TY - JOUR
T1 - Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study)
T2 - A randomised single-blind trial
AU - Singh, Ram B.
AU - Dubnov, Gal
AU - Niaz, Mohammad A.
AU - Ghosh, Saraswati
AU - Singh, Reema
AU - Rastogi, Shanti S.
AU - Manor, Orly
AU - Pella, Daniel
AU - Berry, Elliot M.
PY - 2002/11/9
Y1 - 2002/11/9
N2 - Background: The rapid emergence of coronary artery disease (CAD) in south Asian people is not explained by conventional risk factors. In view of cardioprotective effects of a Mediterranean style diet rich in α-linolenic acid, we assessed the benefits of this diet for patients at high risk of CAD. Methods: We did a randomised, single-blind trial in 1000 patients with angina pectoris, myocardial infarction, or surrogate risk factors for CAD. 499 patients were allocated to a diet rich in whole grains, fruits, vegetables, walnuts, and almonds. 501 controls consumed a local diet similar to the step I National Cholesterol Education Program (NCEP) prudent diet. Findings: The intervention group consumed more fruits, vegetables, legumes, walnuts, and almonds than did controls (573 g [SD 127] vs 231 g [19] per day p<0.001). The intervention group had an increased intake of whole grains and mustard or soy bean oil. The mean intake of α-linolenic acid was two-fold greater in the intervention group (1.8 g [SD 0.4] vs 0.8 g [0.2] per day, p<0.001). Total cardiac end points were significantly fewer in the intervention group than the controls (39 vs 76 events, p<0.001). Sudden cardiac deaths were also reduced (6 vs 16, p=0.015), as were non-fatal myocardial infarctions (21 vs 43, p<0.001). We noted a significant reduction in serum cholesterol concentration and other risk factors in both groups, but especially in the intervention diet group. In the treatment group, patients with pre-existing CAD had significantly greater benefits compared with such patients in the control group. Interpretation: An Indo-Mediterranean diet that is rich in α-linolenic acid might be more effective in primary and secondary prevention of CAD than the conventional step I NCEP prudent diet.
AB - Background: The rapid emergence of coronary artery disease (CAD) in south Asian people is not explained by conventional risk factors. In view of cardioprotective effects of a Mediterranean style diet rich in α-linolenic acid, we assessed the benefits of this diet for patients at high risk of CAD. Methods: We did a randomised, single-blind trial in 1000 patients with angina pectoris, myocardial infarction, or surrogate risk factors for CAD. 499 patients were allocated to a diet rich in whole grains, fruits, vegetables, walnuts, and almonds. 501 controls consumed a local diet similar to the step I National Cholesterol Education Program (NCEP) prudent diet. Findings: The intervention group consumed more fruits, vegetables, legumes, walnuts, and almonds than did controls (573 g [SD 127] vs 231 g [19] per day p<0.001). The intervention group had an increased intake of whole grains and mustard or soy bean oil. The mean intake of α-linolenic acid was two-fold greater in the intervention group (1.8 g [SD 0.4] vs 0.8 g [0.2] per day, p<0.001). Total cardiac end points were significantly fewer in the intervention group than the controls (39 vs 76 events, p<0.001). Sudden cardiac deaths were also reduced (6 vs 16, p=0.015), as were non-fatal myocardial infarctions (21 vs 43, p<0.001). We noted a significant reduction in serum cholesterol concentration and other risk factors in both groups, but especially in the intervention diet group. In the treatment group, patients with pre-existing CAD had significantly greater benefits compared with such patients in the control group. Interpretation: An Indo-Mediterranean diet that is rich in α-linolenic acid might be more effective in primary and secondary prevention of CAD than the conventional step I NCEP prudent diet.
UR - http://www.scopus.com/inward/record.url?scp=0037048928&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(02)11472-3
DO - 10.1016/S0140-6736(02)11472-3
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C2 - 12433513
AN - SCOPUS:0037048928
SN - 0140-6736
VL - 360
SP - 1455
EP - 1461
JO - Lancet
JF - Lancet
IS - 9344
ER -