Med Diet Reduces Risk of Major Cardiac Events

In a recent study, the Mediterranean diet decreased the risk of adverse events for patients with cardiovascular disease, while surprisingly the Western diet showed no association for an adverse risk.

May. 9, 2016
By Jedha Dening

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The Mediterranean diet (MedDiet) is based on ample con­sump­tion of healthy foods such as veg­eta­bles, fruits, legumes, whole grains, fruit, fish, mod­er­ate alco­hol and olive oil. The MedDiet pat­tern has been asso­ci­ated with reduced car­dio­vas­cu­lar dis­ease (CVD) out­comes in both epi­demi­o­log­i­cal stud­ies and clin­i­cal tri­als. Therefore, many health author­i­ties rec­om­mend the con­sump­tion of more veg­eta­bles, fruit, whole grains and fish. It’s also a com­mon assump­tion that ingre­di­ents asso­ci­ated with a Western dietary pat­tern may cause more adverse effects. Therefore, the decreased con­sump­tion of processed foods that con­tain refined car­bo­hy­drates, sugar, sodium, and sat­u­rated fats are also rec­om­mended.
See Also: Olive Oil Health Benefits
Though it’s assumed that a healthy diet is ben­e­fi­cial for patients who already have coro­nary heart dis­ease (CHD), very lit­tle research has estab­lished any asso­ci­ated out­comes. Because diet is rarely assessed in a clin­i­cal sit­u­a­tion, it is impor­tant to under­stand if dietary pat­tern assess­ment dur­ing rou­tine clin­i­cal care could also be con­sid­ered a potent sec­ondary pre­ven­tion strat­egy that deserves more atten­tion.

A study pub­lished in the European Heart Journal aimed to estab­lish whether the MedDiet or Western dietary pat­terns pre­dict adverse out­comes in high-risk patients or in those with sta­ble CHD.

Taken from the Stability trial, a total of 15,482 par­tic­i­pants from 39 coun­tries were included in this sec­ondary obser­va­tional analy­sis. Participants were either at high risk of CVD or cur­rently had sta­ble CHD. Though the Stability trial was ini­tially designed to assess the risk of adverse CVD events from Darapladib, a lipopro­tein inhibitor, the trial also col­lected dietary infor­ma­tion from food fre­quency ques­tion­naires.

This sec­ondary analy­sis logged food con­sump­tion data into selec­tive food groups and scored them along both the Mediterranean diet score (MDS) and the Western diet score (WDS). The researchers reported that the pri­mary out­come of the study was the first occur­rence of major adverse car­diac events (MACE) defined as non-fatal myocar­dial infarc­tion, non-fatal stroke, or death from a CV cause dur­ing a median fol­low-up of 3.7 years.”

The results of the study showed that a higher MDS score is sig­nif­i­cantly asso­ci­ated with lower risk of CVD death, myocar­dial infarc­tion, stroke and all-cause death. Every one-unit increase in MDS score was asso­ci­ated with a seven per­cent reduc­tion in adverse out­comes. The authors sug­gest that the MedDiet pat­tern eval­u­ated in this study is sim­i­lar to the DASH diet and con­sump­tion of the healthy foods com­monly rec­om­mended in dietary guide­lines.

According to the analy­sis, fruits, veg­eta­bles, fish, alco­hol, dairy foods and tofu/soybean were asso­ci­ated with decreased risk of MACE. Surprisingly, legumes, whole grains, sweet­ened drinks, refined grains desserts, sweet snacks, and meat showed no asso­ci­a­tion. Therefore, while the MedDiet clearly shows a decreased risk, the Western dietary pat­tern was not shown to increase risk of adverse out­comes in this study, which was an unex­pected result.

The research indi­cates that dietary advice to increase the con­sump­tion of fruits, veg­eta­bles and fish may be more impor­tant than rec­om­mend­ing a reduc­tion of Western dietary foods. While this study could not estab­lish an asso­ci­a­tion between adverse effects on CVD out­comes and typ­i­cal Western foods, it cer­tainly doesn’t give indi­vid­u­als per­mis­sion to con­sume junk food in copi­ous amounts.

As an author of the study, Ralph Stewart, was quoted as say­ing in the Sydney Morning Herald, because the assess­ments were rel­a­tively crude, some harm can­not be excluded.” It must also be noted that this is an obser­va­tional study, which does not show cause and effect.

One thing is clear, the results of this large obser­va­tional study do show that the dietary advice to include more healthy foods still stands strong. And, on a pub­lic health level, plac­ing dietary pat­tern assess­ment into rou­tine clin­i­cal care for CVD and CHD patients may in fact act as a potent sec­ondary pre­ven­tion mea­sure.

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