Mediterranean‐Style Diet For The Primary And Secondary Prevention Of Cardiovascular Disease, Cochrane Library, 19 March 2019

Authors’ conclusions:

Despite the relatively large number of studies included in this review,* there is still some uncertainty regarding the effects of a Mediterranean‐style diet on clinical endpoints and CVD risk factors for both primary and secondary prevention. The quality of evidence for the modest benefits on CVD risk factors in primary prevention is low or moderate, with a small number of studies reporting minimal harms. There is a paucity of evidence for secondary prevention. The ongoing studies may provide more certainty in the future.

* In this substantive review update, 30 randomised controlled trials [RCTs] (49 papers) (12,461 participants randomised) and seven ongoing trials met our inclusion criteria.

I suspect Cochrane found uncertainty regarding the effects of a Mediterranean diet because the Mediterranean diets used in the interventions were higher in fat, alcohol, meat, and dairy food than the Mediterranean diet followed by people prior to Western influence. (The large PREDIMED trial, which did not find benefit for “heart attacks, death from heart disease or other causes” was included.) (See my Mediterranean Diet Posts 1 through 11 for backup).