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Study touts Mediterranean diet heart benefits

Pour on the olive oil, preferably over fish and vegetables: One of the longest and most scientific tests of a Mediterranean diet suggests this style of eating can cut the chance of suffering heart-related problems, especially strokes, in older people at high risk of them.

The five-year study involved about 7,500 people in Spain. Those who ate Mediterranean-style with lots of olive oil or nuts had a 30 percent lower risk of major cardiovascular problems, compared with those who were told to follow a low-fat diet but who, in reality, didn't cut fat very much. Mediterranean meant plenty of fruit, fish, chicken, beans, tomato sauce, salads and wine -- yes, wine -- and small amounts of baked goods and pastries.

Mediterranean diets have long been touted as heart-healthy, but that's based on observational studies that can't prove the point. In the new research, people were assigned diets to follow for a long time and carefully monitored. Doctors even did lab tests to verify that the Mediterranean dieters were consuming more olive oil or nuts, as recommended.

Most of these people were taking medicines for high cholesterol and blood pressure, and researchers did not alter those, said one study leader, Dr. Ramon Estruch of Hospital Clinic in Barcelona.

As a first step to prevent heart problems, "we think diet is better than a drug" because it has few if any side effects, Estruch said. "Diet works."

The results were published online yesterday by the New England Journal of Medicine and discussed at a nutrition conference in Loma Linda, Calif.

People in the study were not given rigid menus or calorie goals because weight loss was not the aim. That could be why they found the "diets" easy to stick with. Only about 7 percent dropped out within two years. There were twice as many dropouts in the low-fat group.

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Researchers also provided the nuts and olive oil, so it didn't cost participants anything for these relatively pricey ingredients. The use of extra-virgin olive oil may have mattered. It is minimally processed and richer than regular or light olive oil in the chemicals and nutrients that earlier studies have suggested are beneficial.

The study involved people ages 55 to 80, slightly more than half of them women. All were free of heart disease at the start but were at high risk for it because of health problems. Half had diabetes. Most were overweight and had high cholesterol and blood pressure.

They were assigned to one of three groups: Two followed a Mediterranean diet supplemented with either extra-virgin olive oil (4 tablespoons a day) or with walnuts, hazelnuts and almonds (a fistful a day). The third group was urged to eat a low-fat diet heavy on bread, potatoes, pasta, rice, fruits, vegetables and fish, and light on baked goods, nuts, oils and red meat.

Independent monitors stopped the study after nearly five years when they saw fewer problems in the two groups on Mediterranean diets.

Doctors tracked a composite of heart attacks, strokes or heart-related deaths. There were 96 of these in the Mediterranean-olive oil group, 83 in the Mediterranean-nut group and 109 in the low-fat group.

Rena Wing, a weight-loss expert at Brown University, noted that researchers provided the oil and nuts, and said "it's not clear if people could get the same results from self-designed Mediterranean diets" -- or if Americans would stick to them more than Europeans who are used to such foods.

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