"Mediterranean Diet and Atherosclerosis" The heart of a traditionalMediterranean diet is mainly vegetarian, much lower in meat and dairy,and uses fruit for dessert.
So no surprise, those eating that wayhad very low heart disease rates compared to those eatingstandard Western diets.
This landmark study, though,has been cited to suggest that all types of fat, animal or vegetable,was associated with the appearance of new atherosclerotic lesions in ourcoronary arteries feeding our hearts.
About a hundred men were givenangiograms at baseline, and then two years later, looking forthe development of lesions like this, before and after, all the whilemonitoring their diets every year.
Only about 1 in 20 eating lowerfat diets had new lesions, compared to about 8 in 20on more typical American diets — around 33% or more fat.
When they drilled down, though,only three types of fat appeared to significantly increase the likelihoodof the appearance of new lesions: lauric, oleic, and linoleic.
Lauric acid is a saturated fat foundin coconut oil, and palm kernel oil, which is found in junk food—whipped cream, candy bars.
Oleic, from the Latin wordoleum for olive oil, but that's not where these menwere getting their oleic acid from.
The top sources for Americans arebasically cake, chicken, and pork.
And linoleic comesmostly from chicken.
So the study really just showed thatpeople eating lots of junk, chicken, and pork tended to closeoff their coronary arteries.
To see if major sources of plant fatslike olive oil or nuts help or hurt, ideally we'd do a multi-yearrandomized study where you takethousands of people and have a third eat nuts,a third eat more olive oil, and a third do essentially nothingto see who does better.
And that's exactly what was done.
The PREDIMED studytook thousands of people at high risk for heart disease inSpain, who were already eating a Mediterranean-ish diet, andrandomized them into three groups for a couple years: one withadded extra virgin olive oil, one with added nuts, anda third group that was told to cut down on fat,but they didn't, so basically ended up as ano dietary changes control group.
What happened to the amount ofplaque in their arteries over time? Whereas there was significant worseningof carotid artery thickening and plaque in the no dietary change control group,those in the added nuts group showed a significant reversal in thickening,an arrest in plaque progression.
There were no significant changesin the added olive oil group.
The richness of the plant-basedMediterranean diet in potentially beneficial foods, suchas fruit, vegetables, beans, nuts, whole grains and olive oil, is believedto explain its cardioprotective effects, though these results suggest that nutsreally are a preferable source of fat to olive oil, and may delaythe progression of atherosclerosis, the harbinger of futurecardiovascular events such as stroke.
Adding nuts appeared tocut the risk of stroke in half.
Note, though, they werestill having strokes.
Half as many strokes, so thenuts appeared to be helping, but they were still eating a dietconducive to strokes and heart attacks.
All three groups had basicallythe same heart attack rates, the same overall death rates.
That's what Dr.
Ornishnoted when he wrote in: no significant reduction in the rates ofheart attack, death from cardiovascular causes, or death from any cause,just that stroke benefit.
But hey, that's something.
A Mediterranean diet is certainly betterthan what most people are consuming, but even better may be adiet based on whole plant foods, shown to reverse heart disease,not contribute to it.
The authors of thestudy replied that they didn't wish to detractfrom Ornish's work, noting that Mediterranean andplant-based diets actually share a great number offoods in common.
Yes, Ornish's diet may reverse heartdisease, but the Mediterranean diet proponents argue, themajor problem with Ornish's diet is that it doesn't taste goodand so hardly anyone sticks to it.