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“Background dietary habits close to the Mediterranean diet seem to be associated with lower severity of coronary heart disease,” said lead author Demosthenes Panagiotakos from Harokopio University in Athens.
The Med diet, rich in olive oil, fruit, vegetables and fish, has long been linked to lower the incidence of heart disease, obesity and certain types of cancers. However, studies into the severity and prognosis of people with heart disease is lacking.
“The results of our study extend previous scientific knowledge that greater adherence to the Mediterranean diet has a beneficial effect on the severity of acute coronary syndrome (ACS), and on its short-term prognosis, in a free-eating population,” wrote Panagiotakos.
The Greek study
The new article, published online in the journal Nutrition (doi:10.1016/j.nut.2006.04.005), reports the results of the Greek Study of Acute Coronary Syndrome (GREECS) of 2172 patients (76 percent men) who had been hospitalised with myocardial infarction (MI) or unstable angina (UA) and their adherence to the Mediterranean diet.
Dietary assessment was performed using validated, semi-quantitative 156-item food frequency questionnaires, and correlated to the Mediterranean diet using a 55-point scale. The higher the score, the closer to the Med diet.
Diet score was also linked to biological markers of heart disease and heart attack, such as cardiac troponin I, creatine phosphokinase, and creatine phosphokinase-MB, and an inverse association was observed.
Lower adherence to the Mediterranean diet, linked to younger patients, smokers, or people with a family history of coronary heart disease (CHD), was associated with a higher degree of severity of CHD.
“A five-unit increase in diet score [increased adherence to the Med diet] was associated with 15 percent lower odds of having MI, after controlling for confounders,” said Panagiotakos.
Complex mechanism
The mechanism by which the Mediterranean diet exerts its benefits to heart health is thought to be complex, and scientists have proposed improvements in blood pressure, body weight, blood lipid concentrations, and inflammation.
“These mechanisms might have a major impact on plaque instability, rupture, or erosion and the exacerbation of the following acute MI,” said the researchers.
The main limitations of this study are, firstly, that the study was limited to survivors of coronary events, and not people who died as a result of their first events. Secondly, people may have changed dietary habits leading up to or as a result of their CHD.
Despite these limitations, Panagiotakos and colleagues conclude: “At a population level, a Mediterranean dietary pattern with a potential of favourably modifying both the severity and the prognosis of ACS could be invaluable.”
Source: Decision News Media
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