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The Mediterranean-style diet for the prevention of cardiovascular diseases

  • Michel de Lorgeril (a1) and Patricia Salen (a1)
Abstract
Objectives

To discuss present knowledge about Mediterranean diet and cardiovascular diseases.

Design

Review of existing literature.

Setting and Results

Epidemiological studies as well as randomised dietary trials suggest that Mediterranean diet may be important in relation to the pathogenesis (and prevention) of CHD. For instance, a striking protective effect of an ALA-rich Mediterranean diet was reported in the Lyon Diet Heart Study with a 50 to 70% reduction of the risk of recurrence after 4 years of follow-up in CHD patients. According to our current knowledge, dietary ALA should represent about 0.6 to 1% of total daily energy or about 2 g per day in patients following a Mediterranean diet, whereas the average intake in linoleic acid should not exceed 7 g per day. Supplementation with very-long-chain omega-3 fatty acids (about 1 g per day) in patients following a Mediterranean type of diet was shown to decrease the risk of cardiac death by 30% and of sudden cardiac death by 45% in the GISSI trial.

Conclusions

In the context of a diet rich in oleic acid, poor in saturated fats and low in omega-6 fatty acids (a dietary pattern characterising the traditional Mediterranean diet), even small doses of omega-3 fatty acids (about 1 g EPA + DHA the form of fish oil capsules or 2 g α-linolenic acid in canola oil and margarine) might be very protective. These data underline the importance of the accompanying diet in any dietary strategy using fatty acid complements.

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Copyright
Corresponding author
*Corresponding author: E-mail michel.delorgeril@ujf-grenoble.fr
References
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1Keys, A. Seven countries. A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge, MA: Harvard University Press, 1980; 1381.
2de Lorgeril, M. Mediterranean diet in the prevention of coronary heart disease. Nutrition 1998; 14: 55–7.
3de Lorgeril, M, Renaud, S, Mamelle, N. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343: 1454–9.
4de Lorgeril, M, Salen, P, Martin, JL. Effect of a Mediterranea n - type of diet on the rate of cardiovascular complications in coronary patients. Insights into the cardioprotective effect of certain nutriments. Journal of the American College of Cardiology 1996; 28: 1103–8.
5de Lorgeril, M, Salen, P, Caillat-Vallet, E. Control of bias in dietary trial to prevent coronary recurrences. The Lyon Diet Heart Study. European Journal of Clinical Nutrition 1997; 51: 116–22.
6de Lorgeril, M, Salen, P, Martin, JL. Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study. Circulation 1999; 99: 779–85.
7de Lorgeril, M, Salen, P. Modified Mediterranean diet in the prevention of coronary heart disease and cancer. World Review of Nutrition and Dietetics 2000; 87: 123.
8McLennan, PL, Abeywardena, MY, Charnock, JS. Reversal of arrhythmogenic effects of long term saturated fatty acid intake by dietary n—3 and n—6 polyunsaturated fatty acids. American Journal of Clinical Nutrition 1990; 51: 53–8.
9Billman, GE, Kang, JX, Leaf, A. Prevention of sudden cardiac death by dietary pure omega-3 polyunsaturated fatty acids in dogs. Circulation 1999; 99: 2452–7.
10Burr, ML, Fehily, AM, Gilbert, JF. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet And Reinfarction Trial (DART). Lancet 1989; 2: 757–61.
11GISSI-Prevenzione Investigators. Dietary supplementation with n—3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999; 354: 447–55.
12Albert, C, Oh, K, Whang, W, Manson, JE, Chae, CU, Stampfer, MJ, et al. Dietary alpha-linolenic acid intake and risk of sudden cardiac death and coronary heart disease. Circulation 2005; 112: 3232–8.
13Sandker, GN, Kromhout, D, Aravanis, C. Serum cholesteryl ester fatty acids and their relation with serum lipids in elderly men in Crete and Netherlands. European Journal of Clinical Nutrition 1993; 47: 201–8.
14Simopoulos, AP, Norman, HA, Gillapsy, JE, Duke, JA. Common purslane: a source of omega-3 fatty acids and antioxidants. Journal of the American College of Nutrition 1992; 11: 374–82.
15Simopoulos, AP, Salem, N. n—3 fatty acids in eggs from range-fed Greek chickens. New England Journal of Medicine 1989; 321 1412.
16Renaud, S. Linoleic acid, platelet aggregation and myocardial infarction. Atherosclerosis 1990; 80: 255–6.
17Renaud, S, Nordoy, A. Small is beautiful: alpha-linolenic and eicosapentanoic acids in man. Lancet 1983; 1: 1169.
18Renaud, S, de Lorgeril, M. Dietary lipids and their relation to ischemic heart disease: from epidemiology to prevention. Journal of Internal Medicine 1989; 225 3946.
19de Lorgeril, M, Salen, P, Laporte, F. Potential use of nuts for the prevention and treatment of coronary heart disease: from natural to functional foods. Nutrition, Metabolism and Cardiovascular Diseases 2001; 11: 362–71.
20Robinson, K, Arheart, K, Refsum, H. Low circulating folate and vitamin B6 concentrations. Risk factors for stroke, peripheral vascular disease and coronary heart disease. Circulation 1998; 97: 437–43.
21Bostom, AG, Selhub, J. Homocysteine and arteriosclerosis. Subclinical and clinical disease associations. Circulation 1999; 99: 2361–3.
22Corr, PB, Saffitz, JE, Sobel, BE. What is the contribution of altered lipid metabolism to arrhythmogenesis in the ischemic heart? In: Hearse, DJ, Manning, AS, Janse, MJ, eds. Life Threatening Arrhythmias during Ischemia and Infarction. New York, NY Raven Press, 1987; 91114.
23Parratt, JR, Coker, SJ, Wainwright, CL. Eicosanoids and susceptibility to ventricular arrhythmias during myocardial ischemia and reperfusion. Journal of Molecular and Cellular Cardiology 1987; 19(Suppl. 5): 5566.
24Sellmayer, A, Witzgall, H, Lorenz, RL. Effects of dietary fish oil on ventricular premature complexes. American Journal of Cardiology 1995; 76: 974–7.
25Christensen, JH, Gustenhoff, P, Korup, E. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. British Medical Journal 1996; 312: 677–8.
26Christensen, JH, Christensen, MS, Dyerberg, J, Schmidt, EB. Heart rate variability and fatty acid content of blood cell membranes: a dose–response study with n—3 fatty acids. American Journal of Clinical Nutrition 1999; 70: 331–7.
27Farrell, TG, Bashir, Y, Cripps, T. Risk stratification for arrhythmic events in postinfarction patients based on heart rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram. Journal of the American College of Cardiology 1991; 18: 687–97.
28Siscovick, DS, Raghunathan, TE, King, I. Dietary intake and cell membrane levels of long-chain n—3 polyunsaturated fatty acids and the risk of primary cardiac arrest. Journal of the American Medical Association 1995; 274: 1363–7.
29Albert, CM, Hennekens, CH, O'Donnel, CJ. Fish consumption and the risk of sudden cardiac death. Journal of the American Medical Association 1998; 279: 23–8.
30Leaf, A, Albert, C, Josephson, M, Steinhaus, D, Kluger, J, Kang, JX, et al. Prevention of fatal arrhythmias in high-risk subjects by fish oil n—3 fatty acid intake. Circulation 2005; 112: 2762–8.
31Raitt, MH, Connor, WE, Morris, C, Kron, J, Halperin, B, Chug, SS, et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators. Journal of the American Medical Association 2005; 293: 2884–91.
32Barzi, F, Woodward, M, Marfisi, RM. Mediterranean diet and all-causes mortality after myocardial infarction: results from the GISSI-Prevenzione trial. European Journal of Clinical Nutrition 2003; 57: 604–11.
33Trichopoulou, A, Costacou, T, Barnia, C, Trichopoulos, D. Adherence to a Mediterranean and survival in a Greek population. New England Journal of Medicine 2003; 348: 2599–608.
34Kris-Etherton, P, Eckel, R, Howard, B, Jeor, S, St Bazzarre, T. Lyon. Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I Dietary Pattern on cardiovascular disease. Circulation 2001; 103: 1823–5.
35Chrysohoou, C, Panagiotakos, D, Pitsavos, C. Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults. The ATTICA Study. Journal of the American College of Cardiology 2004; 44: 152–8.
36Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on the Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Journal of American Medical Association 2001; 285: 2486–97.
37Esposito, K, Marfella, R, Ciotola, M, Di Paolo, C. Effects of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome. A randomized trial. Journal of the American Medical Association 2004; 292: 1440–6.
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