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A recent study has shown that a Mediterranean diet is linked to a lower cardiovascular mortality risk in patients who are already diagnosed with heart disease.

Diet plays a very important role in the ability of the human body to be able to perform optimally. Important nutrients from products that are consumed are necessary as the body can't produce these certain vital minerals and elements. A diet though where the incorrect types of foods are consumed in high volumes, may result in an increase in a person's mortality risk.

A so-called Mediterranean diet, which is a diet containing high amounts of fruit, vegetables, unrefined foods and fish, has been shown to reduce the risk of cardiovascular complications in patients who are diagnosed with heart disease. The findings of the study that was done also showed that consuming higher amounts of healthy foods, by the involved patients, was deemed to be more important than avoiding non-healthy foods such as deep-fried foods, desserts, refined grains and sugar containing beverages (Western diet).

The study

Researchers interviewed over 15,000 patients with an average age of 67 years old and who were diagnosed with stable coronary artery disease. The questions asked were regarding which foods they consumed and the choices were those foods which are mentioned above. The researchers wanted to determine whether assessing these patients' diets could be linked to the development of major cardiovascular events (MACE) such as strokes, heart attacks or sudden death.

The patients were then scored depending on what answers they gave. If they said that they consumed more healthy foods then they were given a 'Mediterranean diet score' (MDS), and if they chose more unhealthy foods they were given a 'Western diet score' (WDS).

The participants were then followed up after nearly 4 years and it was found that just over 10% of them had suffered a MACE. The following findings were also made:

  • Just over 7% of the patients who had an MDS score of 15 experienced a MACE.
  • 10,5% of patients who had an MDS score of 13-14 experienced a MACE.
  • Nearly 11% of patients with an MDS score of 12 or less had experienced a MACE.

Some limitations such as not assessing the total calorie intake of food, which has been shown to be a major determining factor for obesity-related health issues, was noted. Also, the researchers weren't able to assess bad fats and good fats, therefore they weren't able to comment on the importance of these foods to the patients' health.

Interpretation of the findings

It was noted, after other factors which could have affected the results were adjusted, that for every 1 unit that was given on the MDS the patient's risk of developing a MACE decreased by 7%.

What was interesting to see though, was that an increased consumption of the foods of a Western diet did not result in an increased risk of developing cardiovascular complications.

The clinical significance

The suggestion here would then be that healthcare workers should put more emphasis on their patients eating more healthy foods than the emphasis of avoiding unhealthy foods. This doesn't mean that patients should then have free rein to eat unhealthy foods, but rather that foods such as vegetables and fruit should be taken as a preference over others.

What Constitutes A Mediterranean diet

The importance of a Mediterranean diet has been explained, so now we can discuss in detail what foods make up this so-called diet. Called a Mediterranean diet because it incorporates foods and cooking styles used by countries and islands bordering and situated in the Mediterranean Sea.

Benefits of the diet

Besides the already mentioned benefit of this diet being that it reduces the risk of cardiovascular complications and mortality rates in patients with heart disease, there are other benefits to it as well. These may include the following:

  • Lower levels of low-density lipoprotein (LDL) fats in the bloodstream.
  • Women can have a reduced rate of breast cancer.
  • There may be a reduced incidence of neurodegenerative issues such as Alzheimer's and Parkinson's disease.
  • Generally reduced incidence of cancer.

Major components

A Mediterranean diet focuses on the following foods and products:

  • Vegetables and fruit - one should try and consume 7-10 servings of these foods every day. A variety should also be incorporated to avoid repetition and eventual disdain for these foods.
  • Whole grain versions of foods such as cereals, breads, pastas and rice should be eaten. The increased fibre from these foods will also benefit the gastrointestinal tract and keep the colon more regular. Plenty of water should also be consumed on a daily basis to prevent constipation.
  • Legumes and nuts such as cashews, almonds, pistachios and macadamias should be consumed and in moderation. Tahini (made from sesame seeds) is a good alternative for use as a spread on bread or as a dip.
  • The use of herbs and spices to flavour food instead of salt.
  • Olive oil is used to replace butter. The extra-virgin version of this oil is unrefined which makes it a good fat to use. It can be consumed raw and poured in salads as well as be used for cooking food.
  • Red meat should be limited to only be consumed a few days in a month. If red meat is eaten then it should be lean meats with minimal fat on it, as well as the animal being grass-fed as this affects the fat make-up of the meat. High-fat meats such as bacon and sausages should be avoided if possible.
  • Fish and poultry should be eaten at the very least 2 times a week. Fresh salmon, tuna, mackerel, trout and herring are healthy choices as they contain omega-3 which the body needs. Grilled fish is a better cooking options than frying it in oil and also tastes great.
  • Dairy products may be consumed as long as they have limited fat content such as skim milk, low-fat cheeses and fat-free yogurts.
  • Making sure that one is physically active and even getting plenty of aerobic exercise in. This can aid in reducing a person's waist circumference, which also reduces the risk of developing cardiovascular complications.
  • If one consumes alcohol, then it should be limited to a glass of red wine 2-3 times per week. If a person doesn't consume alcohol then one doesn't need to start drinking wine. 
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