Eating a healthy Mediterranean diet could be better than statins at cutting the risk of an early death, a major study has found.
Leading experts said people with cardiovascular disease should be prescribed a diet high in olive oil, vegetables and nuts before doctors consider turning to pills.
The findings, presented in Rome at the world's biggest heart conference, found that people with cardiovascular disease who followed the diet were 37% less likely to die than patients who did not. Doctors said the study offers a simple way for people with heart disease to boost their survival chances – with no risk of side effects.
The Mediterranean diet is already known to protect healthy people from developing heart problems, diabetes and cancer.
But the new study is the strongest evidence to date that it could also be a powerful treatment for people who already have cardiovascular disease. These patients are nearly always prescribed statins, which reduce levels of cholesterol, and are proven to save lives. The medication cuts the chance of early death among people with cardiovascular disease by 18%, according to a 2013 review involving 200,000 patients.
Some experts say statins are priceless. But many GPs and patients are concerned about over-prescription of the pills. A Mediterranean diet is typically rich in fruit and vegetables, fish, and olive oil. It usually involves low levels of carbohydrate, sugar and processed food – but people who follow it do not usually count calories or watch their fat intake.
Experts think the diet has such a strong impact on heart patients because it is high in protective fats, such as omega-3 fatty acids and mono-unsaturated fatty acids.
The Italian team looked at the diet of nearly 1,200 heart patients and tracked them for seven years.
In that time 208 patients died. After taking into account other factors such as diabetes, smoking, cholesterol levels and age, they calculated that those who most closely followed the 'ideal' Mediterranean diet were 37% less likely to die during the study period than those whose eating patterns were the farthest from the Mediterranean diet.
Scientists warned that people prescribed the drugs should not stop taking them without speaking to their doctor. But they said people with heart disease – whether they are taking statins or not – could significantly improve their life expectancy if they changed their eating habits.
Researcher Professor Giovanni de Gaetano, of the IRCCS Neuromed Institute in Pozzilli, Italy, said: 'First of all doctors should consider diet before drugs.
'It could allow patients to get the benefits of statins but without the side effects.'
Presenting his data at the European Society of Cardiology Congress, Professor de Gaetano said statins remained important. But he added if more doctors advised patients to change their diet, statin use might be reduced. He suggested Government subsidies would make it easier for people to follow the Mediterranean diet. 'The problem is that the NHS pays for drugs, but it does not pay for vegetables and fruit.'
London cardiologist Dr Aseem Malhotra, who has long advocated a diet-driven approach to maintaining health, said the results were 'extraordinary'.
He added: 'The Mediterranean diet is more powerful than any drug at reducing death rates in patients with cardiovascular disease.
'It's the powerful anti-inflammatory effects of foods such as olive oil, nuts, oily fish and vegetables where the benefits lie, and unlike cholesterol-lowering statin drugs, come without side effects. It's time for the NHS to embrace lifestyle medicine to save it from the collapse being predominantly driven by diet-related disease.'
Professor Jeremy Pearson, associate medical director at the British Heart Foundation, added: 'It is good to know that even if you already have a history of cardiovascular disease, adhering to a Mediterranean diet reduces the risk of death.'
Pensioners who spend little more than half an hour a day pottering in the garden reduce their chance of dying from a heart attack or stroke by half, researchers have found.
Light exercise such as walking, fishing or gentle cycling for four hours a week was associated with a 54% reduction in deaths from heart conditions over the next 12 years, with a 31% drop in heart attacks and strokes, according to researchers at the University of Oulu in Finland.