Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra‐Virgin Olive Oil or Nuts

Study answer

What this study found

Both Mediterranean diet supplementation strategies reduced major cardiovascular events compared with the reduced-fat control diet in this high-risk primary-prevention population. Primary end-point events were 96 (3.8%) with EVOO, 83 (3.4%) with nuts, and 109 (4.4%) with control; adjusted hazard ratios versus control were 0.69 (0.53-0.91) for EVOO and 0.72 (0.54-0.95) for nuts. Incidence rates per 1000 person-yr were 8.1, 8.0, and 11.2, respectively. No relevant diet-related adverse effects were reported.

Study & population

Multicenter randomized trial in Spain among adults without established cardiovascular disease but at high cardiovascular risk.

Intervention

The active intervention was a Mediterranean diet supplemented with either extra-virgin olive oil or mixed nuts, compared with a reduced-fat control diet.

Key limitation

The intervention was dietary and could not be fully blinded, and adherence relied on questionnaires plus biomarker assessment in subsamples rather than full-arm biochemical verification.

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Original abstract