Research

Macro partitioning

Adherence to a Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts significantly reduces the incidence of major cardiovascular events (myocardial infarction, stroke, or cardiovascular death) in high-risk individuals compared to a control low-fat diet.

If you are at high risk for heart disease (e.g., high blood pressure, diabetes, or high cholesterol), switching to a Mediterranean-style diet can significantly lower your risk of heart attack or stroke. You don't need to count calories; instead, focus on adding specific foods. Aim to eat about 4 tablespoons of extra-virgin olive oil daily and a small handful (30g) of mixed nuts (walnuts, almonds, hazelnuts) every day. Replace refined vegetable oils and processed meats with these whole-food fats. This approach was shown to be more effective than a standard low-fat diet in reducing major cardiovascular events over nearly 5 years.

LimitedSupportsHIGH confidence
In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.
Ramón Estruch et al. · New England Journal of Medicine · 2018

Why this rating

High-quality randomized trial design, but the study was halted early due to protocol deviations in randomization, requiring sensitivity analyses and propensity score adjustments.

Source

Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts

Ramón Estruch et al. · New England Journal of Medicine · 2018

DOI 10.1056/nejmoa1800389

rct · n=7447Cited 3,431×
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DOI resolved against Crossref · corpus check 2026-06-10

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