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Mediterranean Diet — EECC MCQ

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EasyHypertension & Preventive CardiologyMediterranean DietEECC

A 48-year-old woman with no CVD has a total cholesterol of 6.2 mmol/L and LDL-C of 4.0 mmol/L. Her GP calculates a SCORE2 risk and finds it is in the moderate-risk range. She does not want to take medications. Which dietary pattern has the strongest evidence for CVD risk reduction?

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Correct answer: D — Mediterranean diet — rich in olive oil, nuts, fish, fruits, vegetables, and whole grains, with limited red meat and processed foods

The PREDIMED trial demonstrated that a Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts reduced major cardiovascular events by approximately 30% compared with a low-fat control diet. The ESC Prevention Guidelines (2021) recommend the Mediterranean dietary pattern as the best-evidenced dietary approach for CVD prevention (Class I, LOE A). Key components include: high consumption of olive oil, nuts, fruits, vegetables, legumes, fish, and whole grains; moderate wine consumption; and low consumption of red/processed meat, refined carbohydrates, and ultra-processed foods. While other dietary patterns may have metabolic benefits, the Mediterranean diet has the strongest RCT evidence for hard cardiovascular endpoints.

Reference: ESC (2021): Guidelines on Cardiovascular Disease Prevention; PREDIMED Trial