Mediterranean diet associated with lower risk of peripheral artery disease

A multicenter study that previously reported a reduction in heart attack and stroke with a Mediterranean diet supplemented with extra-virgin olive oil or with nuts now also reports a lower risk of peripheral artery disease, according to a study in the January 22/29 issue of JAMA.

The hypothesis that a Mediterranean diet may reduce the risk of peripheral artery disease (PAD) has never been tested in a randomized trial, according to background information in the article.

Miguel Ruiz-Canela, Ph.D., of the University of Navarra, Pamplona, Spain, and colleagues assessed the association of Mediterranean diets with the occurrence of symptomatic PAD in a randomized trial conducted from October 2003 and December 2010. Eligible participants were men 55 to 80 years of age and women 60 to 80 years of age without clinical PAD or baseline cardiovascular disease but with type 2 diabetes mellitus or at least 3 cardiovascular risk factors. Participants were randomized to 1 of 3 groups: a Mediterranean diet supplemented with extra-virgin olive oil; a Mediterranean diet supplemented with nuts; or counseling on a low-fat diet (control group). All participants received a comprehensive dietary educational program on a quarterly basis.

The trial included 7,477 participants, with an average age of 67 years, and 58 percent of whom were women. There were 89 confirmed new cases of clinical PAD after a median (midpoint) follow-up of 4.8 years. Both Mediterranean diet interventions were associated with a lower risk of PAD compared with the control group.

"To our knowledge, this is the first randomized primary prevention trial to suggest an association between a dietary intervention and [reduction in] PAD. These results are consistent with previous observational studies and relevant from a public health perspective," the authors write.