This Diet Cuts Heart Disease Risk By Over 20%, Per 20 Years Of Data
Craving a taste of the Mediterranean? It is possible to replicate in your own home. This June, we’re sharing recipes, shopping tips, and the science behind what is considered the healthiest dietary pattern to follow. That way, everyone can enjoy a Mediterranean summer.
For decades, "low-fat" was considered the gold standard for eating heart-healthy. The label that dominated grocery store aisles, and it was the default advice handed down from major health organizations. Thankfully, this assumption has been challenged, and we now know that the right types of fat can be crucial for protecting heart health. One dietary pattern that's garnered significant traction for its cardiovascular benefits is the Mediterranean diet.
A new study published in the American Journal of Clinical Nutrition, recently compared 20-year cardiovascular disease (CVD) risk across three dietary patterns in US adults: a low-fat diet, a Mediterranean diet, and the American Heart Association's 2020 dietary goals. Here's what came out on top.
About the study
Researchers used data from two large, well-established cohorts: the Nurses' Health Study and the Health Professionals Follow-up Study. The analysis included over 12,000 US adults between the ages of 55 and 80 who had diabetes or at least three major CVD risk factors. Participants' diets were assessed every four years using food frequency questionnaires, allowing researchers to track dietary patterns over time rather than relying on a single snapshot.
To estimate 20-year CVD risk, researchers used a statistical model simulating sustained adherence to each diet over the full study period. CVD outcomes, including nonfatal heart attack, coronary revascularization, stroke, and CVD death, were all confirmed by medical records.
Most prior Mediterranean diet research has focused on European populations, so the goal of this study was to understand how these three dietary approaches compare in a US population.
The Mediterranean diet cut CVD risk by more than 20%
Over 20 years, 3,469 CVD cases occurred across the study population. Over 20 years, an estimated 36% of participants following the low-fat diet were expected to develop CVD, compared to 31% on the AHA-2020 diet and 28% on the Mediterranean diet.
Compared to low-fat, the Mediterranean diet was associated with a 21% lower relative risk of CVD. The AHA-2020 diet also outperformed low-fat, though by a smaller margin. In a broader population without CVD risk factors, the Mediterranean diet still showed a meaningful edge over low-fat.
What this means for your heart
The low-fat diet was originally positioned as the gold standard for cardiovascular protection, largely because saturated fat was linked to elevated LDL cholesterol. But rather than restricting fat broadly, the Mediterranean diet emphasizes healthy fats from sources like olive oil, nuts, and fatty fish, alongside an abundance of vegetables, legumes, and whole grains.
Both the Mediterranean diet and the AHA-2020 dietary goals outperformed the low-fat diet in this analysis, suggesting that dietary quality and fat source are more relevant to long-term heart health than fat quantity alone.
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How to eat more like the Mediterranean diet
Instead of being a rigid meal plan, the Mediterranean diet is considered more of dietary approach that is built around whole, minimally processed foods. The pattern is flexible and adaptable, which is part of why it performs well in long-term studies. If you want to shift your diet in this direction, here's what to focus on:
- Olive oil: Use it as your primary cooking oil and for dressings.
- Vegetables: Aim to fill at least half your plate with veggies at every meal.
- Legumes: Incorporate beans, lentils, and chickpeas into your meals several times a week.
- Fish: Prioritize fatty fish like salmon, sardines, and mackerel at least twice a week.
- Whole grains: Choose whole grain bread, farro, barley, or brown rice over refined grain options.
- Nuts: Snack on a small handful of walnuts, almonds, or pistachios daily.
- Ultra-processed foods: A Mediterranean diet emphasizes whole foods, not ones that have been processed.
For more advice on how to eat like a Mediterranean, check out these tips from a Sardinian chef, or read about the 8 foods your bound to find in any Mediterranean kitchen.
The takeaway
This study reveals that broadly reducing fat in your diet doesn't protect your heart the way eating the right fats does. This study makes a compelling case that the Mediterranean diet's emphasis on fat quality over fat restriction is the more effective long-term strategy.
Plus, the flexibility of the Mediterranean approach may make it easier to follow than a traditional diet. Build your meals around healthy fats, protein, and vegetables, and you will be a step closer to heart health, and maybe even feel like you're on vacation.