The ‘low-fat’ dark ages are over — evidence shows the Mediterranean diet is best

More evidence has been forthcoming this week regarding the efficacy of the Mediterranean diet and its positive impact on health. A systematic review and meta-analysis was performed to ascertain the impact of adherence to a Mediterranean diet on defined health outcomes, among them cardiovascular disease, death from cardiovascular disease, diabetes and breast cancer. (A Mediterranean diet emphasises healthy fats such as olive oil, nuts and seeds, fish and other natural protein sources, fruit, vegetables and whole grains, with processed carbohydrates kept to a minimum.)

The trial looked at outcomes at two levels: primary (preventing disease in the first place) and secondary (preventing the complications of pre-existing disease). At a primary level, a 29 per cent decrease in cardiovascular events (heart attack, stroke or death) was noted, as was a 14 per cent reduction in overall deaths from cancer as well as a 30 per cent decrease in diabetes incidence.

At a secondary level, the most rigorous trial performed suggested a 68 per cent decrease in the incidence of new heart attacks or deaths from heart attacks in patients with existing disease who followed the diet. There appeared to be no impact on cancer mortality in patients with colon, breast or prostate cancer. No benefit of the diet was seen in patients with pre-existing Alzheimer’s disease or rheumatoid arthritis.

Overall a rather mixed picture was seen, though consistent with previous data showing the benefit of the diet on weight loss and cardiovascular risk factors as well as diabetes prevention.

Lest the ire of the purists be aroused, let me hastily acknowledge that any meta-analysis is only as reliable and useful as the quality of the papers that were analysed and, while there were question marks over several of the papers used here, in reality there is no such thing as the ideal paper, particularly in the nutritional sciences.

The evidence in favour of the Mediterranean diet is now overwhelming. Heart UK, NICE, and the British Heart Foundation all speak highly of the diet. The American Heart Association sadly remains stuck in the nutritional dark ages, even if it does speak favourably of the diet as an alternative to traditional low-fat guidance. It will no doubt join us in the sunshine very soon.

What are you waiting for? Get stuck in, even if you did vote for Brexit.