The Mediterranean Diet, Tested in a Landmark Heart Trial

In one of the largest dietary trials ever run, 7,447 older Spanish adults at high cardiovascular risk, 57 percent of them women, were randomly assigned to a Mediterranean diet topped up with either extra virgin olive oil or mixed nuts, or to a reduced-fat control diet, and followed for close to five years. Those on either Mediterranean diet had roughly 30 percent fewer major cardiovascular events, meaning heart attack, stroke or cardiovascular death, than the control group. The trial carries an honest complication worth knowing: the original 2013 paper was retracted over irregularities in how some participants were randomised, then reanalysed and republished in 2018 with the main conclusion intact. It remains the largest trial of this diet, and it sits within a wide body of evidence pointing the same way. For a woman in midlife thinking about her heart, it supports a pattern built on olive oil, vegetables, fish, nuts and pulses as a genuinely protective way to eat.