Keep in MIND: The Mediterranean Diet is a ‘Gold Standard’ for Heart Health

February 16, 2024

February is Heart Health Month, a month where hearts are at the forefront of everything, whether it’s thinking about and sharing love, or cardiovascular health and how to reduce risk and prevent cardiovascular disease.  You may wonder what’s considered “cardiovascular disease.”  It’s actually not a particular disease, but an umbrella term used to describe several diseases, including heart disease, heart attack, stroke, heart failure, arrhythmia, and heart valve problems.1  Thus, cardiovascular disease impacts millions of Americans.  In fact, according to the CDC, heart disease is the 1st and stroke is the 5th leading cause of death in the United States, and these are the two biggest components of cardiovascular disease that we’ll be focusing on here.2  And just in case you’re wondering, one of the biggest drivers and risk reduction tools for cardiovascular disease is a proper diet, with the Mediterranean diet being a top choice.3  

Focus on Heart Disease: Are You at Risk? 

Heart disease itself also encompasses several types of heart conditions, with coronary artery disease (or CAD) being the most common.  CAD involves the buildup of plaque inside the arteries which can reduce blood flow to the heart.  Plaque is formed when fatty substances, cholesterol, calcium, and a protein involved in blood clotting called fibrin are deposited in the walls of the arteries.  More complications including heart attack, heart failure, angina, or arrhythmias can occur when the heart doesn’t get enough blood flow.4 

How do you know if you’re at risk?  There are several factors which can increase your risk of heart disease, including poor diet, inactivity, age, smoking, and not managing other health conditions.  In fact, in terms of poor diet, each additional serving of ultra-processed foods was associated with a 7% increased risk of incident cardiovascular disease.5  Among such other health conditions, a critical one to keep in check is metabolic syndrome, which is associated with a 50-60% increased risk of cardiovascular disease.6 

Stroke Risk and Heart Health 

A stroke occurs when the blood supply to part of the brain is blocked or when a blood vessel bursts in the brain, leading to brain damage.  There are different types of strokes, with ischemic and hemorrhagic strokes being the major types of strokes.  Ischemic strokes are more common and occur when blood flow is blocked by either a blood clot or built-up plaque clogging an artery.  Hemorrhagic strokes occur when a blood vessel bursts and blood leaks into the brain, causing brain damage due to high pressure build up.  Transient ischemic attacks (or TIAs) are often referred to as “mini-strokes” and are a temporary attack similar to a stroke.  A TIA can signal risk of a future stroke and is accompanied by symptoms similar to that of a stroke including weakness, blurred vision, slurred speech, and vertigo.7 

Strokes are related to heart health because the same plaque that builds up in the arteries throughout the body during CAD also builds up in the arteries in the brain, increasing risk of ischemic stroke.  The risk factors for stroke are also very similar to those of heart disease, including hypertension (high blood pressure), high cholesterol, diabetes, obesity, and smoking.  Hypertension alone is associated with 54% of strokes worldwide, and studies have found each 10 mmHg increase in systolic blood pressure increases the risk of ischemic stroke by 28% and hemorrhagic stroke by 38%.8,9 

Mediterranean Diet, a Gold Standard for Heart Health & Stroke Reduction:  

The Mediterranean diet has been associated with reducing heart disease risk by nearly 33%.3  As a comparison, some of the best drugs for cardiovascular disease reduce risk by about 25%, less than if you decided to follow the Mediterranean diet.  More specifically, the Mediterranean diet has been linked to promoting health in many ways, including lowering blood pressure, improving insulin resistance, reducing inflammation, weight loss, fighting oxidative stress, improving lipid levels and more.10,11  Diet really is medicine! 

How did we come to know this?  The Mediterranean diet may be well-known today for its many health benefits, but cardiovascular disease reduction was the original inspiration for the first research studies of how the Mediterranean diet affects health.  It began with Ancel Keys, a physiologist who first established the association between the Mediterranean diet and cardiovascular health in the late 1950s.  Keys kickstarted research into the Mediterranean diet which has continued until today, including the recent PREDIMED clinical trial in Spain, which used the Mediterranean diet as a primary prevention tool for cardiovascular disease.12  (Later, PREDIMED also provided key evidence that the Mediterranean diet benefits cognitive health.13)  

While the Mediterranean diet as a whole is recommended for heart health, there are certain foods and nutrients which are particularly beneficial to reduce cardiovascular risk: 

  • Fish, like sardines and salmon, contain high amounts of omega-3’s, which support heart health by reducing cholesterol and other fatty substances in the blood and lowering blood pressure, which are believed to be brought about by reducing inflammation, fighting oxidation, and inhibiting coagulation.11 
  • Olive oil is rich in unsaturated fats, which helps improve lipid levels, including increasing HDL, the “good” cholesterol, and regulating blood pressure.14 
  • Fruits and vegetables are packed with micronutrients like vitamins, minerals, flavonoids (like kaempferol, quercetin), and carotenoids (like lutein and zeaxanthin), supporting heart health by fighting inflammation and serving as potent antioxidants.  In fact, there is a 4% relative risk reduction in cardiovascular disease with each serving of vegetables, along with a 7% relative risk reduction in cardiovascular disease with each daily increase in servings of fruit, a big motivation for “stacking-up” risk reducing foods.11 
  • Whole grains, like oats and barley, are associated with a 21% reduction in cardiovascular disease events and are a major source of fiber in the diet.  Similar to other key Mediterranean diet foods, whole grains are thought to exert their effects by reducing inflammation and reactive oxidation, improving lipid profiles, and reducing blood pressure.11 
  • Nuts reduce the risk for cardiovascular disease by about 40%, while legumes have been associated with an 11% risk reduction.  Nuts in particular are associated with improving vascular function, reducing blood pressure, and improving cardiovascular morbidity and mortality.11  

Why Managing Heart Health is Important for Brain Health 

Heart health and brain health are directly linked, and paying close attention to both during midlife can help you keep your heart and brain healthy as you age.  For example, the worsening of cardiovascular risk is associated with cognitive decline in midlife and an increased risk of dementia.  Midlife cardiovascular risk factors impacting dementia risk include hypertension, hypercholesterolemia, and vascular stiffness/dysfunction.15,16  

Coronary heart disease is associated with a 26% increased risk of dementia, and recent research suggests that a younger age of onset of coronary heart disease is associated with greater risk of dementia.17  Stroke is strongly linked to dementia as well.  In fact, one study found that 7 years following stroke, 37% of participants had mild cognitive impairment and 22% had dementia.18 

Heart disease and stroke affect risk for vascular dementia, a type of dementia which is caused by brain damage resulting from decreased blood flow in the brain.  Vascular dementia is the second most common form of dementia (the first being Alzheimer’s disease), and the risk factors for vascular dementia happen to be the same as those for cardiovascular disease.16  In fact, vascular dementia can be caused by a stroke in some cases.  We’ll be delving deeper into vascular dementia later this month! 

Mediterranean and DASH Diets = MIND Diet 

Another dietary pattern like the Mediterranean diet is the DASH diet (Dietary Approaches to Stop Hypertension), which focuses more on reducing sodium intake and is also commonly recommended for heart health.  The combination of the DASH and Mediterranean diets, as well as a focus on foods and nutrients that have strong evidence for brain health benefits, creates the MIND diet.  The MIND diet mainly focuses on supporting brain health, but not surprisingly, it is also effective for heart health.  In fact, the MIND diet can help people who have already had a stroke and reduce cognitive decline after a stroke!19  

Our nutritional supplement RELEVATE supplies 17 nutrients from the Mediterranean diet which have many benefits for both heart and brain health.  Specific nutrients in RELEVATE are particularly associated with stroke reduction, including vitamin D3, B vitamins, green tea catechins, and magnesium.20-23  Also, RELEVATE’s nutrients can help reduce chances of health conditions that may lead to cognitive decline down the road.  

During February, Heart Health Month, it’s important to give extra consideration to our own and our loved ones’ heart health.  Every beat our heart pumps life to the rest of our body, it’s the core of our health.  

Learn more about risk factors you can take control of to improve your brain and heart health by downloading our FREE E-Guide “6 Steps to Building Lasting Brain Power,” click here to download.  

References

  1. What is Cardiovascular Disease. American Heart Association. http://www.heart.org/HEARTORG/Caregiver/Resources/WhatisCardiovascularDisease/What-is-Cardiovascular-Disease_UCM_301852_Article.jsp. Published 2024.
  2. Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2021.; 2022.
  3. Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Cardiovascular Health: A Critical Review. Circ Res. 2019;124(5):779-798. doi:10.1161/CIRCRESAHA.118.313348
  4. About Heart Disease. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/about.htm. Published 2023.
  5. Juul F, Vaidean G, Lin Y, Deierlein AL, Parekh N. Ultra-Processed Foods and Incident Cardiovascular Disease in the Framingham Offspring Study. J Am Coll Cardiol. 2021;77(12):1520-1531. doi:10.1016/j.jacc.2021.01.047
  6. Qiao Q, Gao W, Zhang L, Nyamdorj R, Tuomilehto J. Metabolic syndrome and cardiovascular disease. Ann Clin Biochem. 2007;44(3):232-263. doi:10.1258/000456307780480963
  7. About Stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/about.htm. Published 2023.
  8. Gaciong Z, Siński M, Lewandowski J. Blood pressure control and primary prevention of stroke: Summary of the recent clinical trial data and meta-analyses. Curr Hypertens Rep. 2013;15(6):559-574. doi:10.1007/s11906-013-0401-0
  9. Blood pressure and your brain. Harvard Health Publishing, Harvard Medical School. https://www.health.harvard.edu/heart-health/blood-pressure-and-your-brain. Published 2022.
  10. Fan H, Wang Y, Ren Z, et al. Mediterranean diet lowers all-cause and cardiovascular mortality for patients with metabolic syndrome. Diabetol Metab Syndr. 2023;15(1):1-16. doi:10.1186/s13098-023-01052-7
  11. Widmer RJ, Flammer AJ, Lerman LO, Lerman A. The Mediterranean diet, its components, and cardiovascular disease. Am J Med. 2015;128(3):229-238. doi:10.1016/j.amjmed.2014.10.014
  12. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018;378(25). doi:10.1056/NEJMoa1800389
  13. Martínez-Lapiscina EH, Clavero P, Toledo E, et al. Mediterranean diet improves cognition: The PREDIMED-NAVARRA randomised trial. J Neurol Neurosurg Psychiatry. 2013;84(12):1318-1325. doi:10.1136/jnnp-2012-304792
  14. Seidita A, Soresi M, Giannitrapani L, et al. The clinical impact of an extra virgin olive oil enriched mediterranean diet on metabolic syndrome: Lights and shadows of a nutraceutical approach. Front Nutr. 2022;9(August):1-13. doi:10.3389/fnut.2022.980429
  15. Farnsworth Von Cederwald B, Josefsson M, Wåhlin A, Nyberg L, Karalija N. Association of Cardiovascular Risk Trajectory With Cognitive Decline and Incident Dementia. Neurology. 2022;98(20):E2013-E2022. doi:10.1212/WNL.0000000000200255
  16. Brain J, Greene L, Tang EYH, et al. Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses. Front Epidemiol. 2023;3(February):1-14. doi:10.3389/fepid.2023.1095236
  17. Liang J, Li C, Gao D, et al. Association Between Onset Age of Coronary Heart Disease and Incident Dementia: A Prospective Cohort Study. J Am Heart Assoc. 2023;12(23):1-9. doi:10.1161/JAHA.123.031407
  18. El Husseini N, Katzan IL, Rost NS, et al. Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association. Stroke. 2023;54(6):E272-E291. doi:10.1161/STR.0000000000000430
  19. Cherian L, Wang Y, Fakuda K, Leurgans S, Aggarwal N, Morris M. Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) Diet Slows Cognitive Decline After Stroke. J Prev Alzheimer’s Dis. 2019;6(4):267-273. doi:10.14283/jpad.2019.28
  20. Hankey GJ. B vitamins for stroke prevention. Stroke Vasc Neurol. 2018;3(2):51-58. doi:10.1136/svn-2018-000156
  21. Marek K, Cichoń N, Saluk-Bijak J, Bijak M, Miller E. The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients. 2022;14(13). doi:10.3390/nu14132761
  22. Zhao B, Hu L, Dong Y, et al. The effect of magnesium intake on stroke incidence: A systematic review and meta-analysis with trial sequential analysis. Front Neurol. 2019;10(JUL). doi:10.3389/fneur.2019.00852
  23. Lee J, Kim Y. Association between green tea consumption and risk of stroke in middle-aged and older Korean men: The health Examinees (HEXA) study. Prev Nutr Food Sci. 2019;24(1):24-31. doi:10.3746/pnf.2019.24.1.24
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