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The Mediterranean diet is hailed as one of the health­i­est diets around.

While the ben­e­fits include boost­ing brain health, being good for the gut and reduc­ing the risk of sev­eral types of can­cer, it is par­tic­u­larly lauded for pro­mot­ing car­dio­vas­cu­lar well-being.

Much of this is down to the omega-3s and healthy fats found in olive oil, fish, legumes and nuts, which make up a large part of any tra­di­tional Mediterranean menu.

Multiple stud­ies have demon­strated that adher­ents to the MedDiet are less likely to suf­fer heart prob­lems than those who fol­low a bad diet and make unhealthy lifestyle choices.

However, a new study pub­lished in the December 2020 issue of PLOS Medicine demon­strated that fol­low­ing the Mediterranean diet can lower the pos­si­bil­ity of hav­ing a sec­ond heart attack.

In the study, researchers from the University of Córdoba, Queen Sofia University Hospital and the Maimonides Biomedical Research Institute of Córdoba (Imibic) com­pared the effects of two dif­fer­ent healthy diets on the endothe­lium, the walls that cover the arteries.

One thou­sand two par­tic­i­pants who had pre­vi­ously expe­ri­enced a heart attack agreed to be mon­i­tored over the course of a year.

During that period, half of the patients were instructed to fol­low a Mediterranean diet. Daily meals were based on the abun­dant use of extra vir­gin olive oil and con­sisted of other plant-based foods such as fruit and veggies.

The par­tic­i­pants were also told to include three serv­ings of legumes, fish and nuts each week. In addi­tion, foods high in sugar con­tent were off the menu as were sat­u­rated fats, such as red meat, but­ter and margarine.

The other half of the group was guided toward a low-fat diet that excluded sev­eral kinds of plant and ani­mal fats from their daily dishes. They also increased their intake of com­plex car­bo­hy­drates, adher­ing to an eat­ing plan of whole grains, peas, beans and fiber-rich fruit and veg­eta­bles dur­ing the study.

Like their coun­ter­parts on the Mediterranean diet, they were also told to cut down on red meat as well as reduce sugar-loaded foods and nuts.

As all par­tic­i­pants had already expe­ri­enced a heart attack, each one had their arter­ies checked at the start of the year to assess their hearts’ per­ma­nent dam­age as well as blood ves­sels’ vasodi­la­tion capac­ity, which relates to the heart’s abil­ity to widen and increase blood flow to other areas of the body.

Alongside this, the repa­ra­tion capac­ity of the arter­ies using endothe­lial prog­en­i­tor cells, or stem cells, was also measured.

Each of these areas was reviewed once again at the end of the study and accord­ing to José López Miranda, one of the main researchers and coor­di­na­tor of the nutri­tional genomics and meta­bolic syn­drome research group at the Maimonides Biomedical Research Institute of Córdoba, it was the Mediterranean diet that proved to be more effective.

“We observed that the Mediterranean diet model induced bet­ter endothe­lial func­tion, mean­ing that the arter­ies were more flex­i­ble in adapt­ing to dif­fer­ent sit­u­a­tions in which greater blood flow is required,” López Miranda said.

“The endothe­li­um’s abil­ity to regen­er­ate was bet­ter and we detected a dras­tic reduc­tion in dam­age to the endothe­lium, even in patients at severe risk,” he added.

Proving that a Mediterranean diet is good for heart health is noth­ing new – numer­ous stud­ies over the last few decades have high­lighted this fact.

However, what made this new Spanish study spe­cial was that it was the first to ably show that adopt­ing the Mediterranean diet after suf­fer­ing a heart attack could reduce the pos­si­bil­ity of another – and help lessen the dam­age brought on by car­dio­vas­cu­lar disease.

• PLOS Medicine