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Randomized controlled trial
Epidemiological and observational studies have suggested that high blood triglycerides are independently associated with increased cardiovascular disease. Nonetheless, no human studies have evaluated the independent effects of omega-3 fatty acids- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)- on de novo lipogenesis as a potential mechanism for their divergent triglyceride-lowering properties. A new clinical study found DHA more effective than EPA in lowering blood triglycerides.
The association between diet and cardiovascular health in the general population is well-established. Notwithstanding, there is limited evidence on the relation between dietary patterns and cardiovascular disease (CVD) outcomes among populations with type 2 diabetes mellitus. Various small randomized intervention studies conducted in people with type 2 diabetes exhibited modest changes in CVD risk factors with Dietary Approach to Stop Hypertension and Mediterranean diets, and a subgroup analysis of the Prevención con Dieta Mediterránea (PREDIMED) study showed the benefit of a Mediterranean diet on CVD risk in people with type 2 diabetes.
To further add to this evidence base, a new study from the Women’s Health Initiative evaluated the association between diet quality and CVD risk over time in postmenopausal women with type 2 diabetes. Researchers showed that a higher adherence to the alternate Mediterranean (aMed), characterized by high consumption of minimally processed plant-based foods and olive oil as the principal source of fat, was associated with lower risk of incident cardiovascular disease [HR Q5 vs Q1 0.77(95% CI 0.65–0.93)] in postmenopausal women with type 2 diabetes. Moreover, women with higher Dietary Approach to Stop Hypertension, and American Diabetes Association dietary pattern scores had also a lower risk of CVD compared with women with lower scores.
Furthermore, incident CVD, CVD mortality, and all-cause mortality was assessed in a new analysis from the Atherosclerosis Risk in Communities (ARIC) Study using four diet quality scores (Healthy Eating-Index, HEI -2015 score, Alternate HEI-2010, aMed, and DASH diet indices). Authors found that a higher diet quality, characterized by the adherence to the abovementioned dietary indices, was associated with reduced risks of incident CVD, CVD mortality and all-cause mortality in 12,413 black and white adults.
Overall, the best evidence-based, healthy, sustainable diet is the Mediterranean Dietary Pattern, based primarily on olive oil, grains, pulses fruits and vegetables. Nonetheless, there has been a gradual abandonment of this traditional pattern as a result of the current socioeconomic situation, which may have an impact on health and the environment.