It is well established that traditional Mediterranean diet patterns are linked to better cardiovascular (CV) health and lower rates of cardiovascular disease (CVD). Researchers from Harvard sought to determine what, if any, specific items in the Mediterranean diet provide the greatest benefit with regards to longevity.
The researchers examined data from the European Prospective Investigation into Cancer and Nutrition (EPIC) trial, which was completed on over 23,000 healthy Greek men and women aged 20 to 86. The researchers calculated a Mediterranean diet score based on participant responses to a questionnaire. The score was based on nine components of a Mediterranean diet: alcohol consumption, cereal, dairy products, fruit and nuts, fish and seafood, legumes, meat and meat products, monounsaturated-to-saturated fat ratio, and vegetables. Foods were then assigned a value on a scale of 0 to 9, with lower numbers being assigned to healthier foods or practices.
After a mean follow-up of 8.5 years, more deaths occurred in participants with low versus high Mediterranean diet scores. The contribution of each of the diet components on lower mortality were as follows:
- Moderate consumption of alcohol (23.5% of the effect)
- Low consumption of meat (16.6% of the effect)
- High consumption of vegetables (16.2% of the effect)
- High consumption of fruit and nuts (11.2% of the effect)
- High monounsaturated-to-saturated fat ratio (10. 6% of the effect)
- High consumption of legumes (9.7% of the effect)
Eating lots of cereal and few dairy products contributed to only 5% of the effect, and consumption of fish was associated with a small, but nonsignificant increase in mortality.
Although moderate consumption of alcohol had the greatest effect on lowering mortality, it is important to point out that the subjects in this study consumed anywhere from one to five glasses of wine per day – almost always during meals. The authors concluded that it is not one single dietary practice, rather a combination of practices in the Mediterranean diet that confer the greatest benefit.
Bottom line: These findings are consistent with Cleveland Clinic’s overall dietary recommendations for greatest CV protection. An abundance of fresh produce, nuts, legumes, minimal red meat consumption and dairy, including rich sources of monounsaturated fat such as olive oil, and imbibing in moderate amounts of alcohol seem to grant the greatest health benefits.
Resource: Trichopoulou A, Barnia C, Trichopoulos D. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. British Medical Journal (BMJ). 2009;338:b2337.
Written by Melissa Ohlson, MS, RD, LD, Preventive Cardiology and Rehabilitation.
Get more information on nutrition strategies. To make an appointment with a registered dietitian, call the Cleveland Clinic Preventive Cardiology - 216.444.9353 or 800.223.2273 ext. 9353. Or, get a nutrition consultation online with our private and secure MyConsult Nutrition Consultation.
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