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Mediterranean diet reduces atherosclerosis progression in coronary heart disease

For patients with coronary artery disease (CHD), following a Mediterranean diet is more effective in reducing the progression of carotid atherosclerosis than a low-fat diet, according to the new data from a randomized controlled trial Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention (CORDIOPREV). This analysis was published online in August 2021 in Stroke. Previously, the effectiveness of the Mediterranean diet in reducing cardiovascular risk has been seen in primary prevention, and currently there is no consensus about a recommended dietary model for the secondary prevention of cardiovascular disease.

The CORDIOPREV study is an ongoing prospective, randomized, single-blind, controlled trial in 1002 coronary heart disease patients, whose primary objective is to compare the effect of 2 healthy dietary patterns (low-fat rich in complex carbohydrates versus Mediterranean diet rich in extra virgin olive oil) on the incidence of cardiovascular events. The participants were randomized to follow a Mediterranean diet (35% fat, 22% monounsaturated fatty acids, <50% carbohydrates) or a low-fat diet (28% fat, 12% monounsaturated fatty acids, >55% carbohydrates). Intima-media thickness of both common carotid arteries (IMT-CC) was usaed as a surrogate for the status and future cardiovascular disease risk.

A total of 939 participants (459 in the low-fat diet group and 480 in the Mediterranean diet group) completed IMT-CC evaluation at baseline, and 809 (377 and 432, respectively) completed the IMT-CC evaluation at 5 years; 731 (335 and 396, respectively) did so at 7 years. The Mediterranean diet significantly decreased IMT-CC both after 5 years (-0.027; P < .001) and after 7 years (-0.031 mm; P < .001), relative to baseline. In contrast, the low-fat diet did not exert any change on IMT-CC after 5 or 7 years, the researchers report. The higher was the IMT-CC at baseline, the greater was the reduction in this parameter. The Mediterranean diet also produced a greater decrease in carotid plaque maximum height, compared with the low-fat diet, but there were no between-group differences in carotid plaque numbers during follow-up.

 

Reference: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033214

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