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Mediterranean Diets Supplemented With Olive Oil or Nuts Have Beneficial Effects on Cardiovascular Risk Factors

July 28, 2006

By Sahar Bedrood B.S. and Asher Kimchi M.D.

Barcelona, Spain - The low incidence of coronary artery disease in Mediterranean countries has been attributed to the dietary habits of the people in that region. A multi-center, randomized study by Ramon Estruch, MD, PhD et al from the Hospital Clinic in Spain compared the short-term effects of two Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk. The findings, published in the July 4, 2006 issue of Annals of Internal Medicine, found that compared to low-fat diets, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors.

From October 2003 to March 2004, 930 potential participants in primary care centers affiliated with 10 teaching hospitals across Spain were selected. Eligible participants were community-dwelling men, 55 to 80 years of age, and women, 60 to 80 years of age, who fulfilled at least 1 of 2 criteria: type 2 diabetes or 3 or more CHD risk factors (current smoking, hypertension [blood pressure >140/90 mm Hg or treatment with antihypertensive drugs], low-density lipoprotein [LDL] cholesterol level 4.14 mmol/L [160 mg/dL] [or treatment with hypolipidemic drugs], high-density lipoprotein [HDL] cholesterol level 1.04 mmol/L [40 mg/dL], body mass index [BMI] 25 kg/m2, or a family history of premature CHD).

Participants were assigned to a low-fat diet (n = 257) or to 1 of 2 Mediterranean diets. Those allocated to Mediterranean diets received nutritional education and either free virgin olive oil, 1 liter per week (n = 257), or free nuts, 30 g/d (n = 258). The authors evaluated outcome changes at 3 months.

The completion rate was 99.6%. Compared with the low-fat diet, the two Mediterranean diets produced beneficial changes in most outcomes. Compared with the low-fat diet, the mean changes of plasma glucose levels in the Mediterranean diet with olive oil group and the Mediterranean diet with nuts group were –0.39 mmol/L (95% CI, –0.70 to – 0.07 mmol/L) and – 0.30 mmol/L (CI, –0.58 to – 0.01 mmol/L), respectively; systolic blood pressure changes were: –5.9 mm Hg (CI, –8.7 to –3.1 mm Hg) and – 7.1 mm Hg (CI, –10.0 to –4.1 mm Hg), respectively; and for the cholesterol–high-density lipoprotein cholesterol ratio the changes were: –0.38 (CI, –0.55 to – 0.22) and – 0.26 (CI, –0.42 to –0.10), respectively,. The Mediterranean diet with olive oil reduced C-reactive protein levels by 0.54 mg/L (CI, 1.04 to 0.03 mg/L) compared with the low-fat diet.

Overall, the study concluded that Mediterranean diets are associated with a significant reduction in cardiovascular risk factors, such as blood pressure, fasting glucose levels and C-reactive protein levels.

Co-authors: Ramon Estruch, MD, PhD; Miguel Ángel Martínez-González, MD, PhD; Dolores Corella, PhD; Jordi Salas-Salvadó, MD, PhD; Valentina Ruiz-Gutiérrez, PhD; María Isabel Covas, PhD; Miguel Fiol, MD, PhD; Enrique Gómez-Gracia, MD, PhD; Mari Carmen López-Sabater, PhD; Ernest Vinyoles, MD, PhD; Fernando Arós, MD, PhD; Manuel Conde, MD, PhD; Carlos Lahoz, MD, PhD; José Lapetra, MD, PhD; Guillermo Sáez, MD, PhD; Emilio Ros, MD, PhD, for the PREDIMED Study Investigators*



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