What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

The skeptical cardiologist was asked to give a lecture in July on diet to the cardiology fellows in our training program at Saint Louis University. Needless to say, I didn’t hew to current recommendations from the American Heart Association or the Dietary Guidelines for Americans. For example, these recommendations are still promoting the narrative that…

What is the Optimal Diet for the Prevention of Atherosclerotic Cardiovascular Disease? — The Skeptical Cardiologist

Great lecture. Thank you Dr. Pearson.

The App That Helps Me Be a More Patient Centered Physician — A Country Doctor Writes:

One of the most rewarding things I do in my clinic happens on my iPhone. When I sit down with a middle aged patient to talk about their cardiovascular risk, I open the risk calculator created by the American Heart Association and the American College of Cardiology. I talk my way through as I enter […]

The App That Helps Me Be a More Patient Centered Physician — A Country Doctor Writes:

The risk calculator is quite useful but I re-blogged this post for its link to the Hale study, which was news to me. This study published in 2004 showed older people between the ages of 70 and 90 who followed a Mediterranean diet have 50% lower rate of all-cause and cause-specific mortality than people who dine on the SAD Western diet. The four primary risk factors were diet, moderate alcohol intake, physical activity, and non-smoking.

Lifestyle matters.

Statins are more effective for those who follow the Mediterranean diet

Science Daily article here.  Study abstract here.


MD lowered the risk of all-cause, cardiovascular and CAD/cerebrovascular mortality CVD patients, net of statins. In the same population, statins reduced CVD death risk only in combination with MD. Low-grade inflammation, rather than lipids, is likely to be on the pathway of the interaction between MD and statins towards mortality risk.

Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News

Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease. According to a study published…

via Even When Not In Rome, Eat A Mediterranean Diet To Cut Heart Disease Risk — Kaiser Health News

Mediterranean-style diet may eliminate need for reflux medications — ScienceDaily

Source: Mediterranean-style diet may eliminate need for reflux medications — ScienceDaily

When compared to patients who took the traditional reflux medication, proton pump inhibitors (PPI), those patients who consumed a 90-95% whole food, plant-based, Mediterranean-style diet paired with alkaline water had the same if not better reduction in reflux symptoms. 62.6 percent of patients treated with a plant-based diet and alkaline water saw a six point reduction in their Reflux Symptom Index (RSI — a measurement for the severity of reflux symptoms), compared to 54.1 percent reduction in patients taking PPI’s. Though this research only focused on those with laryngopharyngeal reflux, this same diet regimen has implications to help patients with gastro-esophageal acid reflux (also known as GERD).

The diet suggested by Dr. Zalvan consists of mostly fruits, vegetables, grains and nuts with near complete cessation of dairy and meats including beef, chicken, fish, eggs and pork. This is in addition to standard reflux diet precautions like avoiding coffee, tea, chocolate, soda, greasy and fried food, spicy foods, fatty foods and alcohol. Along with relieving reflux symptoms, Dr. Zalvan noted that many of his patients who were treated with a plant-based diet also experienced some weight loss and a reduction of symptoms and medication use from other medical conditions like high blood pressure and high cholesterol. Dr. Zalvan said that a plant-based diet approach with alkaline water and standard reflux precautions should either be attempted prior to the use of medication or with the short-term use of medication for more severe needs.

Change in Diet Can Lower Mortality Risk

A worsening diet over the course of 12 years was associated with an increased mortality of 6% to 12%, the researchers found.  Those who stayed consistently on a healthy diet starting at baseline had a 9% to 14% lower risk for death than those who stayed consistently on a poor diet.

Source: Change in Diet Can Lower Mortality Risk

Source: Association of Changes in Diet Quality with Total and Cause-Specific Mortality — NEJM


Mediterranean Diet Cuts Risk of Diabetes

Compared with a control diet and a Mediterranean diet supplemented with mixed nuts, the olive oil-supplemented Mediterranean diet was associated with a 40% lower likelihood for new-onset diabetes (HR 0.60, 95% CI 0.43-0.85) , according to Jordi Salas-Salvado, MD, PhD, of the Universitat Rovira i Virgili in Reus, Spain, and colleagues.

Dieters who consumed a nut-supplemented Mediterranean diet did not see such protective benefits (HR 0.82, 95% CI 0.61-1.10), they wrote online in the Annals of Internal Medicine.

via Mediterranean Diet Cuts Risk of Diabetes.

Read the article and then the readers’ comments.  The following are some excerpts:

The findings of this study identify inherent weaknesses in methodology. The low fat control group did not adhere to a low fat diet and the improbable risks of CVD were notably higher.


I wonder if the researchers would consider the benefits of asking their subjects to spread their food intake more evenly throughout the day rather than the the usual Spanish pattern of negligible breakfast, snack about 11, then large lunch mid-afternoon and a big, late evening meal. Also in my experience travelling in various parts of Spain, the diet includes plenty of pork.’Every bit of the pig but the eyes.’.


The olive oil group was probably using that in place of other vegetable oils for cooking and salad. Vegetable oils like soy and corn oil are high in pro-inflammatory omega-6, and are often partially hydrogenated (ie trans fats.) Avoidance of these in the olive group could have made a difference.


Be cautious in coming to conclusions based upon this study.  The sample size was small.  Perhaps too little attention was paid to what the participants did not consume.  We all know less red meat is better for health.  The Mediterranean style diet is clearly a healthy diet but I’m not quite ready to attribute all the wonderful benefits to the diet alone.

Think lifestyle.  Despite the increase in US style fast food restaurants in Spain, the overall dietary preference continues to be a Mediterranean diet.  So how much of the study’s effect come from fast food avoidance?

BTW, yesterday was a totally Mediterranean day for me.  Veggie pizza for lunch and a Greek salad with grilled chicken for dinner.



Mediterranean Diet May Protect Kidneys

In a prospective cohort study, patients whose eating habits were closer to the tenets of a Mediterranean diet had about a 50% reduced odds of developing chronic kidney disease (CKD) over 7 years compared with those whose diets didn\’t resemble the fruit-and-vegetable-rich, low-saturated-fat diet, according to Minesh Khatri, MD, of Columbia University Medical Center, and colleagues.

via Mediterranean Diet May Protect Kidneys.