, whole grains, fruit, fish, mod­er­ate alco­hol and olive oil. The MedDiet pat­tern has been asso­ci­ated with reduced car­dio­vas­cu­lar dis­ease (CVD) out­comes in both epi­demi­o­log­i­cal stud­ies and clin­i­cal tri­als. Therefore, many health author­i­ties rec­om­mend the con­sump­tion of more veg­eta­bles, fruit, whole grains and fish. It’s also a com­mon assump­tion that ingre­di­ents asso­ci­ated with a Western dietary pat­tern may cause more adverse effects. Therefore, the decreased con­sump­tion of processed foods that con­tain refined car­bo­hy­drates, sugar, sodium, and sat­u­rated fats are also rec­om­mended.
See Also:Olive Oil Health Benefits
Though it’s assumed that a healthy diet is ben­e­fi­cial for patients who already have coro­nary heart dis­ease (CHD), very lit­tle research has estab­lished any asso­ci­ated out­comes. Because diet is rarely assessed in a clin­i­cal sit­u­a­tion, it is impor­tant to under­stand if dietary pat­tern assess­ment dur­ing rou­tine clin­i­cal care could also be con­sid­ered a potent sec­ondary pre­ven­tion strat­egy that deserves more atten­tion.

A study pub­lished in the European Heart Journal aimed to estab­lish whether the MedDiet or Western dietary pat­terns pre­dict adverse out­comes in high-risk patients or in those with sta­ble CHD.

Taken from the Stability trial, a total of 15,482 par­tic­i­pants from 39 coun­tries were included in this sec­ondary obser­va­tional analy­sis. Participants were either at high risk of CVD or cur­rently had sta­ble CHD. Though the Stability trial was ini­tially designed to assess the risk of adverse CVD events from Darapladib, a lipopro­tein inhibitor, the trial also col­lected dietary infor­ma­tion from food fre­quency ques­tion­naires.

This sec­ondary analy­sis logged food con­sump­tion data into selec­tive food groups and scored them along both the Mediterranean diet score (MDS) and the Western diet score (WDS). The researchers reported that the pri­mary out­come of the study ​“was the first occur­rence of major adverse car­diac events (MACE) defined as non-fatal myocar­dial infarc­tion, non-fatal stroke, or death from a CV cause dur­ing a median fol­low-up of 3.7 years.”

The results of the study showed that a higher MDS score is sig­nif­i­cantly asso­ci­ated with lower risk of CVD death, myocar­dial infarc­tion, stroke and all-cause death. Every one-unit increase in MDS score was asso­ci­ated with a seven per­cent reduc­tion in adverse out­comes. The authors sug­gest that the MedDiet pat­tern eval­u­ated in this study is sim­i­lar to the DASH diet and con­sump­tion of the healthy foods com­monly rec­om­mended in dietary guide­lines.

According to the analy­sis, fruits, veg­eta­bles, fish, alco­hol, dairy foods and tofu/soybean were asso­ci­ated with decreased risk of MACE. Surprisingly, legumes, whole grains, sweet­ened drinks, refined grains desserts, sweet snacks, and meat showed no asso­ci­a­tion. Therefore, while the MedDiet clearly shows a decreased risk, the Western dietary pat­tern was not shown to increase risk of adverse out­comes in this study, which was an unex­pected result.

The research indi­cates that dietary advice to increase the con­sump­tion of fruits, veg­eta­bles and fish may be more impor­tant than rec­om­mend­ing a reduc­tion of Western dietary foods. While this study could not estab­lish an asso­ci­a­tion between adverse effects on CVD out­comes and typ­i­cal Western foods, it cer­tainly doesn’t give indi­vid­u­als per­mis­sion to con­sume junk food in copi­ous amounts.

As an author of the study, Ralph Stewart, was quoted as say­ing in the Sydney Morning Herald, ​“because the assess­ments were rel­a­tively crude, some harm can­not be excluded.” It must also be noted that this is an obser­va­tional study, which does not show cause and effect.

One thing is clear, the results of this large obser­va­tional study do show that the dietary advice to include more healthy foods still stands strong. And, on a pub­lic health level, plac­ing dietary pat­tern assess­ment into rou­tine clin­i­cal care for CVD and CHD patients may in fact act as a potent sec­ondary pre­ven­tion mea­sure.

• European Heart Journal


• The Sydney Morning Herald