Mediterranean diet is better than statins

A Mediterranean diet is better than statins at slashing the risk of an early death for millions of Brits.

A landmark seven-year study found the healthy eating regime is twice as effective as the drugs alone at boosting the lifespan of heart patients.

Seven million Brits live with cardiovascular disease . The vast majority take statins every day, which can produce unwanted side effects.

The “extraordinary” findings were presented at the world’s biggest heart conference in Rome, Italy.

In the first ever study to look at the impact of a Med diet on heart patients, experts found a diet high in fruit , vegetables, fish, nuts and olive oil slashed the risk of an early death by 37%.

Previous research found just taking statins cuts mortality by 18%.

And leading experts said the discovery meant heart patients should be prescribed the Med diet before being given cholesterol-busting drugs.

Others hailed the breakthrough research as proof that the Med diet is “more powerful than any drug” and said it was “time for the NHS to embrace lifestyle medicine”.

Speaking at the annual congress of the European Society of Cardiology, Professor Giovanni de Gaetano, of the Neuromed Institute in Pozzilli, Italy, said: “We found that among those with a higher adherence to the Mediterranean diet, death from any cause was reduced by 37% in comparison to those who poorly adhered to this dietary regime.”

He added: “We know that taking drugs like statins for prevention can reduce mortality by around 20%.

“The message is that it is not only drugs that should be considered for secondary prevention, but also the Mediterranean diet.”

He also suggested that following the Med diet could reduce the need for drugs.

He added: “Adhering to the Mediterranean diet can reduce mortality for any cause to a large extent. It is a powerful means to reduce all causes of death.”

Speaking in Rome, he added: “The Mediterranean diet may be more effective than drugs .

“We are not saying exclude the use of drugs. We are saying that first of all doctors should consider diet before drugs.

“It could allow patients to get the benefits of statins but without the side effects.”

Lead author Dr Marialaura Bonaccio revealed: “The major contributors to mortality risk reduction were a higher consumption of vegetables, fish, fruits, nuts and monounsaturated fatty acids – that means olive oil.”

Researchers followed 1,200 Italians with heart disease over seven years.

Professor de Gaetano said: “The Mediterranean diet is widely recognised as one of the healthier nutrition habits in the world.

But so far research has focused on the general population, which is mainly composed of healthy people.

“What happens to people who have already suffered from cardiovascular disease? Is the Mediterranean diet optimal for them too?”

The study results, released for the first time this weekend, proved the answer is yes.

The 1,200 heart patients were among 25,000 participants enrolled into the MOLI-SANI project, a prospective epidemiological study that randomly recruited adults living in Molise, Italy.

Researchers recorded the food intake of the participants using the European Prospective Investigation into Cancer (EPIC) food frequency questionnaire.

Adherence to the Mediterranean diet was appraised with a 9-point Mediterranean diet score (MDS).




Over seven years, there were 208 deaths. After controlling for age, sex, education, exercise, smoking, blood pressure, cholesterol levels, diabetes and cancer, a 2-point increase in the Mediterranean diet score was linked with a 21% reduced risk of death.

When considered as a 3-level categorical variable, the top category – a score of 6 to 9 – of adherence to the Mediterranean diet was associated with a 37% lower risk of death compared to the bottom category (a score of 0-3).

A previous study of 92 trials involving 200,000 patients found that people with cardiovascular disease were 18% less likely to die early if they took statins.

Researchers said the next step would be to investigate why exactly the Mediterranean diet helps reduce the risk of dying early.

Mediterranean diet
Mediterranean diet

Professor de Gaetano concluded: “These results prompt us to investigate the mechanism(s) through which the Mediterranean diet may protect against death.

“This was an observational study so we cannot say that the effect is causal.

“We expect that dietary effects on mediators common to chronic diseases such as inflammation might result in the reduction of mortality from any cause but further research is needed.”

British experts said it was likely to be the “powerful anti-inflammatory effects” of the Mediterranean diet that slashes the risk of an early death.

Dr Aseem Malhotra, one of the world’s leading cardiologists, hailed the results as “extraordinary” and added that eating well is better than taking drugs for heart protection.

He said: “The results of this robust observational study are quite extraordinary and confirms previous randomised controlled trial data that the Mediterranean diet is more powerful than any drug at reducing death rates in patients with cardiovascular disease.




“It’s the powerful anti-inflammatory effects of foods such as olive oil, nuts, oily fish and vegetables where the benefits lie and unlike cholesterol-lowering statin drugs come without side effects.

He added: “It’s time for the NHS to embrace lifestyle medicine to rapidly save it from the collapse being predominantly driven by diet related disease.”

Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, said: “It is good to know that even if you already have a history of cardiovascular disease, adhering to a Mediterranean diet reduces the risk of death.

“This study suggests that even if you are already receiving medical care, if you add a Mediterranean diet, it will have further benefit.

“Maintaining a healthy lifestyle, even if you have had a heart attack or stroke is really important and continues to benefit you.”

Fruit significantly lowers the risk of suffering a heart attack or stroke

Eating a piece of fruit each day significantly lowers the risk of suffering a heart attack or stroke – an effect size as large as taking a statin, Oxford University has found.

In the largest study of its kind, researchers looked at the dietary habits of half a million middle-aged people in China to find out if what they ate was linked to heart health.

The population was chosen because a large number of Chinese people do not eat fresh fruit at all, so scientists were able to tease apart the impact more easily than in western countries.

It was found that even eating just one piece of fruit each day (3.5oz) lowered the risk of a heart attack or stroke by one third over the seven year study period, compared with people who never or rarely ate fruit.

Statins also lower the chance of a heart attack by one third, but many people complain of side effects associated with the drug, such as muscle pains and fatigue.

Although the Oxford researchers do not recommend swapping statins for fruit, they say increasing fruit in the diet may provide an extra boost for people at risk of heart problems and potentially save thousands of lives each year.

Zhengming Chen, Professor of Epidemiology at the Nuffield Department of Population Health, Oxford University, said: “The potential impact is huge. In China if the current rate of consumption was to increase to a piece of fruit everyday around half a million deaths could be avoided each year, and maybe thousands in Britain.




“This was the largest study ever carried out and it is very robust, but the challenge is that it is an observational study so there may be something that people who eat fruit do which protects them, although we have tried to control for that.

“There are a lot of potential mechanisms for why fruit may improve cardiovascular health. It is known that fresh fruit lower blood pressure so that is something that is really good. Lots of fibre is good for certain diseases, and it contains anti-oxidants.

“It may be that fresh fruit changes the gut bacteria in a way that does not work with processed fruit. The take home message is that fresh fruit is very good for you and it should be encouraged to potentially reduce mortality.”

Around 17.5 million people are currently eligible for statins in Britain meaning that most men over 60 and women over 65 are offered the drug by GPs.

Fruit
Fruit

But many stop taking the pills within a year because of muscle pain, weakness and fatigue, leaving them at risk of suffering heart disease, heart attacks and strokes.

The National Institute for Health and Care Excellence (Nice) estimates that 50,000 deaths a year could be prevented if everyone who was eligible for statins was taking the drugs, which equates to around one third of deaths.

Researchers from Oxford and the Chinese Academy of Medical Sciences studied 500,000 adults from 10 urban and rural localities across China, tracking health for 7 years through death records and electronic hospital records of illness.




After allowing for factors such as education and non-smoking, a 100g portion of fruit (one portion) per day was associated with about one-third less cardiovascular mortality, the authors reported in the New England Journal of Medicine.

Although more people consume fruit in western countries, a large amount is processed in fruit juices, so the study suggests that it is better to eat fresh fruit

A separate study found that a common drug which is used to make medication dissolve quickly in the body also melts away cholesterol in clogged arteries, potentially ending the need for statins.

Cyclodextrin, which is already clinically approved and safe in humans, was found to dissolve cholesterol crystals and reduced plaques in mice even when the animals continued to eat a high-fat diet.

It is thought that the drug increases activity in the liver which triggers the release of immune cells which clear out cholesterol.