A presentation at the recent meeting of the American College of Cardiology compared the results in 101 patients started on the Mediterranean diet or the American Heart Association (AHA) diet within six weeks after a heart attack. This trial was the first direct comparison of these heart-healthy diets in people with a history of heart attack.
The AHA diet advises moderate intake of animal protein and emphasizes whole grains, fruits, and vegetables. The Mediterranean diet features fish and other sources of omega-3 fats instead of animal fats, and limits other sources of animal protein. Patients on both diets had extensive individual and small group counseling with a dietitian over a period of two years.
After two years, both groups had the same rates of overall mortality and survival free from heat attacks. The number of cardiovascular events was almost identical in patients who were followed for six years.
In addition, patients on either diet had a one-third reduction in heart attack risk compared to another group of 101 patients who received only standard low-fat diet advice while hospitalized for a heart attack.
The message seems clear: the Mediterranean diet and the AHA diet provide equal cardiovascular benefits after a heart attack. What really counts is compliance with a prescribed healthy diet, which may require intense dietary counseling. Too often patients get little or no counseling from their doctors or a dietitian.
The importance of dietary counseling and compliance with diet also holds true for people at high risk but who have not had a heart attack. A direct comparison involving many more patients is needed to determine whether both of these diets are equally effective in preventing the first heart attack.