The Mediterranean diet can help prevent heart attack and stroke better than a low-fat diet, study suggests

• A Mediterranean diet may be better for heart health than a low fat diet, study suggests
• Mediterranean dieters had significantly lower risk of heart attack and stroke, researchers say.

There's even more evidence a Mediterranean diet can help protect your heart, new research suggests.

Following a Mediterranean diet helped people with pre-existing heart disease prevent heart attack or stroke more effectively than a low-fat diet, according to a study published May 4 in The Lancet.

Researchers from the University of Cordoba and Reina Sofia University Hospital in Spain looked at 1,002 Spanish patients with coronary artery disease over seven years of follow up. Half the participants were randomly assigned to follow a low fat diet, and the other half assigned a Mediterranean diet rich in vegetables, olive oil,whole grains, nuts, fish, and some wine.

They found the Mediterranean dieters were 26% less likely to experience a major cardiovascular issue, like a heart attack or stroke, than the low fat dieters over the course of the study. The Mediterranean diet was especially effective for men, who had a 33% lower risk, according to data.

However, the low fat diet may still have had benefits, since overall there were significantly fewer deaths and adverse events than researchers expected. Similar studies involving a Western-style diet reported more than twice the number of deaths as the most recent study, suggesting a low fat diet may still be better than nothing.

Benefits of the Mediterranean diet are linked to healthy fats and easiness to follow over time

Both groups in the recent study were eating more fiber and less processed food than before they began the study, according to data, which may help explain the lower rates of death.

Getting enough fiber in your diet is linked to benefits like better digestive health and lower risk of chronic illness, whereas processed food is associated with a range of worse health outcomes, including higher risk of cancer and heart disease.

But the Mediterranean diet is uniquely rich in a type of healthy fat called unsaturated fat. Participants on the diet were eating significantly more unsaturated fat than they had at the start of the study, from sources like olive oil, nuts, and fatty fish.

In contrast, the low-fat diet group was eating more carbs, making up about 45% of their daily calories, and about 12% less fat overall, including unsaturated fat.

Evidence suggests unsaturated fat may help raise the levels of good cholesterol and protect against heart attack and stroke, according to the Mayo Clinic. Previous research has also found diets that increase unsaturated fat, like the Mediterranean diet, are linked to better outcomes for heart health.

The Mediterranean diet also includes small amounts of wine (up to a glass per day for women and two for men), which was not allowed on the low fat diet. Some studies suggest drinking wine in moderation may have health benefits like better levels of good cholesterol.

Participants were also less likely to give up on the Mediterranean diet before the end of the study. Only 46 participants quit the diet, compared to nearly twice as many people who abandoned the low fat diet prior to finishing the study. Mediterranean dieters were also able to stick to the diet recommendations more closely than the low fat group, researchers noted, and the better they followed the diet, the greater the benefits for reducing heart disease risks.

The findings are supported by previous evidence and expert endorsements that the Mediterranean diet is one of the most sustainable and healthy ways to eat long term.

Research suggests additional benefits of the diet may include lower risk of diabetes, less inflammation, and better cognitive health.