A retracted and republished report of a primary prevention study in Spain reaffirmed that an energy-unrestricted Mediterranean diet supplemented with extra-virgin olive oil or nuts lowered rate of major cardiovascular events than a reduced-fat diet in persons at high risk for cardiovascular disease (CVD). The study included 7447 participants (55 to 80 years of age, 57% women) who were at high cardiovascular risk, but with no CVD at enrollment, with a median follow-up of 4.8 years. A primary end-point event (a composite of myocardial infarction, stroke, and death from cardiovascular causes) occurred in 288 participants; there were 96 events in the group assigned to a Mediterranean diet with extra-virgin olive oil (3.8%), 83 in the group assigned to a Mediterranean diet with nuts (3.4%), and 109 in the control group (4.4%). In the intention-to-treat analysis including all the participants and adjusting for baseline characteristics and propensity scores, the hazard ratio was 0.69 for a Mediterranean diet with extra-virgin olive oil and 0.72 for a Mediterranean diet with nuts, as compared with the control diet. Results were similar after the omission of 1588 participants whose study-group assignments were known or suspected to have departed from the protocol. The findings are consistent with other studies. Source: https://www.nejm.org/
