Cited by 663Nutritional Studies and DietFatty Acid Research and HealthCardiovascular Health and Risk Factors

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Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial

Singh, Ram B, Dubnov, Gal, Niaz, Mohammad A, Ghosh, Saraswati, Singh, Reema, Rastogi, Shanti S, Manor, Orly, Pella, Daniel, Berry, Elliot M·2002·The Lancet

DOI 10.1016/s0140-6736(02)11472-3

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Abstract

Background The rapid emergence of coronary artery disease (CAD) in south Asian people is not explained by conventional risk factors. In view of cardioprotective effects of a Mediterranean style diet rich in alpha-linolenic acid, we assessed the benefits of this diet for patients at high risk of CAD.Methods We did a randomised, single-blind trial in 1000 patients with angina pectoris, myocardial infarction, or surrogate risk factors for CAD. 499 patients were allocated to a diet rich in whole grains, fruits, vegetables, walnuts, and almonds. 501 controls consumed a local diet similar to the step I National Cholesterol Education Program (NCEP) prudent diet.Findings The intervention group consumed more fruits, vegetables, legumes, walnuts, and almonds than did controls (573 g [SD 127] vs 231 g [19] per day p<0.001). The intervention group had an increased intake of whole grains and mustard or soy bean oil. The mean intake of alpha-linolenic acid was two-fold greater in the intervention group (1.8 g [SD 0.4] vs 0.8 g [0.2] per day, p<0.001). Total cardiac end points were significantly fewer in the intervention group than the controls (39 vs 76 events, p<0.001). Sudden cardiac deaths were also reduced (6 vs 16, p=0.015), as were non-fatal myocardial infarctions (21 vs 43, p<0.001). We noted a significant reduction in serum cholesterol concentration and other risk factors in both groups, but especially in the intervention diet group. In the treatment group, patients with pre-existing CAD had significantly greater benefits compared with such patients in the control group.Interpretation An Indo-Mediterranean diet that is rich in alpha-linolenic acid might be more effective in primary and secondary prevention of CAD than the conventional step I NCEP prudent diet.

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“A study by Singh et al. (2002) on 1,000 patients with a previous history of heart attacks or those having at least one main risk factor for coronary heart disease examined the benefit of MedDiet, precisely an Indo-MedDiet, on the incidence of CVDs (115 cases).”
Influential
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“Singh (2002)((53)) Indo-Mediterranean diet CTRL: NCEP Step 1 INT: NCEP Step 1 with ↑ whole grains, legumes, F&V, nuts, mustard/soyabean oil 1 week food record Not stated Provide instruction, Unclear Significant differences (P<0·001) between INT & CTRL at 2 years: ↑ total fibre (23 g/d), ↑ soluble fibre (12 g/d), ↑ fru…”
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Authors: Singh, R. B., Dubnov, G., Niaz, M. A., Ghosh, S., Singh, R., Rastogi, S. S., Manor, O., Pella, D., & Berry, E. M.
Affiliations: Teerthanker Mahaveer Medical College & Research Centre (IN)
Hebrew University of Jerusalem (IL)
Corresponding author: Berry, Elliot M
ORCID: Singh, Ram B
Singh, Reema
Manor, Orly
Pella, Daniel
Berry, Elliot M
Venue: The Lancet
Publisher: Elsevier BV
Published: 2002-11
Volume: 360
Issue: 9344
Pages: 1455-1461
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(02)11472-3
OpenAlex: W2093983853
Cited by: 663
References: 39
Citations by year: 2026: 8 · 2025: 12 · 2024: 11 · 2023: 14 · 2022: 12 · 2021: 25 · 2020: 11 · 2019: 19 · 2018: 25 · 2017: 18 · 2016: 19 · 2015: 25 · 2014: 25 · 2013: 21 · 2012: 37
FWCI: 57.17
Type: journal article
Language: en
Update notices: expression_of_concern (2005-07-30)
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: coronary artery disease, alpha-linolenic acid, dietary intervention, angina pectoris, myocardial infarction, sudden cardiac death, whole grains, nuts, fruits and vegetables, serum cholesterol, secondary prevention, South Asian populations
MeSH terms: Angina Pectoris, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Myocardial Infarction, Risk Factors, Proportional Hazards Models, Survival Analysis, Single-Blind Method, Disease Progression, Diet, Mediterranean

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Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial

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