PREDIMED & The Mediterranean Diet

We’re doing a classic article this week – looking at the PREDIMED study. PREDIMED stands for Prevención con Dieta Mediterránea (Prevention with Mediterranean Diet). PREDIMED is the study that led to claims such as “olive oil and/or nuts and/or ‘The Mediterranean Diet’ can prevent heart disease.” To date there have been 238 publications from this one study. The main publication from the study (Ref 1) has been cited by other articles 2,596 at the time of writing this note. That is immense.

As we will see, PREDIMED was a strange trial. Ostensibly it was two interventions, compared against one control. Had the interventions changed one thing alone – olive oil in one arm and nuts in the other arm – and compared these against a control that changed nothing, perhaps we could eulogise about olive oil and nuts. However, this was not what happened.

Upon closer examination, it transpires that there was no control. To be more specific – the group that experienced the most change was in fact the so-called control.

The authors’ conclusion was “Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events.” My conclusion would be: “Among Spanish people, aged 55-80, mostly women, at high cardiovascular risk, a low-fat diet increased the incidence of major cardiovascular events (only strokes significantly) by 3 events per 1,000 person years.”

Let’s take a good look at this fascinating study...


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