The Mediterranean dietary patterns are associated with lower CHD rates and with improved CHD risk factors. In the interpretation of observational data, it is often difficult to separate the effects of diet from other factors, e.g., smoking and physical inactivity, that likely account, in part, for observed differences in CHD risk. Nonetheless, the totality of evidence documenting a beneficial impact of Mediterranean dietary patterns on CHD risk is remarkable and consistent in both the original Seven Countries Study and in recent studies of populations with Western variants of the original diet. Cardiovascular disease risk reduction by consumption of the Mediterranean diet may be mediated through demonstrated effects on traditional CVD risk factors of through effects of factors which reduce oxidative stress.
Overall, such findings have tremendously important public health implications. Despite broad variation in geography, lifestyle, and locally available foods, it is evident that for most populations, a Mediterranean style diet that reduces CHD risk is readily available. The public health challenge is achieving population-wide adoption of beneficial dietary patterns in the setting of powerful influences that promote unhealthy lifestyles.
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