This week, the scientific and medical communities are abuzz with the news that consuming nuts and oils, olive oil in particular, fatty fish and red wine is good for people. The findings of a five-year study by Spanish doctors that was actually cut short because the results were so dramatic, were published Monday on the New England Journal of Medicine website. The evidence points to at least a 30 percent reduction in the risk of heart attack and stroke through adherence to the Mediterranean Diet.
This is American Heart Month, and so the release of these findings is particularly pertinent. Heart disease is the Number One cause of death in this country.
Even though for many years proponents have cited the traditional diet choices of citizens of the 16 nations surrounding the Mediterranean as a reason for the low rates of chronic heart disease in those countries, there has previously been no proof, and a good deal of dissent.
One reason the findings have caused a stir is that the benefit seems to accrue to all, regardless of additional risk factors and independent of weight loss.
The study was designed to test the effects of diet for those at high risk for heart disease, and was conducted with almost 7,500 Spanish participants who were randomly assigned to one of three groups. Oddly, however, there is some reluctance to concede that, because the study was performed with those at high risk, the effects would be the same for those with no or low-risk factors.
Scientific studies sometimes confirm what some people already suspect: Disease and illness may have more to do with total lifestyle than with specifics; and the recommendations of the health community over the last 40 years or so in this country may have done little to reduce he risks. This study points to the fact that the low-fat diet traditionally prescribed for high-risk patients is not only difficult to maintain, but actually does not lower the incidence of heart disease as much as a well-balanced diet rich in fruits, vegetables, whole grains, olive oil, fish and chicken.
The traditional Mediterranean diet is characterized by a high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.
Taken directly from the study, that was the governing dietary plan prescribed for the test participants. Additionally, some of them were given supplemental virgin olive oil, and others additional nuts in an effort to further define specific benefits. A control group was charged to maintain a low-fat diet for primary cardiovascular prevention. But they found it harder to maintain that low-fat requirement over the years of the study.
The study was begun in 2003, with men between the ages of 55 and 80 and women between 60 and 80, all of whom also had “either type 2 diabetes mellitus or at least three of the following major risk factors: Smoking, hypertension, elevated low-density lipoprotein (LDL) cholesterol levels, low high-density (HDL) lipoprotein cholesterol levels, overweight or obesity, or a family history of premature coronary heart disease.”
No calorie restrictions were advised, and no change in previous physical activity was mandated. Additionally, throughout the study, it was noted that participants in none of the groups showed significant weight loss. Still, the two Mediterranean diet groups exhibited the risk reduction for both heart attack and stroke in such overwhelming manner that the study was cut short for “ethical” reasons.
Diet and exercise, as well as quitting smoking, have long been recommended as ways to reduce risk of heart disease and stroke. The well-known Cooper Clinic in Dallas, noting that one-third of the population has some form of heart disease, endorses some of the dietary tenets of the Mediterranean diet, but still restricts olive oil to "sparing use." The clinic also stresses exercise and other measures to increase overall health.
While some doctors hail the study as confirmation that a reasonable and balanced diet is more important than specifics, others are not convinced that it provides a blueprint for everyone to follow. Dissenters include doctors who prescribe extremely low-fat diets as a way to reverse heart disease, as well as those who favor a vegan regimen for maximum health benefits.
The American Heart Association, while not recommending any specific plan, does weigh in on the side of eating "a healthy diet" as one of its simple step to add years to your life.
Presumably, there will now be further studies to ascertain whether any dietary plan can lower risk for already low-risk individuals.