Q: How does the Mediterranean diet stack up against statins in preventing heart attacks and strokes?
A: Research suggests that the Mediterranean diet and statins can be effective in helping to lower the risk of potentially fatal complications of heart disease. But there has been no published scientific research in which a large number of people were given either statins or a Mediterranean-style diet at random and then followed carefully to see what became of their heart health.
As Rosemary Stanton, nutritionist and visiting fellow at the School of Medicinal Sciences, University of New South Wales, explains in an article posted by The Conversation, "Such a trial is unlikely to occur, as withholding medication from people at risk of heart attack or stroke would be regarded as unethical."
But there is evidence that both approaches are helpful and that the optimal choice, at least for those at high risk of cardiovascular disease, would be a combination of diet and statins. Research also suggests that, for people at lower risk, lifestyle measures like the Mediterranean diet could be sufficient.
Traditionally, the Mediterranean diet includes lots of fruit, nuts, vegetables, cereals and oil from olives; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats and sweets; and -- taken with meals -- wine in moderation. (Researchers tested two versions, one with lots of olive oil and the other with lots of oil from nuts.)
"I don't view these things as either-or," said Dr. Meir Stampfer, a professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. "My advice is to start with the Mediterranean diet because it's good for you in multiple ways -- lowering risk of cognitive decline, reduction in some cancers, lower risk of diabetes -- that go beyond what statins do."
If cholesterol numbers remain high despite a heart-healthy diet, statins or other medical treatments can be added, he said.
In 2009, Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association, reported research that showed statin therapy resulting in a 44 percent reduction in heart disease-related problems including heart attacks, strokes and deaths. (The study can be downloaded at bit.ly/2lX1tuF.)
In 2013, a large and rigorous study published by The New England Journal of Medicine found that switching to a Mediterranean diet prevented about 30 percent of heart attacks, strokes and deaths from heart disease in people at high risk. That study, which looked at two versions of the diet, can be found at bit.ly/2np3VY2.
Statin takers often wrongly think they don't have to worry about diet and exercise.
"Quantitatively, you get more mileage from optimal exercise and diet than statins, so it's not one or the other," Stampfer said. "Everybody needs the diet and exercise, and some people, despite that, will still need statins. It's not a failure; it's not a character flaw -- if you need it, you need it."
The bottom line is that the Mediterranean diet helps even if one is taking statins and, along with other potential benefits, might help avoid the need for statins altogether.
Celia Storey added information to this report.
ActiveStyle on 05/01/2017