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From the Feb. 6, 2014 Science Daily:

Whole diet approach to lower cardiovascular risk has more evidence than low-fat diets

A study published in The American Journal of Medicine reveals that a whole diet approach, which focuses on increased intake of fruits, vegetables, nuts, and fish, has more evidence for reducing cardiovascular risk than strategies that focus exclusively on reduced dietary fat.

This new study explains that while strictly low-fat diets have the ability to lower cholesterol, they are not as conclusive in reducing cardiac deaths. By analyzing major diet and heart disease studies conducted over the last several decades, investigators found that participants directed to adopt a whole diet approach instead of limiting fat intake had a greater reduction in cardiovascular death and non-fatal myocardial infarction.

"Nearly all clinical trials in the 1960s, 70s and 80s compared usual diets to those characterized by low total fat, low saturated fat, low dietary cholesterol, and increased polyunsaturated fats," says study co-author James E. Dalen, MD, MPH, Weil Foundation, and University of Arizona College of Medicine. "These diets did reduce cholesterol levels. However they did not reduce the incidence of myocardial infarction or coronary heart disease deaths."

Carefully analyzing studies and trials from 1957 to the present, investigators found that the whole diet approach, and specifically Mediterranean-style diets, are effective in preventing heart disease, even though they may not lower total serum or LDL cholesterol. The Mediterranean-style diet is low in animal products and saturated fat, and encourages intake of monounsaturated fats found in nuts and olive oil. In particular, the diet emphasizes consumption of vegetables, fruit, legumes, whole grains, and fish.

"The potency of combining individual cardioprotective foods is substantial -- and perhaps even stronger than many of the medications and procedures that have been the focus of modern cardiology," explains co-author Stephen Devries, MD, FACC.

More evidence in support of Mediterranean style diet. From the Feb. 4, 2014 Science Daily:

Mediterranean diet linked with lower risk of heart disease among young U.S. workers

Among a large group of Midwestern firefighters, greater adherence to Mediterranean-style diet was associated with lower risk factors for cardiovascular disease (CVD), according to a new study led by researchers from Harvard School of Public Health (HSPH) and Cambridge Health Alliance (CHA). The study is the first to assess the effects of Mediterranean-style diet among a group of young, working U.S. adults.

The researchers analyzed medical and lifestyle data, including dietary habits, from an existing cohort of 780 male firefighters in the Midwest. They developed a modified Mediterranean diet score (mMDS) to assess the participants' dietary patterns.

The firefighter group with greatest adherence to Mediterranean-style diet showed a 35% decreased risk in metabolic syndrome, a condition with risk factors that include a large waistline, high triglyceride level, low HDL ("good") cholesterol level, high blood pressure, and high blood sugar. The group with the highest mMDS also had a 43% lower risk of weight gain compared with the lowest mMDS group. Additionally, greater adherence to a Mediterranean-style diet was significantly associated with higher HDL cholesterol and lower LDL ("bad") cholesterol. Consistent with previous investigations, obese participants in the firefighter study reported a higher intake of both fast foods and sugary drinks.