Are They Lying About the Lyon Heart Trial?
Updated: Jul 27
The Mediterranean diet continues to receive many accolades in the news and media. Just recently, I was asked to respond to the following quote which appeared in the main-stream media.
“The landmark Lyon Diet Heart Study1 found that heart attack survivors who adopted a Mediterranean-style diet — low in red meat and dairy but rich in olive oil, nuts, fish, whole grains, fruits, and vegetables — lowered their risk of heart attacks, sudden death, and cardiac events.”
Sound almost too good to be true?
Well, it is. And not only will we see that this is not true, this is typical of the way media reports misrepresent information. So, let us take a closer look at this issue.
The Mediterranean diet was not “rich” in olive oil or nuts, nor was olive oil even the main oil used in the famous Lyon Heart Trial. Not only that, this study is often used as a rationale to promote the Mediterranean (MED) diet, as if there is one specific diet everyone in the Mediterranean follows. But again, this is not true. In fact, food consumption varies dramatically throughout the Mediterranean countries and in some areas, there is little if any oil intake and/or wine consumption. And, in some regions where they do consume oil, they do not consume much wine and vice versa.2
Quoting from the author of the largest MED diet studies to date 3,4 in an editorial on the topic: “If the main message that Americans get is to just increase their olive or canola oil consumption, that’s unfortunate because they will increase their caloric intake and they are already getting too many calories. What they need to do is eat more fruits, vegetables, and legumes and fewer foods rich in saturated fats.”
In addition, a recent study in the British Journal of Nutrition5 found that on the Isle of Crete today, the group with the highest incidence of heart disease, consumed the most olive oil and the more olive oil consumed within the group, the more heart disease they had.
Now, let’s remember, for something to be contributing to our overall health and be considered “healthy,” it must be a good source of at least some of our needed nutrients if not many of them. Olive oil is not only a very poor source of Omega 3s and all other nutrients, it also contains 14 percent of its calories from saturated fat and has an Omega 6/3 ratio of 11:1. Not exactly a health food.
Many people often get into trouble because they confuse foods that may be “allowed” in limited or small amounts with the main foods that are recommended and create an unhealthy diet based on “allowed” foods. They end up consuming diets based on foods that should be consumed in limited amounts, if consumed at all. So, while someone might be able to get away with consuming a little oil, if their diet and lifestyle is otherwise healthy, this does not make oil a health food nor should it form the basis of someone’s diet.
On the same token, people get confused with what are the exceptions of the diet and lifestyle of longer lived cultures, with what are the basic healthy diet and lifestyle principles and fundamentals of these same cultures that are contributing to their long and healthy lives. The Mediterranean countries are not healthy “because” of the olive oil, they are healthy “in spite” of the olive oil. What they can and do get away with is not the same as what results in their health.
However, most of us were not raised with the same basic healthy fundamentals as part of our lifestyles as some of these other Mediterranean cultures, as we have been raised as an overweight, sedentary, unhealthy (and junk food craving) nation. Applying the principles of these other cultures to our life may not only prove troublesome, it may prove harmful.
Professor Philip James, the Chairman of the International Obesity Task Force (IOTF), agrees when he recently said, “Ancel Keys’ Seven Country Study observations that fat might be related to the BMIs of his samples but not to coronary heart disease because the Greeks, on a high olive oil diet, had a low saturated fat intake at that time. The subjects also happened to be incredibly physically active: the selected shepherds in Crete were walking and climbing mountains all day long so this is hardly a realistic basis for suggesting that fat (and/or oil) intakes do not matter (in the USA).” 6
So, in other words, using the example of the diet of the very active shepherds in Crete, who were able to get away with consuming some olive oil and eating a higher fat diet, does not automatically apply to an overweight sedentary American.
It is also important to note that most of the unfortunate popularity and (mis)information about the MED diet and the Lyon Heart Trial is a result of the “Mediterranean” diet pyramid and all the marketing and advertising that came out as a result and not a result of actual clinical trial, randomized controlled trials, and population studies. This MED diet pyramid was actually originally created by “OldWays” and is heavily sponsored by the food industry.7
Someday, we will separate true “public health initiatives” that are based on sound science, from advertising and marketing that are based on the food industries’ bottom lines.
Let us stay out of the world of the corporate/industrial food business, their unhealthy products and the abundance of misinformation they spread trying to sell them. By the industries own admission, over 76 percent of the food they tested (outside the produce section) against minimal standards of what might be considered healthy, failed the test. And that was based on minimal standards of what might be considered healthy. We do not need most of the products of the food industry to eat and live well.
1. Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction Final Report of the Lyon Diet Heart Study. Circulation. 1999;99:779-785
2. Changes in food supply in Mediterranean countries from 1961 to 2001. Public Health Nutrition: 9(1), 53–6
3. Adherence to a Mediterranean Diet and Survival in a Greek Population N Engl J Med 348:2599, June 26, 2003
4. The Mediterranean Diet and Mortality — Olive Oil and Beyond N Engl J Med 348::2595-2596, June 26, 2003
5. Diet, serum homocysteine levels and ischaemic heart disease in a Mediterranean population. Br J Nutr. 2004 Jun;91(6):1013-9
6. The Epidemiology Of Obesity:The Size Of The Problem Journal of Internal Medicine 263; 336–352, 2008