The Lyon Heart Study was a randomized, controlled trial conducted in France between 1988 and 1992, to investigate the effects of a Mediterranean-style diet on cardiovascular disease (CVD) outcomes in patients who had previously experienced a myocardial infarction (MI), or heart attack. The study is considered a landmark in the field of cardiovascular nutrition, as it demonstrated the benefits of dietary changes for heart health, and challenged the traditional focus on pharmaceutical interventions.
The Lyon Heart Study
The study enrolled 605 participants, aged 35-70 years, who had suffered a myocardial infarction in the previous 6 months. Participants were excluded if they had a history of other significant cardiovascular events, or if they had any conditions that would interfere with their ability to comply with the study protocol. Participants were randomly assigned to one of two groups: the control group, which received advice on a low-fat, American Heart Association (AHA) diet, or the intervention group, which received advice on a Mediterranean-style diet.
The control group was advised to follow a low-fat, AHA diet, which included less than 30% of calories from fat, less than 10% of calories from saturated fat, and less than 300 mg of cholesterol per day. The intervention group was advised to follow a Mediterranean-style diet, which included less than 35% of calories from fat, less than 8% of calories from saturated fat, and less than 100 mg of cholesterol per day. The Mediterranean-style diet was also rich in fruits, vegetables, legumes, whole grains, fish, and olive oil, and included moderate amounts of wine.
The baseline characteristics of the participants were similar between the two groups. The mean age of the participants was 56 years, and 86% were men. The mean body mass index (BMI) was 26 kg/m2, and 21% of participants had diabetes. The mean serum cholesterol level was 251 mg/dL, and 47% of participants had a history of smoking.
The primary endpoint of the study was a composite of cardiac death, non-fatal myocardial infarction, and stroke. The study found that after a mean follow-up of 27 months, the incidence of the primary endpoint was significantly lower in the intervention group than in the control group (2.0% vs. 7.9%; p=0.002). The secondary endpoint, which included all-cause mortality, was also significantly lower in the intervention group (3.1% vs. 9.8%; p=0.006).
Diet vs medication for cardiovascular health
The Lyon Heart Study demonstrated that dietary changes can have a significant impact on cardiovascular health, and can be even more effective than pharmacological interventions. The Mediterranean-style diet used in the study is rich in antioxidants, omega-3 fatty acids, and other beneficial nutrients, which can reduce inflammation, lower blood pressure, and improve lipid profiles. In contrast, many medications used to treat cardiovascular disease have significant side effects, and may not address the underlying causes of the disease.
Furthermore, dietary changes are often more sustainable and affordable than medications, and can have additional benefits for overall health and wellbeing. For example, a plant-based diet has been shown to reduce the risk of many chronic diseases, including cancer, diabetes, and obesity, and can improve mental health and cognitive function.
In conclusion, the Lyon Heart Study demonstrated that a Mediterranean-style diet significantly reduces the risk of recurrent cardiovascular events in patients who have experienced a heart attack. The study highlights the importance of dietary changes in the prevention and treatment of cardiovascular disease, and challenges the traditional focus on medications as the primary intervention. Healthcare providers should prioritize lifestyle interventions, such as dietary changes, in the management of cardiovascular disease.
If you wish to learn more about this or want to optimise your cardiovascular risk profile, please get in touch and Dr Grosser will thoroughly assess your risk and provide detailed advice.