For years we have heard about the mediterranean diet and the anomalous finding that despite relatively high dietary fat intake the people living in Greece, Italy, Southern France (in particular) have very low frequency of vascular disease. This has been ascribed to the particular characteristics of the ‘mediterranean diet’ with its high intake of olive oil, especially extra-virgin olive oil, which is rich in polyphenols and monounsaturated fat, and mixed nuts which are rich in polyphenols, monounsaturated fat, and polyunsaturated fat, including alpha-linolenic acid.

A recently published article in the PNEJM actually performed the first big prospective randomized trial of primary prevention of vascular disease in high risk men and women, over 55 for men, over 60 for women, with other risk factors or type 2 diabetes. The intervention was dietary advice to eat a mediterranean diet with extra extra-virgin olive oil (1 litre a week!) or extra mixed nuts (30 g a day).

They stopped the trial early as there were much more composite endpoints (myocardial infarction, stroke or cardiovascular death) in the controls.

The diet included advice to use extra-virgin olive oil as the only dietary oil (including for cooking) and at least 7 glasses of wine a week.

I think I am part way there….