Atherosclerosis--epidemiological studies on the health effects of a Mediterranean diet.

Mediterranean diets are characterized by olive oil, as the dominant fat source and a high to moderate consumption of fruit and vegetables, cereal products, fish, legumes, in combination with little meat and wine with meals. The "reference" Mediterranean diet seems to differ according to country, but is associated with good health and a long life expectancy. From the Seven Countries Studies, it has been shown that especially the traditional Cretan diet was associated with very low 25-year mortality rates for coronary heart disease, cancer and all-causes. In terms of nutrients and bioactive compounds the "reference" Mediterranean diet is low in saturated fat and high in monounsaturated fatty acids, high in antioxidants especially vitamin C and E, and high in fiber and folic acid. Several epidemiological studies have investigated these dietary components either separately or in combination in other than Mediterranean populations. In general, also in other populations beneficial effects on the coronary risk profile have been observed, which gives further support to the positive health effects of the Mediterranean diet. Intervention studies in East Finland and Southern Italy have convincingly shown that the coronary risk profile (lower LDL cholesterol and blood pressure levels) is improved by a Mediterranean diet. Moreover, the Cretan diet was tested in cardiac patients and showed a 70 % lower cardiac and all-causes mortality compared to the control diet. In conclusion, epidemiological studies and intervention trials suggest that the Cretan Mediterranean diet lowers the risk of coronary heart disease.