How the Mediterranean Diet Can Help Prevent Heart Disease in Women

Following a Mediterranean diet was associated with reducing the risk of cardiovascular disease by 25 to 28 percent, according to research published in December 2018 in JAMA Network Open, an international peer-reviewed general medical journal. Researchers followed 25,994 initially healthy U.S. women (people who weren't suffering from heart disease, cancer or another life-threatening illness likely to be fatal within a few years) over a span of up to 12 years. Consuming a Mediterranean diet was associated with a significant reduction in heart disease, the study found. It was also associated with decreased inflammation, improved glucose metabolism and lower blood pressure, among several other health benefits, researchers found.

"This study highlights and reinforces how the move toward a Mediterranean diet pattern is associated with improved cardiovascular outcomes," says Dr. Robert Ostfeld, director of preventive cardiology at the Montefiore Health System in New York City. Ostfeld was not involved in the JAMA study.

The Mediterranean diet is an eating regimen rich in vegetables, fruits, nuts, whole grains, beans, nuts, legumes, olive oil and flavorful herbs and spices. The diet also calls for consuming fish and seafood at least a couple times a week, plus eating poultry, eggs, cheese and yogurt in moderation and indulging infrequently in sweets and red meat on special occasions. For those who don't have alcohol misuse disorder, drinking alcohol (in particular red wine) in moderation is fine. Other studies suggest that the Mediterranean diet is beneficial for weight loss and helps ward off chronic diseases such as cancer, dementia and diabetes.

Dr. Shalini Bobra, a board-certified cardiologist with White Plains Hospital in White Plains, New York, says many of her patients are concerned about their eating regimens. "It's the No. 1 question people ask me: What should I eat?" she says. "It's a big topic in many initial consults." Heart disease is the leading cause of death for women in the U.S., and more than two-thirds of women who die from it don't have symptoms, Bobra notes. The new research helps bolster her advice to patients that they should follow a Mediterranean diet to prevent cardiovascular disease, she says. "It's something concrete patients can do on a day-to-day basis," Bobra says. "There are a lot of health issues we can't control, like our genetics or getting older. But we can control what we eat." Advising patients to eat a Mediterranean diet is akin to providing a food prescription based on science, she says.

Unlike some diets, adhering to a Mediterranean diet is sustainable in the long run because the regimen is varied and doesn't make you feel like you're denying yourself from eating what you'd like, says Dr. Samia Mora, a cardiologist at the Brigham and Women's Hospital in Boston and the senior author of the new study. She's also an associate professor of medicine at Harvard Medical School. "It includes a wide variety of foods, and it's not a low-fat diet but a moderate-fat diet," she says. "That's why people can sustain it, because you're not depriving yourself of any particular food." And you don't have to go to an all-Mediterranean eating regiment to realize health benefits. Adding more servings of fruits, vegetables, whole grains and other Mediterranean staples to your diet can improve your health. "You don't have to go 100 percent," Mora says. "It's a great diet."

For women seeking to ward off cardiovascular disease, here are some of the benefits of eating a Mediterranean diet:

  • Reduced inflammation.
  • Lower cholesterol.
  • Improved glucose metabolism.
  • Lower blood pressure.
  • Reduced body mass index 

1. Reduced inflammation.

Inflammation in the body is a risk factor for cardiovascular disease and is associated with other health conditions, like cancer, rheumatoid arthritis, obesity and diabetes, Ostfeld says. "Increased inflammation in the body can promote the development and progression of plaque in the blood vessels that feed our heart with blood," he says. Increased plaque in the blood vessels is associated with increased risk of heart attack or stroke. Consuming a Mediterranean diet can help you reduce inflammation, and therefore your risk of cardiovascular disease, Ostfeld says.

2. Lower cholesterol.

With an emphasis on vegetables, fruit, whole grains, legumes, nuts and healthy fats like olive oil and avocado, the Mediterranean diet is helpful in reducing "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides, which can build up plaque in the blood vessels and increase the risk of cardiovascular disease, says Dr. Victoria Shin, a cardiologist with Torrance Memorial Medical Center in Torrance, California. "These are all foods that have a lot of nutrients but are low in saturated fats that increase bad cholesterol," Shin says. The Mediterranean diet also limits the consumption of red meat and fried foods, which helps lower cholesterol.

3. Improved glucose metabolism.

Insulin, secreted from the pancreas, helps transport glucose from blood into muscles, where it is stored, Ostfeld says. The Mediterranean diet is low in saturated fat and added sugars, the consumption of which can increase inflammation and fat deposits in the muscles. This makes it harder for insulin to transport glucose into the muscles, which leads to insulin resistance and diabetes, he says. Both insulin resistance and diabetes degrade the health of blood vessels, which put a strain on the heart and can lead to cardiovascular disease or a stroke, Ostfeld says.

4. Lower blood pressure.

Consuming a Mediterranean regimen encourages weight loss, which helps keep blood pressure at proper levels, Bobra says. The Mediterranean diet also encourages cooking with spices and natural herbs instead of salt. High blood pressure, a risk factor for cardiovascular disease, can be exacerbated by increased salt intake, she says.

5. Reduced body mass index.

Two-thirds of U.S. women are overweight or obese, according to the Centers for Disease Control and Prevention. Being overweight or obese can promote inflammation, increased insulin resistance and high blood pressure, which are all risk factors for cardiovascular disease, Ostfeld says. Eating a Mediterranean diet can help you lose weight and mitigate those risk factors, he says.

Ruben Castaneda, Staff Writer

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