PREDIMED Mediterranean Diet Evidence — EECC MCQ

Correct answer: E — The PREDIMED trial showed the Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced MACE by ~30% compared with a low-fat diet in high-risk individuals — it is the dietary pattern with the strongest cardiovascular evidence and is recommended by ESC Prevention Guidelines (Class I)

The PREDIMED trial (2013, republished 2018 after methodological corrections) randomised 7,447 high-CV-risk individuals without established CVD to: (1) Mediterranean diet + extra-virgin olive oil (~50 mL/day); (2) Mediterranean diet + mixed nuts (30 g/day); (3) control (low-fat diet advice). Both Mediterranean diet groups reduced the composite of MI, stroke, and CV death by ~30% (HR 0.70 for EVOO, 0.72 for nuts). The Mediterranean diet pattern: high in fruits, vegetables, legumes, whole grains, fish, olive oil, nuts; moderate wine consumption; low in red meat, processed foods, refined carbohydrates. The ESC 2021 CVD Prevention Guidelines recommend the Mediterranean diet as the preferred dietary pattern for cardiovascular prevention (Class I, LOE A). Additional benefits: reduced T2DM incidence, improved lipid profile, anti-inflammatory effects (reduced CRP).

Reference: ESC (2021): CVD Prevention; PREDIMED Trial