Choosing the right diet could mean the difference between life and death, especially for those at a higher risk of heart disease.
According to a review published in The BMJ, Mediterranean and low-fat diets seem to help reduce the chances of heart attacks and death for people already at risk for cardiovascular diseases.
The study compared randomized trials of seven popular diet programs and found these two diets to be the most beneficial.
What the Study Revealed
The review looked at 40 trials, involving 35,548 participants who were tracked for an average of three years.
These trials examined seven named dietary programs (low fat, Mediterranean, very low fat, modified fat, combined low fat and low sodium, Ornish, and Pritikin).
Based on moderate certainty evidence, the Mediterranean dietary program turned out to be superior in preventing all-cause mortality (17 fewer deaths per 1000 over five years), non-fatal heart attacks (17 fewer per 1000), and strokes (7 fewer per 1000) for patients with intermediate risk of cardiovascular disease.
Low-fat programs also performed well, showing clear benefits in preventing all-cause mortality (9 fewer deaths per 1000) and non-fatal heart attacks (7 fewer per 1000).
When compared to each other, the researchers found no significant differences between the Mediterranean and low-fat diets in terms of mortality or non-fatal heart attacks.
High-Risk Patients Benefitted the Most
The study found that the absolute effects of both diet programs were more pronounced for patients at high risk of cardiovascular disease.
For instance, those following the Mediterranean dietary program had 36 fewer all-cause deaths per 1000 and 39 fewer cardiovascular deaths per 1000 over a span of five years.
Other Diet Programs Didn’t Stand Out
The other five diet programs in the study, including very low fat and modified fat diets, generally showed little or no benefit compared to minimal intervention, typically based on low to moderate certainty evidence.
Limitations and Conclusion
The study did have some limitations, including the inability to measure adherence to dietary programs and the possibility that benefits could be due to other elements within the programs like drug treatment and support to quit smoking.
Despite these limitations, the review remains comprehensive, involving a thorough literature search, rigorous assessment of study bias, and adherence to recognized GRADE methods to assess the certainty of estimates.
The researchers conclude that Mediterranean and low-fat diets “probably reduce the risk of mortality and non-fatal myocardial infarction in people at increased cardiovascular risk.”
Mediterranean diets are also likely to reduce the risk of stroke. Other named diets didn’t show any significant superiority over minimal intervention.
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The study was published in The BMJ.
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