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(Circulation. 2001;103:1821.)
© 2001 American Heart Association, Inc.

Editorial

Can a Mediterranean-Style Diet Reduce Heart Disease?

Rose Marie Robertson, MD; Lynn Smaha, MD, PhD

Key Words: AHA Science Advisory • diet • cardiovascular diseases

Cardiovascular disease and stroke are the leading causes of death and disability in the United States, and the prevalence of these diseases continues to increase on a global basis. Since Brown and Goldstein¹ first reported the influence of plasma cholesterol levels on the atherosclerotic process, there has been a public health focus on the effects of altering cholesterol levels by diet and other lifestyle behaviors on the progression and development of cardiovascular disease.

Recently, evidence has also suggested that dietary patterns may have an effect on the mechanisms of atherosclerotic plaque vulnerability and the progression to thrombosis.²

Both epidemiological studies and randomized clinical trials^{3 4 5 6} have shown that a substantial number of cases of coronary heart disease can be prevented by appropriate interventions. Although the beneficial effect of lowering LDL cholesterol and triglycerides with medications^{7 8 9 10} has been well documented, lifestyle modifications, dietary interventions, and control of known risk factors are all considered key components of treatment and prevention.

The American Heart Association (AHA) Step I and II diets have been widely recommended as components of treatment for patients at risk of coronary heart disease.¹¹ Key components of these diets are reductions in the proportion of dietary calories derived from fat and, in particular, a decrease in saturated fats and cholesterol to levels substantially below the average American diet.¹² There are also specific recommendations to increase the dietary intake of fruits, vegetables, and whole grain products.

Unfortunately, despite the well-documented evidence regarding currently available and effective methods of intervention, the burden of . . . [Full Text of this Article]

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