Mediterranean diet and heart disease: Spanish study finds reduction in stroke, cardiac death rates

From the Globe

Spanish researchers tracked thousands of participants over roughly five years and found a 30 percent reduction in the rate of heart disease, primarily strokes, among the Mediterranean diet eaters compared with those who consumed more traditional low-fat fare. That diet included more starch and grains, but fewer nuts and oils.

Earlier studies analyzed health outcomes based on participants’ recall of meals and concluded there likely were benefits from a Mediterranean diet.

From the New England Journal of Medicine

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A total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean-diet groups had good adherence to the intervention, according to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval [CI], 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, versus the control group (109 events). No diet-related adverse effects were reported.

The folks at the Harvard School of Public Health have been touting the diet for years. More here from them:

The key to this longevity is a diet that successfully resisted the last 50 years of “modernizing” foods and drinks in industrialized countries. These modern trends led to more meat (mostly beef) and other animal products, fewer fresh fruits and vegetables, and more processed convenience foods. Ironically, this diet of “prosperity” was responsible for burgeoning rates of heart disease, obesity, diabetes, and other chronic diseases.

The “poor” diet of the people of the southern Mediterranean, consisting mainly of fruits and vegetables, beans and nuts, healthy grains, fish, olive oil, small amounts of dairy, and red wine, proved to be much more likely to lead to lifelong good health.

 Other vital elements of the Mediterranean Diet are daily exercise, sharing meals with others, and fostering a deep appreciation for the pleasures of eating healthy and delicious foods.

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Most Mass stroke patients arrive too late for clotbuster

Some of the hospital reps argue in this story that a lack of neurologists keeps them from giving tPA in time. But, the Globe also reports that only 4.5 percent of stroke patient make it to a hospital in time to qualify for the drug. Link here to the state’s actual study.

 From the Globe:

State officials said they found wide variation among hospitals in the use of a powerful stroke drug during the years 2006 to 2008, the most recent period for which data are available. The officials have been examining the data as part of an effort to improve care for the more than 10,000 Massachusetts residents each year who suffer strokes.

At 23 hospitals in the Boston area, 72 percent of eligible patients got the drug, called tissue plasminogen activator (tPA), which can halt a stroke and prevent patients from suffering serious lifelong disabilities. In Central Massachusetts, a region that includes Worcester, just 52 percent of stroke sufferers were given the treatment. Statewide, 62 percent of patients got the medication.

 More here from the state on its Primary Stroke Service:

In 2002, the Massachusetts Department of Public Health (MDPH) initiated a program with the goal of improving stroke care in Massachusetts. The Department promulgated licensure regulations in March 2004 which specified the requirements for a hospital to become a designated Primary Stroke Services (PSS). Only hospitals that are licensed by the Department of Public Health can apply to become designated. MDPH began designating hospitals meeting the requirements for Primary Stroke Service (PSS) later in 2004. PSS designation requires that hospitals follow very specific stroke protocols for patient assessment and care and commit to continuous education of the public about warning signs and symptoms of stroke. As part of its PSS designation, a hospital must provide emergency diagnostic and therapeutic services 24 hours-a-day, seven days-a-week to patients presenting with symptoms of acute stroke. These services are needed to ensure that every patient who arrives within hours of the start of his/her stroke symptoms and is eligible can be treated with IV-tPA. In follow up to the PSS program, a diversion plan for ambulances was created requiring the transport of patients presenting with symptoms of acute stroke to the nearest designated PSS hospital (bypassing non-PSS hospitals even if they are closer