The low-fat group ate low-fat dairy, breads, potatoes, fruits and vegetables and lean fish. They were told to avoid oils, baked goods, nuts, red and processed meat and fatty fish.
At the end of the study, 288 cardiovascular events had occurred. While 109 of those events occurred in the low-fat group, 96 were in the group that ate a Mediterranean diet with olive oil, and 83 were in the Mediterranean diet-with-nuts group.
When the researchers looked separately at stroke, heart attack and death, only the link between the Mediterranean diet and stroke was statistically significant. The researchers found a link between the diets and heart protection, but it did not prove cause and effect, they said.
So why does the Mediterranean diet seem to boost heart health? Martinez-Gonzalez said it's probably the combination of good-quality fats -- both monounsaturated like olive oil and polyunsaturated like vegetable oils -- and the wide range of other nutrients.
The findings came as no surprise to two U.S. experts.
"I think this is demonstrating again, conclusively, that this is the diet to go on to prevent heart disease," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, and a spokeswoman for the American Heart Association's Go Red for Women campaign.
The 30 percent reduction in relative risk, she said, is ''significant."
Alice Lichtenstein, the Stanley Gershoff Professor of Nutrition Science and Policy at Tufts University in Boston, said the new findings are "confirming what we have been saying all along." The findings are strong, she s
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