Switching to the Mediterranean Diet Can Reduce the Risk of Having a Second Heart Attack

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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