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European sci­en­tists found that fol­low­ing the Mediterranean diet (MedDiet) has a dose-depen­dent pro­tec­tive effect against ath­er­o­scle­rotic plaque. This means that the more closely peo­ple adhere to the eat­ing plan, the less their arter­ies will be clogged, a ben­e­fit that low­ers their risk of heart attack and stroke.

Lead author Rocio Mateo-Gallego, of the Hospital Universitario Miguel Servet in Zaragoza, Spain, pre­sented the study’s results recently at the European Atherosclerosis Society 2017 Annual Congress. She said the MedDiet was asso­ci­ated with reduced pres­ence, thick­ness and num­ber of ath­er­o­scle­rotic plaques, adding that the link was strongest in the artery in the thigh, called the femoral artery. The ben­e­fit was par­tic­u­larly robust among smokers. 

Mateo-Gallego explained that stud­ies on ath­er­o­scle­ro­sis mainly involve the artery in the neck, termed the carotid artery. In an ear­lier ran­dom­ized con­trolled clin­i­cal trial eval­u­at­ing the effects of the MedDiet, researchers found it was asso­ci­ated with the regres­sion of carotid plaque over sev­eral years. 

However, recent research sug­gests plaques in the femoral artery are bet­ter pre­dic­tors of the risk of car­dio­vas­cu­lar dis­ease. The pres­ence of plaque in this blood ves­sel is also highly cor­re­lated with cal­cium in the arter­ies of the heart. Therefore, Mateo-Gallego sought to inves­ti­gate the effect of the MedDiet on the femoral artery, as well as the aorta and the carotid artery. 

Tomography was used to deter­mine the extent of ath­er­o­scle­rotic plaque in 2,523 mid­dle-aged auto work­ers who didn’t have a his­tory of car­dio­vas­cu­lar dis­ease. Plaque was present in 1,983 of the participants. 

A 134-food item ques­tion­naire was employed to assess the degree of adher­ence to the MedDiet. This eat­ing plan con­sists of fruits, veg­eta­bles, whole grains, nuts, legumes and fish. The main source of fat in the diet is olive oil, but it also includes mod­er­ate amounts of sat­u­rated fat and dairy products. 

Scores denot­ing adher­ence to the MedDiet can range from 0 to 9, with higher scores indi­cat­ing food choices that more closely resem­ble the plan. The aver­age over­all score was 4.19, which sug­gested mod­er­ate adherence. 

When par­tic­i­pants in the high­est quar­tile of 6 to 9 were com­pared to those in the low­est quar­tile of 0 to 2, a sig­nif­i­cant reduc­tion was seen in plaque in the femoral arter­ies. Although less plaque was also noted in the aor­tas of those in the high­est quar­tile, it wasn’t sta­tis­ti­cally sig­nif­i­cant after adjust­ments were made for other fac­tors. No dif­fer­ences were seen in the carotid arter­ies between par­tic­i­pants in the two quartiles. 

A big advan­tage was found for smok­ers, as the pres­ence of plaque in the femoral artery was decreased 61 per­cent among those in the high­est quar­tile. Mateo-Gallego said adher­ence to the MedDiet was inversely asso­ci­ated with the num­ber of plaques in all blood ves­sels tested with the excep­tion of the carotid artery. 

While the MedDiet is linked to a reduced like­li­hood of car­dio­vas­cu­lar dis­ease, the mech­a­nisms of action that under­lie this ben­e­fit aren’t known. The new find­ings reveal that part of the advan­tage stems from the fact that it may pre­vent the for­ma­tion of plaque that lines the inner walls of arteries. 

As research pro­gresses, more of the rea­sons that under­lie the MedDiet’s pos­i­tive effects will become under­stood. However, inte­gra­tive physi­cian Michael Wald, direc­tor of longevity ser­vices at Integrated Nutrition in Mount Kisco, New York, shared with Olive Oil Times what has already been dis­cov­ered on the subject. 

“The high con­tent of omega‑3 fatty acids from fish, oleic oil from olive oil and monoun­sat­u­rated fats from avo­ca­dos give the MedDiet its pro­tec­tive effects for all man­ner of inflam­ma­tory dis­eases, includ­ing, but not lim­ited to, heart and blood ves­sel dis­ease. Omega‑3 fatty acids reduce the for­ma­tion of prostaglandins‑1 and 2, sub­stances that pro­mote heart and ves­sel dis­ease; while they increase the for­ma­tion of prostaglandin‑3, an anti-inflam­ma­tory com­pound,” Wald said.

“The omega‑9 fatty acids in olive oil fur­ther reduce inflam­ma­tion and decrease the thick­ness or vis­cos­ity of blood, which helps off­set blood clots, hard­en­ing of arter­ies and even hyper­ten­sion. Avocados are high in the monoun­sat­u­rated fats believed to improve the flex­i­bil­ity of arter­ies, thus help­ing main­tain cir­cu­la­tion and over­all car­dio­vas­cu­lar health,” he said.

• Fewer Plaques With Real-World Adherence to Mediterranean Diet — Medscape