For Healthy Eating, Think Greek

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Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women, by Teresa T. Fund and colleagues. Circulation 119:1093–1100, 2009

What is the problem and what is known about it so far?

People who follow a traditional Mediterranean diet eat high amounts of monounsaturated fat, protein from plants, whole grains, and fish, consume moderate amounts of alcohol, and eat little red meat, refined grains, and sweets. Several studies have shown that following such a diet reduces the chance of developing heart disease. Less is known about whether a Mediterranean diet has any affect on the risk for having a stroke.

Why did the researchers do this particular study?

The researchers wanted to find out whether people who eat a Mediterranean diet are at lower risk for having a stroke.

Who was studied?

The study included more than 74,800 adult women who participated in the Nurses' Health Study, a large general health study. None of the women had heart disease or diabetes when they signed up for the study.

How was the study done?

The women reported detailed information about their diet at the start of the study and five more times between 1984 and 2002. Researchers scored them in terms of how closely they adhered to a Mediterranean-style diet and then looked at how many of them developed heart disease, had a stroke, or died from a heart attack or stroke during the 20-year study period.

What did the researchers find?

Women who most closely followed a Mediterranean diet were less likely to get both heart disease and stroke than those whose diet least resembled the Mediterranean eating pattern. The women who followed the Mediterranean diet were also less likely to die from a heart attack or stroke. These results were true even after taking other factors into account, such as behaviors, medications, and health history.

What were the limitations of the study?

Because the study relied on participant questionnaires for diet information, some of the information may have been inaccurate. However, the researchers collected diet information several different times to reduce this potential problem. Although it is possible that other factors contributed to the results, the researchers were careful to account for many possible factors in the study. Finally, this is the first study of its kind and was conducted only in women. It needs to be repeated, and the results may not hold true for men.

What are the implications of the study?

Women can reduce their risk of having a heart attack or stroke by following a diet that is rich in monounsaturated fat, plant-based protein, whole grains, and fish, includes only moderate amounts of alcohol, and is low in red meat, refined grains, and sweets.

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