Can You Cut Your Heart Disease Risk In Half?
Author: Dr. Stephen Chaney
Should you use the Mediterranean diet for heart health?
What if…
- You could reduce your risk of heart disease by almost 50%…and…
- It didn’t cost you an extra penny?
- You didn’t need to lose weight (although you would probably get even better results if you did)?
- You didn’t need to buy a gym membership and start a workout program (although you would probably get even better results if you did)?
- There were absolutely no side effects?
- There were considerable side benefits like reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline as you aged?
Would you be interested? I’m willing to bet if this were a TV ad, you would be on the edge of your seat. If it were a new “magic” supplement, you might be reaching for your credit card before the ad was over. If it was the latest “miracle” workout machine, you might order it right away.
However, I am not talking about a magic pill or a miracle workout machine. I’m talking about a way of eating called the Mediterranean diet. Recent headlines have claimed that the Mediterranean diet can cut heart disease risk almost in half. This would lead you to believe you could use the Mediterranean diet for heart health. Let’s look at the evidence behind that claim.
How Was The Study Designed?
The study behind the headlines (C-M. Kastorini et al. Atherosclerosis, 246: 87-93, 2016) enrolled 2583 adults, ages 18-89, from the region around Athens, Greece in a 10-year study beginning in 2001-2002.
At the beginning of the study and at the 5 and 10-year mark, participants completed in-depth surveys about their medical records, lifestyle, and dietary habits. These surveys were conducted by trained personnel (cardiologists, general practitioners, dietitians, and nurses). Participants with active cardiovascular disease in the first survey were excluded from the study.
The study evaluated 4 things:
- Cardiovascular disease risk factors including obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation.
- Adherence to the Mediterranean diet (see below).
- Heart disease incidence based on heart attacks, stroke, angina, ischemia, cardiac arrhythmias and deaths due to heart disease.
- Confounding variables such as age, sex, family history of heart disease, smoking, and lack of physical activity. All comparisons were corrected for these confounding variables so that they did not influence the results.
Adherence to the Mediterranean diet was based on a diet analysis scoring system called MedDietScore. The Mediterranean diet is one which emphasizes fresh fruits and vegetables, whole grains, beans, nuts, fish, olive oil, and moderate consumption of red wine. You can see this might lead you to believe in the Mediterranean diet for heart health.
The MedDietScore gives positive points based on how often these foods are consumed. It gives negative points based on how often meats, meat products, poultry, and full-fat dairy products are consumed. For alcohol, modest consumption is considered a positive, with either no or excess alcohol consumption rating a score of 0. The composite score ranges from 0 to 55, with higher values indicating greater adherence to the Mediterranean diet.
As an aside, you might think that everyone in Greece consumes a Mediterranean diet. Unfortunately, our unhealthy Western diet and our fast foods restaurants are making inroads in the birthplace of the Mediterranean diet.
The Mediterranean Diet for Heart Health?
Even after correcting for confounding variables, the study results were impressive.
- Each 10% increase in adherence to the Mediterranean diet was associated with a 15% decreased risk of developing heart disease during the 10-year study period.
- When they compared participants in the upper third for adherence to the Mediterranean diet to those in the lower third, their risk of developing heart disease was decreased by 47%. That’s huge.
However, the results were even more impressive when they looked at the effects of the Mediterranean diet on other risk factors for heart disease.
- For individuals with low adherence to the Mediterranean diet, each of those risk factors (obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation) independently increased the risk of developing heart disease. These results are identical to almost every other published study looking at those risk factors.
- However, for individuals with high adherence to the Mediterranean diet, those same risk factors had only small, non-significant effects on the risk of developing heart disease. If this finding is verified by future studies, it would suggest that adherence to a Mediterranean diet has the potential to override risk factors like obesity, diabetes, high blood pressure and elevated cholesterol.
Of course, I would not recommend that you ignore obesity and other cardiovascular risk factors and just focus on following a Mediterranean diet. I’m pretty sure you will get even better results if you get your weight, blood sugar, cholesterol, and blood pressure under control in addition to following a Mediterranean diet. Who knows, you might even reduce your risk of heart disease by 75% or more. So, should we believe in the Mediterranean diet for heart health?
What Does This Mean For You?
If this were the only published study showing that adherence to the Mediterranean diet reduces heart disease risk I would consider it speculative. However, it is only one of several recent studies that have come to a similar conclusion. At this point in time, the evidence is strong that following a Mediterranean-type diet will reduce your heart disease risk. The Mediterranean diet for heart health seems to be true.
That brings me back to my opening statement. Following a Mediterranean diet:
- Won’t cost you a penny. You are just spending your food budget on healthier foods.
- May reduce your risk of heart disease by up to 47% even if you don’t lose weight, but I recommend that you do lose weight.
- May be as effective as exercise at reducing your heart disease risk. That statement comes from a talk given by one of the authors when he was describing the study.
- Has no side effects. You could probably achieve a 47% reduction in heart disease using a cardiologist-approved cocktail of 3-5 drugs, but those drugs would come with significant side effects and a considerable cost for someone.
- Will likely come with side benefits like reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline.
My question to you is: Now that you know that a simple dietary change could have all those benefits and no downside, are you willing to give it a try? If so, your heart may just thank you for it.
However, I don’t mean to imply that the Mediterranean diet is the only way to reduce your heart disease risk. If your blood pressure is elevated, you might want to try the DASH diet . If you want to reduce heart disease risk and also minimize cognitive decline as you age, you might want to consider the MIND diet .
Those three diets are actually quite similar. They all emphasize fruits, vegetables, whole grains, nuts, seeds, fish, and moderate amounts of healthy fats. They all minimize refined flour, pastries, sweets, red & processed meats. You won’t find a Twinkie or a Big Mac in any of them.
The Mediterranean diet for heart health? Sure!
The Bottom Line
- A recent study suggests that adherence to a Mediterranean type diet could reduce the risk of developing heart disease by up to 47%.
- The beneficial effect of the Mediterranean diet was so strong that it overcame other cardiovascular risk factors such as obesity, high cholesterol, high triglycerides, high blood pressure, diabetes, and inflammation.
- This study is likely to be accurate because it is fully consistent with several other studies looking at the effect of the Mediterranean diet on heart disease risk.
- To put it into perspective, this simple dietary change.
- Won’t cost you a penny. You just redirect your food budget.
- Has zero side effects. You could probably achieve a similar 47% reduction in heart disease risk with a cardiologist-approved cocktail of 3-5 drugs, but that would come with multiple side effects.
- Has side benefits such as reduced risk of type 2 diabetes, high blood pressure, inflammation, and cognitive decline
- However, the Mediterranean diet is not the only game in town. Other studies suggest that the DASH diet and MIND diet are also effective at reducing heart disease risk.
- Those three diet patterns (Mediterranean, DASH & MIND) are actually quite similar. They all emphasize fruits, vegetables, whole grains, nuts, seeds, fish, and moderate amounts of healthy fats. They all minimize refined flour, pastries, sweets, red & processed meats. You won’t find a Twinkie or a Big Mac in any of them.
- Finally, I am not suggesting that you go on the one of these diets and just throw away your heart medicines without talking to your doctor. However, I would recommend that you talk with your doctor about implementing what the National Institutes of Health calls Therapeutic Lifestyle Change. All three dietary patterns are fully consistent with the NIH-recommended Therapeutic Lifestyle Change. The NIH recommends that Therapeutic Lifestyle Change be tried before considering cholesterol lowering drugs or be used along with cholesterol lowering drugs so that drug dosage can be minimized.
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.