Mediterranean Diet Is Superior to Low-Fat Diet for Secondary Cardiovascular Prevention

The Mediterranean diet (which emphasizes fruits, vegetables, legumes, cereals, white meat, fish, and olive oil) is more effective than a reduced-fat diet in lowering risk for first adverse cardiovascular (CV) events in people at high risk (NEJM JW Gen Med Apr 1 2013 and N Engl J Med 2013; 368:1279), but evidence on its long-term effectiveness for secondary prevention is sparse.

At a single center in Spain, investigators randomized 1000 patients with coronary artery disease (83% men; average age, 60) to follow a Mediterranean diet or a low-fat diet. All patients saw a nutritionist at least 12 times each year and were given food to help them adhere to their diets. Patients in both groups significantly changed their dietary intake in the direct…