This study was conducted in Spain with 7,447 participants and showed a significant (approximately 30%) reduction in the combined endpoint of heart attack, stroke and cardiovascular death.
The trial was a primary prevention trial with enrollment limited to individuals who were at risk for developing future heart attacks and strokes but without any prior history of cardiovascular events. Participants were allocated to one of 3 groups: a Mediterranean Diet with supplemental extra virgin olive oil, a Mediterranean Diet with supplemental tree nuts, and a control diet consisting on advice to reduce all types of dietary fat, though actually there was little reduction in fat intake. Median follow-up of trial participants was 4.8 years. This trial shows benefits occurring in patients without prior heart disease, which expands on the Lyon Diet Heart Trial results showing a reduction in heart attack as well as a reduction in total mortality with a Mediterranean Diet in patients who survived an acute myocardial infarction (i.e., it was a secondary prevention trial).
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