From the Guidelines
The Mediterranean diet is the top dietary approach for reducing coronary calcification, as evidenced by its ability to lower the risk of major adverse cardiovascular events (MACE) and improve overall cardiovascular health 1. This eating pattern emphasizes abundant fruits, vegetables, whole grains, legumes, nuts, olive oil, moderate fish consumption, limited dairy, and minimal red meat and processed foods. For optimal results, aim for 7-10 servings of fruits and vegetables daily, consume fatty fish like salmon or mackerel 2-3 times weekly, use extra virgin olive oil as your primary fat source, and limit saturated fats from red meat and full-fat dairy. The Mediterranean diet works against coronary calcification through multiple mechanisms:
- its high antioxidant content combats oxidative stress that contributes to arterial damage
- its anti-inflammatory properties help reduce vascular inflammation
- its healthy fat profile (high in monounsaturated and omega-3 fatty acids) improves cholesterol levels and endothelial function. Additionally, limiting sodium intake to under 2,300mg daily, avoiding added sugars, and maintaining adequate vitamin K2 intake through leafy greens and fermented foods can further support arterial health, as supported by the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease 1. Regular physical activity and stress management techniques complement this dietary approach for maximum cardiovascular benefit, with studies such as the PREDIMED trial demonstrating a significantly lower risk of MACE in patients randomized to a Mediterranean diet supplemented with extra-virgin olive oil or nuts 1.
From the Research
Diet and Coronary Calcification
The relationship between diet and coronary calcification is a topic of interest in the field of cardiovascular health. Coronary calcification is a marker of atherosclerosis, which is a major risk factor for coronary heart disease.
Key Findings
- The Mediterranean diet has been shown to have a beneficial effect on cardiovascular health, including reducing the risk of coronary heart disease 2, 3, 4, 5.
- A study published in 2021 found that a Mediterranean diet rich in extra virgin olive oil decreased atherosclerosis progression in patients with coronary heart disease, as measured by intima-media thickness of the common carotid arteries 3.
- Another study found that the Mediterranean diet favorably modified the blood fatty acid profile in patients with coronary heart disease, with significant reductions in saturated fatty acids and increases in omega-3 fatty acids 6.
- The Mediterranean diet has been associated with a reduced risk of cardiovascular disease, including coronary heart disease, as well as other health benefits such as reduced risk of cancer, Parkinson's disease, and Alzheimer's disease 4, 5.
Dietary Components
- The Mediterranean diet is characterized by high consumption of:
- Fruits and vegetables
- Whole grains
- Legumes
- Nuts and seeds
- Olive oil
- Fish and poultry
- Low consumption of:
- Red meat
- Processed meats
- Sugary drinks
- Refined grains
- Moderate consumption of:
- Dairy products
- Wine (optional)
Study Limitations
- Many studies on the Mediterranean diet and coronary calcification have methodological limitations, such as small sample sizes and short follow-up periods 2, 5.
- More high-quality prospective cohorts and randomized clinical trials are needed to confirm the findings and increase confidence in the effect estimates 5.