Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med. 2013. Feb 25.
In a multicenter trial in Spain, 7447 participants at high cardiovascular risk were randomly assigned to Mediterranean diet (fruits, vegetables, legume, white meat, and wine) with extra-virgin olive oil, Mediterranean diet with nuts, or a control group with reduced fat diet. The trial was stopped after a median follow-up of less than 5 years as interim analysis showed nearly 30% reduction in cardiovascular risk in the treatment groups.
The primary end point was the rate of major cardiovascular events such as myocardial infarction, stroke or death which occurred in only 288 participants: Those assigned to Mediterranean diet with extra-virgin olive oil (96 events), those on Mediterranean diet with nuts (83 events) versus the control group (109 events) with no reported adverse events.
This trial demonstrated the benefits of Mediterranean diet in preventing cardiovascular diseases.
Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344.
In this meta-analysis, 12 cohort studies were examined that comprised more than 1.5 million healthy individuals and 40,000 non-fatal and fatal events. Greater adherence to the Mediterranean diet was associated with a significant reduction in risk of overall mortality, cancer incidence and mortality, cardiovascular mortality and incidence of Alzheimer's and Parkinson's disease. The cumulative analysis of the 12 studies demonstrated that a two-point score increase in adherence to the diet yielded a 9% reduction of overall mortality, a 6% reduction of incidence or mortality from cancer, a 9% reduction in cardiovascular mortality, and a 13% reduction in incidence of Alzheimer's or Parkinson's disease.