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We have lots of evidence that a Mediterranean diet may help stave off heart disease, heart attacks, and strokes. But what if you already have heart disease? A randomized trial published May 14, 2022, in The Lancet offers insight. It involved a thousand people in Spain who had coronary artery disease (plaque buildup in the heart’s arteries). Participants were randomly divided into two groups. One group ate a Mediterranean diet and the other a low-fat diet. Both diets emphasized fruits and vegetables. However, the Mediterranean diet emphasized food high in monounsaturated fats — particularly olive oil and nuts — along with legumes, whole grains, poultry, and fatty fish. The low-fat diet involved fewer monounsaturated fats, only lean versions of fish and poultry, and more calories per day from carbohydrates, particularly whole grains, legumes, and potatoes. People in both groups consulted with a dietitian regularly. Seven years later, people in the Mediterranean diet group had a 26% lower risk of having a heart attack or stroke, compared with people in the low-fat group. Once again, an excellent study demonstrates the benefits of the Mediterranean diet and its “good fats.”

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