The Lyon Diet Heart Study: dietary implications

This study has shown that a Mediterranean-type diet reduces the risk of a second heart attack. How has it affected your diet?
By John Russo Jr./
VICUS.COM (1 Aug. 2000) — Once again, the French lead the way in good eating. This time it’s not just good for your palate; it’s good for your heart as well.

Mediterranean diet tips:

A Mediterranean diet is easy to follow, and it tastes good! Here are six steps to a healthy Mediterranean diet:

• Eat fish and lean poultry a few times each week.

• Cook with olive oil or canola oil.

• When eating in a restaurant that does not cook with olive oil, ask for as little oil as possible and put all dressings and sauces “on the side.” This way you can control how much oil you eat.

• Eat lots of fruits, vegetables, beans and other plant foods.

• Limit consumption of red meat and saturated fat intake. When you have a choice between red meat, pork or fish, choose fish, preferably grilled.

• Drink alcoholic beverages in moderation (not more than two drinks per day for men and one drink per day for women).

A year ago, the Lyon Diet Heart Study reported that a Mediterranean-type diet reduced the risk of a second heart attack in people who had a previous myocardial infarction (De Lorgeril, et al., Feb 1999).

If you have not yet incorporated Mediterranean cuisine into your diet, now is the time to start. Here are the results that left this change in your diet and some recommendations for a successful change to healthier eating.

The Lyon study 

Approximately half of 600 men and women included in the French study who had had a first heart attack were advised to eat a Mediterranean-style diet that was rich in fruits, vegetables, fish, cereals and beans. The Mediterranean diet included more oleic and alpha-linolenic fatty acids, which are the omega-3 fatty acids found in canola, olive and certain nut oils.

Those in the study who followed the “Western diet” consumed more linoleic or omega-6 fatty acids found in soy and sunflower oils.

Otherwise, the groups were very similar: 30% of calories in the Mediterranean diet came from fat, 8% from saturated fat. The Western diet obtained 34% of total calories from fat and almost 12% from saturated fat. The intake of dietary fiber was higher in the Mediterranean group, about 3 grams, indicating a higher intake of antioxidants and B vitamins found in fruits and vegetables.

The investigators assessed the effect of these diets on three outcomes: cardiac death and nonfatal myocardial infarction; this first outcome in addition to major secondary end points (unstable angina, stroke, heart failure, pulmonary or peripheral embolism); and these first two outcomes plus minor events requiring hospital admission.

Results of study

After 36 months, the participants in the study were similar in body fat, blood pressure and in the number of smokers in each group. However, those who followed the Mediterranean diet had statistically significant reductions in each of the outcomes studied — lower prevalence of cardiac death and nonfatal myocardial infarction, fewer major secondary events such as stroke and pulmonary embolism, and reduced hospitalizations.

Interestingly, the Mediterranean diet did not appear to alter the relationships between major risk factors (e.g., total cholesterol and systolic blood pressure) and protective factors (e.g., female sex and aspirin use) vs. recurrence of myocardial infarction. Therefore, the investigators concluded that a comprehensive strategy to decrease cardiovascular morbidity and mortality should include primarily a cardioprotective diet combined with other options to reduce modifiable risk factors. (Note: The Mediterranean diet is not a substitute for medical treatment for heart disease.)

A Mediterranean diet is high in antioxidants, vitamins and certain fatty acids. It also contains a considerable amount of fat (this is one reason it tastes good). But it is healthier because the olive oil in Mediterranean cooking is high in monounsaturated fat and low in polyunsaturated and saturated fats.

Bon appetit!

John Russo Jr., Pharm.D., is senior vice president of medical communications at He is a pharmacist and medical writer with more than 20 years of experience in medical education.


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De Lorgeril M, Salen P, et al. Control of bias in dietary trial to prevent coronary recurrences: the Lyon Diet Heart study. Eur J Clin Nutr. 1997 Feb; 51(2):116-22.

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