The Lancet 2002;360:1455-1461 (Reuters Health)
A study conducted in India suggests that a Mediterranean-type diet rich in fruits, vegetables, nuts, whole grains and certain oils can reduce the risk of heart attack and death in people who already have heart disease. Such a diet may be more helpful in reducing heart problems than diets that focus solely on cutting saturated fat and cholesterol, according to lead author Dr. Ram B. Singh of the Medical Hospital and Research Centre in Moradabad, India and colleagues.

Singh's team randomly assigned a group of 1,000 people to either a Mediterranean-type diet adapted to local tastes or a "control group" diet that more closely adhered to the step 1 diet promoted by the US National Cholesterol Education Program (NCEP). Both groups followed NCEP recommendations, including limiting total fat intake to no more than 30% of calories, with less than 10% from saturated fat. Those in the Mediterranean diet group were also told to consume certain amounts of fruit, vegetables, nuts such as walnuts or almonds, whole grains and mustard seed or soy bean oil.

Two thirds of the study participants were vegetarians and they were mostly office workers, teachers, doctors and others in relatively sedentary jobs. All the participants had either heart disease-related chest pain, a previous heart attack or other signs of heart disease. After 2 years, those in the Mediterranean diet group were less likely to have had a non-fatal heart attack or die due to sudden cardiac death compared to those in the control group, the report indicates.

While both groups experienced a lowering of cholesterol, those eating the Mediterranean diet had an even lower cholesterol than the control group. "Our trial in a non-Western population has shown that, over 2 years, a diet enriched with fruit, vegetables, nuts, whole grains and mustard or soy bean oil is associated with a pronounced decline in coronary artery disease morbidity and mortality," the authors conclude. "The long-term benefits may be even more substantial," they add.