A Mediterranean Diet Is More Effective Than a Low-Fat Diet for Secondary Cardiovascular Prevention

Substantial evidence, mostly observational, has established that a Mediterranean diet (i.e., emphasizing fruits, vegetables, legumes, cereals, white meat, fish, and olive oil) is optimal for primary prevention of cardiovascular (CV) disease. In a major randomized trial published in 2013, researchers assigned 7400 high-risk adults with no known CV disease to one of two Mediterranean diet versions or provided advice to reduce dietary fat. The incidence of major adverse CV events was significantly lower in both Mediterranean diet groups than in the low-fat group (hazard ratio, ≈0.7; NEJM JW Gen Med Apr 1 2013 and N Engl J Med 2013; 368:1279). Evidence that a Mediterranean diet is effective for secondary CV prevention has been sparse.

In a new s…