The results, published on The New England Publication of Medicine’s Web site on Monday, were depending on the first major medical trial to measure the diet’s impact on center risks. The scale of the diet’s benefits surprised professionals. The research ended early, after almost five years, because the results were so clear it was considered illegal to continue.
The eating plan helped those following it even though they did not shed bodyweight and most of them were already getting statins, or high blood pressure level or diabetes medication to reduced their cardiovascular illness danger.
“Really impressive,” said Rachel Brown, a lecturer of nutrition at the University of Vermont and a speaker for the American Heart Association. “And the really essential factor — the coolest factor — is that they used very meaningful endpoints. They did not look at risks like cholesterol or high blood pressure or bodyweight. They looked at swings and swings and death. At the end of the day, that is what really matters.”
Until now, evidence that the Mediterranean diet eating plan reduced the chance of cardiovascular illness was weak, centered mostly on studies showing that individuals from Mediterranean sea countries seemed to have reduced rates of cardiovascular illness — a pattern that could have been linked to aspects other than eating plan.
And some professionals had been doubtful that the impact of eating plan could be recognized, if it existed at all, because so many individuals are already getting powerful medication to reduce cardiovascular illness danger, while other professionals hesitated to recommend the eating plan plan to individuals who already had overweight, since oils and almonds have a lot of calories.
Heart disease experts said the study was a triumph because it showed that a diet was powerful in reducing heart disease risk, and it did so using the most rigorous methods. Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, or had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one.
Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain — a reality borne out in the new study, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic Foundation.
“Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.”
The study, by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues, was long in the planning. The investigators traveled the world, seeking advice on how best to answer the question of whether a diet alone could make a big difference in heart disease risk. They visited the Harvard School of Public Health several times to consult Dr. Frank M. Sacks, a professor of cardiovascular disease prevention there