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| Mediterranean
Diet |
Heart attack patients can reduce
their risk for a second attack by consuming a lowfat Mediterranean-type diet
that is rich in fruits, vegetables, whole grains and fish and that uses from
olive and canola and as the primary source of fat.
French researchers followed 600 patients
who participated in the Lyon Diet Heart Study to determine whether a
Mediterranean-type diet can reduce the rate of recurrence after a first heart
attack. The results of in the initially planned 5-year study were so impressive
that the study was halted after 27 months.
This study presents the finding of a four-year
follow-up with Lyon Diet Heart Study participants. Researchers studied the
relationship between dietary patterns and traditional heart disease risk
factors with recurrence of heart attacks. Patients were randomly assigned to
one of two groups, a Mediterranean-type lowfat diet experimental group and a
prudent Western-type diet control group, with approximately half assigned to
each group.
Patients in the
control group did not receive dietary instruction except advice by their
physician to follow a prudent diet. Their diet consisted of 34% calories from
fat with 12% from saturated fat. The Mediterranean diet group received dietary
instructions and was advised to follow a diet with approximately 30 % of the
calories from fat and 8 % from saturated fat.
General guidelines for the diet included:
more breads. more root and green vegetables. more fish and less meat (beef,
lamb, and pork replaced with poultry). fruit daily. replacement of butter and
cream with rapseed (canola)-oil based margarine with a composition similar to
olive oil.
Overall, the
researchers found that following a Mediterranean-type diet reduced the risk for
a second heart attack and complications associated with CHD between 70 and 50
percent in this study population. The incidence of cardiac death and non-fatal
myocardial infarction (heart attack) was significantly reduced with the
experimental group experiencing group 14 events compared to 44 in the control
group.
Myocardial infarction
accompanied by other major and minor cardiac complications such as stroke and
angina was also significantly reduced.
The authors attribute the protective effect
of the Mediterranean diet to omega-3 fatty acids. Following a
Mediterranean-type diet did not alter the expected relationship between
traditional risk factors for coronary heart disease and rate of recurrence in
this study.
The following
significant relationships were found: each 1 mmol increase in total cholesterol
was associated with an 18 to 28% increased risk for recurrence. each 1 mm Hg
increase in systolic blood pressure (the top number) increased risk of 1 to 2%
female sex reduced risk for recurrence by about 70% aspirin use reduced risk
for recurrence 20 to 40%.
The bottom line message of this
study is that a lowfat Mediterranean-type diet plays and important role in
prevention of a second heart attack and its complications.
The patients in this study, regardless of
treatment with medication, benefited from dietary treatment. More importantly,
they were able to make dietary changes and sustain the changes over a period of
four years when they had individualized counseling.
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