The Mediterranean-style diet for the prevention of cardiovascular diseases.
OBJECTIVE
To discuss present knowledge about Mediterranean diet and cardiovascular diseases.


METHODS
Review of existing literature.


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 alpha-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.
de Lorgeril
Michel
M
Laboratoire Nutrition, Vieillissement et Maladies Cardiovasculaires (NVMCV), Université Joseph Fourier, Grenoble, France. michel.delorgeril@ujf-grenoble.fr
Salen
Patricia
P
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D038441:Diet, Mediterranean; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage / Q000009:adverse effects; D005395:Fish Oils; D006293:Health Promotion; D006801:Humans; D012307:Risk Factors
D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils