Steering clear of red meat, dairy and processed foods in favor of vegetables, fruits, nuts, extra virgin olive oil and whole grains will do a woman’s heart good, a new review shows.

How much good? Australian investigators concluded that women who most closely followed the Mediterranean diet — which also features legumes, fish and shellfish, and moderate amounts of wine — appeared to lower their long-term risk for heart disease and premature death by nearly 25%, compared with women who didn’t.

Though not involved in the analysis, Connie Diekman, a food and nutrition consultant and former president of the Academy of Nutrition & Dietetics, said the finding “is not surprising.”

For one, Diekman noted that “studies continue to demonstrate the benefit of a plant-based eating plan to reduce inflammation, a likely contributor to disease development. In addition, the limited intake of saturated fats (found predominantly in animal foods) and consumption of unsaturated fats (found in higher amounts in plants) seems to be connected to blood levels of LDL cholesterol (the ‘bad’ cholesterol) and HDL cholesterol (the ‘good’ cholesterol).”

Diekman added that past research has also shown that using olive oil and nuts that are high in unsaturated fats — both key foods in the Mediterranean diet — can help lower heart disease risk.

Dr. Gregg Fonarow is director of the Ahmanson-UCLA Cardiomyopathy Center, co-director of the UCLA Preventative Cardiology Program, and interim chief of University of California, Los Angeles’ division of cardiology.

Though also not involved in the review, Fonarow said that “the magnitude of associated [25%] benefit was similar to what has been previously reported for the overall population.”

Fonarow also pointed to several other reasons why such a diet might protect the heart, including its ability to improve insulin sensitivity; its antioxidant properties; and its “favorable impact on the microbiome [gut] that may translate into lower cardiovascular event risk.”

The research team was led by Anushriya Pant, a doctoral candidate with the Westmead Applied Research Centre at the University of Sydney in Australia.

Pant’s team pointed out that heart disease is the root cause for roughly 35% of all deaths among women around the world.

In the review, the investigators analyzed a total of 16 studies, all of which had been completed between 2003 and 2021.

Thirteen of the studies had been conducted in Europe or the United States. Collectively, they weighed the potential heart health benefit of the Mediterranean diet among more than 722,0000 adult women.

None of the women had signs of heart disease when the studies were launched. They were tracked for the onset of heart disease for an average of nearly 13 years, during which time participants also self-reported their dietary habits.

After analyzing all the studies, Pant’s team noted that they couldn’t establish a statistically significant benefit when it came to diet’s ability to reduce stroke risk, perhaps because many of the studies did not explore this potential link.

However, the team did find that those women who followed a Mediterranean diet most closely appeared to have a 24% lower risk for heart disease and a 23% lower risk for dying as a result of any disease, when compared with women whose eating habits were least in alignment.

The findings were published online March 14 in the journal Heart.

Diekman added that the uniqueness of the finding “is that the authors decided to focus on women,” given that more often the focus has been on men.

Still, Diekman cautioned that all of the studies under review were “observational,” meaning they relied on participants to report what they were eating, without asking any of them to alter their eating habits in any way.

That means “the studies included were not designed to demonstrate cause-and-effect,” and do not prove that following a Mediterranean diet will limit heart risk over time, she explained.

Still, Fonarow pointed out that findings have already “contributed to nutritional and dietary guidelines to recommend the Mediterranean diet” for both men and women.

More information

There’s more on plant-based diets and heart health at the American Heart Association.

SOURCES: Gregg Fonarow, MD, director, Ahmanson-UCLA Cardiomyopathy Center, co-director, UCLA Preventative Cardiology Program, and co-chief, UCLA’s division of cardiology, Los Angeles; Connie Diekman, RD, food and nutrition consultant, and former president, Academy of Nutrition & Dietetics; Heart, March 14, 2023, online

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