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Mediterranean Diet Independently Lowers Cardiovascular Disease Risk: Presented at AHA

By Charlene Laino

ORLANDO, FL -- November 10, 2003 -- A Mediterranean diet rich in olive oil and lean on meat lowered the levels of several inflammation and coagulation markers related to cardiovascular disease (CVD), a cross-sectional study shows.

Demosthenes Panagiotakos, PhD, lecturer in the department of nutrition and dietetics at Harokopio University, Athens, Greece, presented the findings here November 10^th at the American Heart Association's Scientific Sessions 2003.

While studies have suggested that adherence to the Mediterranean diet may reduce the risk of cardiovascular disease by up to 30%, it is not fully understood how the diet exerts its protective effect, according to Dr. Panagiotakos. "Some have suggested it lowers blood pressure; others speculate it reduces cholesterol levels. Still others say it is not the diet itself but other characteristics of people who follow the diet, such as a healthy lifestyle."

For the new study, the researchers chose to evaluate markers of inflammation and coagulation, applying a multivariate analysis to account for the effects of any confounding factors.

The study enrolled 2,282 men and women, age 18 to 89 years, without heart disease. The researchers used a special nutritional questionnaire, developed by the National School of Public Health, to track consumption of red meat, chicken, fish, vegetables, legumes, pasta, salads, cereals, diary products, sweets, and fruits. Plasma levels of C-reactive protein, interleukin-6, homocysteine, and fibrinogen were measured after a 12-hour fast.

Univariate analysis showed that adoption of a Mediterranean diet was associated with a significant reduction in levels of C-reactive protein, fibrinogen, homocysteine, and interluekin-6, Dr. Panagiotakos reported.

In multivariate analysis that controlled for body mass index, age, gender, education, and physical activity, adoption of the diet was associated with a 0.22 mg/dL drop in C-reactive protein levels, a 0.21 pg/mL drop in interluekin-6, a 12.5 mg/dL decrease in fibrinogen, and a 0.87 mmol/L drop in homocysteine levels, he said.

The study not only provides a pathophysiological explanation for the growing evidence of a beneficial effect of the Mediterranean diet, but also "clearly shows that the beneficial effect of this diet was independent of any of these other factors," he said in an interview.

While the cross-sectional design of the study precludes establishment of a causal relationship, Dr. Panagiotakos suggested that patients should be counseled that the benefits "were from the diet as a whole, not from specific items consumed."


[Study title: The Benefits From the Consumption of Mediterranean Diet on Inflammation Process: The ATTICA Study. Abstract 3348]

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