The Mediterranean Diet: Is It Cardioprotective?

Marita C. Bautista, RN; Marguerite M. Engler, PhD, RN, MS


Prog Cardiovasc Nurs. 2005;20(2):70-76. 

In This Article


Increasing evidence suggests that a Mediterranean-style diet rich in fruits, vegetables, nuts, fish, and oils with monounsaturated fat and low in meat is beneficial for CV health. The findings demonstrate the effectiveness of a "whole-diet approach" in the reduction of CV risk and death from all causes. The Mediterranean diet is cardioprotective because of its positive effects on lipid profile, endothelial function, vascular inflammation, and insulin resistance. Studies also suggest that omega-3 fatty acids, integral components of the Mediterranean diet, exert many other beneficial CV effects. Although the physiological mechanisms underlying these effects require further investigation, the research findings suggest that increased intake of healthy fats and other nutrients found in the Mediterranean diet improves CV outcomes.

The studies also suggest that the Mediterranean diet can be adhered to over several years and that the benefits can be maintained long-term. Finally, the Mediterranean diet offers an adjunctive or alternative nutritional approach to current dietary therapy to reduce CHD, and its benefits are realized in other cultures.

An opportunity exists for nurses to develop educational strategies for the implementation of the Mediterranean diet as a nutritional approach for primary and secondary prevention of CHD. Partnerships with nutritionists and other members of the health care team can enhance the learning experience for patients. Individual or group-oriented programs can incorporate elements of behavioral and psychological counseling, skill building in reading food labels and making heart-healthy food choices, interactive cooking demonstrations, and self-monitoring of dietary patterns. Dietary plans can be individualized to specific cultures and environments with possible food substitutions and modifications to recipes based on seasonal availability of food products.[42] Supplemental information such as literature and Web-based modules can augment the educational program. Follow-up of progress by telephone or E-mail communication allows for monitoring of individual responses and assessment of adherence to the Mediterranean dietary plan.

The findings have important implications for future investigations. Further research investigating the physiologic mechanisms associated with the cardioprotective effects of the Mediterranean diet is needed. Studies are also needed to clarify whether individual or cumulative effects of the multiple dietary components confer the CV health benefits.[11] Moreover, investigations that determine whether the Mediterranean diet alone or in combination with other lifestyle factors accounts for the reduction in CV risk are needed.[43] For example, geographic, cultural, and social variations may play a significant role in impacting CHD outcomes, and consideration of these factors will help determine whether the study findings may be extended to other populations.[5] Although current research suggests that the Mediterranean diet may be successfully implemented in other cultures, studies that evaluate the effectiveness of the Mediterranean diet in the Western world (particularly in the United States) are lacking. Finally, studies that compare the effectiveness of the Mediterranean diet guidelines with those of the recently updated ATP III guidelines would help optimize current dietary management recommendations for CV health.


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