Which is better for heart health: the Mediterranean diet or a low-fat diet?

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The importance of diet in maintaining cardiovascular health is well-established, and the Mediterranean Diet has gained significant attention in this regard.

Inspired by the traditional eating habits of Mediterranean countries, this dietary pattern has been studied since the 1950s and continues to demonstrate positive impacts on health when combined with a healthy lifestyle.

While epidemiological and mechanistic studies have shown promising results, the need for large-scale, long-term clinical trials comparing the Mediterranean Diet to other active interventions, particularly in secondary prevention, remains.

Understanding the Mediterranean Diet

The Mediterranean Diet is characterized by a balanced approach to nutrition, emphasizing a high consumption of plant-based foods, including fruits, vegetables, whole grains, legumes, and nuts.

Olive oil is the primary source of fat, replacing unhealthy saturated and trans fats.

Moderate consumption of fish, poultry, dairy products, and wine, particularly red wine, is also a part of this dietary pattern. Meanwhile, red and processed meats are limited.

The Need for Clinical Trials

While observational studies have shown associations between the Mediterranean Diet and cardiovascular health benefits, large-scale clinical trials are essential to establish causality and provide concrete evidence.

Clinical trials can address potential confounding factors and evaluate the specific effects of the Mediterranean Diet on cardiovascular outcomes.


One notable clinical trial addressing the efficacy of the Mediterranean Diet is the CORonary Diet Intervention with Olive oil and cardiovascular PREVention (CORDIOPREV) study.

This randomized trial enrolled approximately 1000 patients with documented coronary artery disease.

Participants were divided into two groups: one following the Mediterranean Diet and the other a low-fat dietary intervention.

7-Year Follow-Up Results

The CORDIOPREV study followed participants for a period of seven years to assess the impact of the Mediterranean Diet on major cardiovascular events.

The results showed promising outcomes, with the Mediterranean Diet group experiencing superior benefits compared to the low-fat diet group in terms of cardiovascular event prevention.


While more extensive research is needed, the CORDIOPREV study provides valuable evidence supporting the cardiovascular benefits of the Mediterranean Diet, particularly in the secondary prevention of cardiovascular events.

By adopting this dietary pattern, individuals can enhance their cardiovascular health by emphasizing plant-based foods, incorporating olive oil as the primary fat source, and practicing moderation in the consumption of fish, poultry, dairy products, and wine.

It is important to note that dietary recommendations should be personalized based on individual health conditions and needs.

Consulting with healthcare professionals and registered dietitians can provide tailored guidance.

Further research is warranted to better understand the mechanisms underlying the Mediterranean Diet’s positive effects and its potential for preventing and managing cardiovascular disease.

In the meantime, incorporating the principles of the Mediterranean Diet into daily food choices can contribute to improved cardiovascular health and overall well-being.

The research was published in European Heart Journal Supplements.

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