Going Nuts

Mediterranean DietDid you catch last Monday’s landmark study in the New England Journal of Medicine showing that nuts in the diet can protect against heart disease? Usually, I’m fairly critical of nutritional studies that are related to health, since so many are poorly designed and biased. This study, known as the PREDIMED trial and led by Ramon Estruch, M.D., Ph.D., warrants a closer look. In fact, it’s so well designed and scientifically controlled that I predict that future diet and wellness studies will likely be compared to this one.

Adopting a Mediterranean Diet slashes your chances by 30 percent of having a heart attack, stroke, or dying from any cardiovascular event, concludes the PREDIMED study.   

Just how did this study determine these impressive benefits from dietary changes? It all started with the enrollment of 7,447 people in Spain who were at high cardiovascular risk, although none of them currently had a cardiovascular disease. Over the next nearly five years, the researchers tracked their cardiovascular health while they ate one of three different diets. The first group ate a Mediterranean diet supplemented with olive oil. The second group ate a Mediterranean diet supplemented with nuts (walnuts/almonds/hazelnuts). And the third group was instructed to consume a low-fat diet (you know, the kind so many people are counseled to eat, but almost no one can actually follow!). Everyone in the study could eat as much as they wanted and exercise as much or as little as they wanted. 

The key components of the Mediterranean diet groups included: 

    • Extra-virgin olive oil: 4+ Tbsp/day     OR      Nuts: 30 grams/day    
    • Fresh fruits: 3+ servings/day
    • Vegetables: 2+ servings/day
    • Fish: 3+ servings/week
    • Legumes: 3+ servings/week
    • Wine (optional): 7 glasses/week
    • White meat instead of red meat 

What didn’t the Mediterranean diet include? You won’t find much dairy products, red meat, processed meats, soda drinks, bakery goods, sweets, pastries, or spreadable fats on these Mediterranean plates.

Mediterranean Diet Pays Off

Without cutting out fat, slashing calories, or upping time at the gym, both of the Mediterranean diets resulted in huge health benefits. The study participants assigned to these diets – and remember they were deemed at high-risk for cardiovascular disease – garnered significant heart protection during the five years of this study. In fact, the risk of life-threatening events, such as strokes, went down about as much as if these people were taking a cholesterol-lowering drug like Lipitor.  

Switching to a Mediterranean diet that includes olive oil or nuts on a regular basis lowers the risk of cardiovascular disease in at-risk individuals by 30 percent, compared to individuals not making diet changes. This study was so well done I’m convinced that many people could eliminate their statin drugs while eating this tasty diet and reduce their risk of major cardiovascular events by about 30 percent (but, of course, talk to your health professional before stopping any medication).  

Just how impressive were the health protections of this study? Well, the outcomes were so statistically significant that the researchers ended this study early and switched all the participants to the “olive oil and nut diet” for the sake of cardiovascular protection.

It’s a very palatable diet and I’m going to change my own diet. “Aw, Nuts” has a whole new meaning to me now.

Stephen C Vogt, PharmD
President and CEO
BioPlus SP


Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New Engl J Med February 25, 2013. DOI: 10.1056/NEJMoa1200303
Going Nuts
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