Italian olive oil image credit: Wikipedia
Earlier this week, results from a massive study on the benefits of the Mediterranean diet were published in the New England Journal of Medicine. The study–which lasted five years and included 7,500 participants ages 55-80–was a triumph for the Med diet, but there are a few important caveats to consider.
As you’ve likely heard, the Mediterranean diet is high in olive oil, fish, nuts, wine and vegetables – it’s not a low-fat diet by any means, but the fats mostly come from monounsaturated sources (olive oil and nuts).
Participants in this study who ate the Med way consumed about 200 calories more per day than the participants who ate a low-fat diet heavy on bread, potatoes, pasta, rice, fruits, vegetables and fish and light on baked goods, nuts, oils and red meat.
Despite the additional calories, results showed that participants eating the Med way had a 30 percent lower risk of major cardiovascular problems compared to those who were told to follow a low-fat diet. Doctors tracked heart attacks, strokes and heart-related deaths over the course of the study; there were 96 in the Mediterranean-olive oil group, 83 in the Mediterranean-nut group and 109 in the low-fat group.
Why is this study different and important?
For years the Med way of eating has been touted as healthier than low-fat diets, but those claims lacked clinical evidence. Until this study, evidence for the Med diet came from observational studies of health outcomes (such as the Seven Countries Study). In the latest study, participants were not only tracked for years, but were given periodic blood tests to ensure people were eating enough nuts and olive oil to make a difference. The blood tests added a clinical evaluation layer that other studies didn’t have.
Does this study tell us that we can eat the Med way instead of taking cardiovascular medications?
No, it does not. In fact, most of the participants in this study assigned to eating the Med diet were already taking prescription medications for cholesterol and blood pressure, and researchers did not alter those prescriptions in any way. Also worth noting, half of the participants had diabetes.
Does this study show that the Med diet prevents all forms of heart disease?
No, but it does show a general decrease in heart-disease outcomes (heart attacks and strokes) in people eating the Med way. When the results are looked at per individual, strokes were the only heart disease outcome to show a significant decrease due to diet. Overall death rates were not affected by diet at all.
If people want to begin a diet closer to the Med way, what does this study say they should focus on most?
Extra virgin olive oil and nuts–specifically walnuts, hazelnuts and almonds. In the study, the two Mediterranean diet groups were supplemented with either four tablespoons a day of extra virgin olive oil or a fistful of nuts. Of these two groups, the Med way-nut group showed the greatest benefits, but both groups did well compared to the third, low-fat group.
Why “extra virgin” olive oil?
While it’s not entirely clear why, or if, extra virgin olive oil is better than other forms of olive oil with respect to heart health, it is less processed and richer in oleic acid than less expensive olive oils. Oleic acid is a monounsaturated fatty acid that previous research has suggested may be a key to improving heart health.
Sources:
The New England Journal of Medicine
AP News
The Mayo Clinic
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