The Mediterranean Diet: How It Can Help Reduce Cardiovascular Mortality and Cancer

Patients and attendees at conferences ask me every day, "What is the Healthiest Diet?"

As a cardiologist that has spent two decades publishing, researching, and lecturing on weight loss, nutrition, and heart disease, I have learned a lot and have been blessed to be able to share it with the world. 

What Is the Healthiest Diet?

The Mediterranean diet, which is a diet which consists of a high intake of fiber, fruits, vegetables, whole grains, legumes, nuts, lean meats, fish, and olive oil, has been associated with numerous health benefits. Most notably it has been shown to reduce the risk of cardiovascular disease, mortality, and cancer.

Let's explore the evidence behind the Mediterranean diet's ability to reduce cardiovascular mortality first.

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Science Behind the Mediterranean Diet

Multiple studies over the past few decades have shown the cardiovascular benefits of the Mediterranean diet. 

According to a systematic review and meta-analysis published in the American Journal of Medicine, following a Mediterranean diet was associated with a significant reduction in cardiovascular mortality. The review included data from 16 studies involving over 1.5 million participants, and found that those who followed a Mediterranean diet had a 9% lower risk of cardiovascular mortality compared to those who did not follow the diet. Not too shabby! (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339461/)

PREDIMED Study

Another study published in the New England Journal of Medicine found that a Mediterranean diet supplemented with extra-virgin olive oil or nuts was associated with a significant reduction in the risk of major cardiovascular events, such as heart attacks and strokes. The study included over 7,447 participants and found that those who followed a Mediterranean diet had a 30% lower risk of major cardiovascular events compared to those who followed a low-fat diet. This is fantastic! (https://www.nejm.org/doi/full/10.1056/nejmoa1800389)

A Mediterranean diet is also beneficial for those with existing cardiovascular disease. A study published in the Journal of the American College of Cardiology found that a Mediterranean diet was associated with a lower risk of recurrent cardiovascular events in patients with coronary heart disease. The study included over 5,000 participants and found that those who followed a Mediterranean diet had a 20% lower risk of recurrent cardiovascular events compared to those who did not follow the diet. This is an incredible reduction for a simple diet intervention. (https://www.acc.org/about-acc/press-releases/2015/03/04/16/36/mediterranean-diet-cuts-heart-disease-risk-by-nearly-half, https://www.jacc.org/doi/10.1016/S0735-1097 )

So, what makes the Mediterranean diet so effective at reducing cardiovascular mortality? One reason may be its focus on whole, minimally processed foods, which are rich in nutrients and antioxidants. The Mediterranean diet is also high in healthy fats, such as fish, olive oil, and nuts, which have been shown to have heart-protective effects. It's also delicious and nutritious! 

Taking "healthy fat" supplements like fish oil and omega 3 supplements has not shown to improve cardiovascular mortality, and actually worsens cardiovascular outcomes. In fact, fish oil supplementation has been shown to increase the incidence of irregular heart rhythms, namely atrial fibrillation. (https://pubmed.ncbi.nlm.nih.gov/34612056/)

Su we know the Mediterranean diet can reduce cardiovascular mortality. But can it also reduce cancer?