One of the best-studied diets for cardiovascular health is the
Mediterranean diet. This consists of fish, monounsaturated
fats from
olive oil, fruits, vegetables, whole grains, legumes/nuts, and moderate alcohol consumption. The
Mediterranean diet has been shown to reduce the burden, or even prevent the development, of
cardiovascular disease,
breast cancer, depression,
colorectal cancer, diabetes,
obesity,
asthma,
erectile dysfunction, and
cognitive decline. This diet is also known to improve surrogates of
cardiovascular disease, such as waist-to-hip ratio,
lipids, and markers of
inflammation, as well as primary
cardiovascular disease outcomes such as death and events in both observational and randomized controlled trial data. These enhancements easily rival those seen with more established tools used to fight
cardiovascular disease such as
aspirin, beta-blockers,
angiotensin-converting enzyme inhibitors, and exercise. However, it is unclear if the
Mediterranean diet offers
cardiovascular disease benefit from its individual constituents or in aggregate. Furthermore, the potential benefit of the
Mediterranean diet or its components is not yet validated by concrete
cardiovascular disease endpoints in randomized trials or observational studies. This review will focus on the effects of the whole and parts of the
Mediterranean diet with regard to both population-based and experimental data highlighting
cardiovascular disease morbidity or mortality and
cardiovascular disease surrogates when hard outcomes are not available. Our synthesis will highlight the potential for the
Mediterranean diet to act as a key player in
cardiovascular disease prevention, and attempt to identify certain aspects of the diet that are particularly beneficial for cardioprotection.