Do a quick search for “Mediterranean diet” on our site and you will find oodles of articles espousing the health benefits of this eating lifestyle. In December, yet another study showed that people who eat a Mediterranean-style diet have a lower risk of cardiovascular disease – possibly even as low as those taking statin drugs.
Let’s see why this diet can be so good for the heart.
Lead study author Shafqut Ahmad, Ph.D., a research fellow at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, said of the findings:
“We didn’t know the potential mechanisms of how a Mediterranean diet reduced risk of cardiovascular disease. It was like a black box. Through this study, we know that a Mediterranean diet reduces or improves a lot of risk factors for cardiovascular disease, which are very important in terms of prevention.”
Heart disease is the leading cause of death for both men and women in the U.S., and kills about 600,000 people each year, according to the U.S. Centers for Disease Control and Prevention (CDC). The most common form is coronary heart disease, which claims 370,000 lives annually. Some 735,000 Americans suffer a heart attack each year. 
For the research, Ahmad and his colleagues recruited more than 25,000 women and asked them to complete food intake questionnaires and provide blood samples. Then, the team followed them for up to 12 years. 
Those who closely followed a Mediterranean-style diet had a 25% lower risk of cardiovascular disease, compared to those who followed the diet the least closely.
The researchers uncovered the mechanisms behind this link by using the participants’ blood samples to measure previously-established and new biomarkers of heart disease and found changes in inflammation, glucose metabolism, and insulin resistance.
“The finding shows that a Mediterranean diet improves inflammation, which is quite a big risk factor for cardiovascular disease. We now also know that a major pathway through which a Mediterranean diet improves cardiovascular disease risk is through improved glucose metabolism, insulin resistance, and body adiposity [fat].”
Moreover, when the body has trouble metabolizing glucose and becomes unable to use insulin efficiently (insulin resistance), it can lead to Type 2 diabetes if left untreated. Type 2 diabetes is a significant risk factor for cardiovascular disease.
The Benefits of Meds, Without the Risks
In the study, the participants were placed into 1 of 3 categories based on their adherence to a Mediterranean diet: low, middle, and upper. Over the course of the study, 428 women in the low group, 356 women in the middle group, and 246 women in the upper group had the highest risk factors for cardiovascular disease.
Based on this information, the researchers determined that women in the middle and upper group had a 23% and 28% reduced risk of experiencing a cardiovascular event, respectively, compared to women in the lower group.
The overall 25% lower risk of cardiovascular disease mimicked similar preventative effects of medication – namely aspirin and statins.
In other words, sticking to a Mediterranean diet may be just as effective as statin drugs, which are linked to more than 300 adverse events, or aspirin, which has been linked to intestinal bleeding and a higher risk of stroke.
Ironically, a study by Finnish researchers published in 2015 linked statins with a 50% increased risk of Type 2 diabetes.
“Statins and aspirin are routinely used medications for cardiovascular disease prevention. Through diet, you can reduce your risk as comparably as through medications.“
It’s even possible that a Mediterranean diet works better than statins at reducing cardiovascular risks. In 2016, a study revealed that people with a history of heart attacks, strokes, and blocked arteries were 37% less likely to die during the study if they adhered to a Mediterranean diet. In past studies, statins were shown to reduce the risk of heart problems by 24%.
Although the study only looked at women, Ahmad said the findings could be generalized and also applied to men, since past studies reached similar conclusions in both men and women.
“It’s very clear, for the first time in a large-scale, epidemiological study, that we showed that Mediterranean diet improves cardiovascular disease risk by 25%, but also improves underlying biomarkers, which is really great.”
The study was not free of limitations, however. For starters, the research relied on self-reported data, which can be inaccurate, particularly when it comes to food intake. Additionally, the women in the study were medical professionals, so it’s possible they led a healthier lifestyle compared to the rest of the population. 
But as I said earlier, there is a ton of data which suggests that eating a Mediterranean diet is one of the healthiest eating patterns you can adopt.
The study was published in JAMA Network Open.
 Everyday Health
 NBC News