title: Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease.
abstract: In a prospective, randomised single-blinded secondary prevention trial we compared the effect of a Mediterranean alpha-linolenic acid-rich diet to the usual post-infarct prudent diet. After a first myocardial infarction, patients were randomly assigned to the experimental (n = 302) or control group (n = 303). Patients were seen again 8 weeks after randomisation, and each year for 5 years. The experimental group consumed significantly less lipids, saturated fat, cholesterol, and linoleic acid but more oleic and alpha-linolenic acids confirmed by measurements in plasma. Serum lipids, blood pressure, and body mass index remained similar in the 2 groups. In the experimental group, plasma levels of albumin, vitamin E, and vitamin C were increased, and granulocyte count decreased. After a mean follow up of 27 months, there were 16 cardiac deaths in the control and 3 in the experimental group; 17 non-fatal myocardial infarction in the control and 5 in the experimental groups: a risk ratio for these two main endpoints combined of 0.27 (95% CI 0.12-0.59, p = 0.001) after adjustment for prognostic variables. Overall mortality was 20 in the control, 8 in the experimental group, an adjusted risk ratio of 0.30 (95% CI 0.11-0.82, p = 0.02). An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets in the secondary prevention of coronary events and death.
authors.affiliation: INSERM (Institut National de la Santé et de la Recherche Médicale), Units 63, Bron, France.
authors.forename: M
authors.initials: M
authors.lastname: de Lorgeril
authors.forename: S
authors.initials: S
authors.lastname: Renaud
authors.forename: N
authors.initials: N
authors.lastname: Mamelle
authors.forename: P
authors.initials: P
authors.lastname: Salen
authors.forename: J L
authors.initials: JL
authors.lastname: Martin
authors.forename: I
authors.initials: I
authors.lastname: Monjaud
authors.forename: J
authors.initials: J
authors.lastname: Guidollet
authors.forename: P
authors.initials: P
authors.lastname: Touboul
authors.forename: J
authors.initials: J
authors.lastname: Delaye
mesh_terms: D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D016019:Survival Analysis; D017962:alpha-Linolenic Acid / Q000008:administration & dosage*
chemical_list: D017962:alpha-Linolenic Acid