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Cited by 2,122Fatty Acid Research and HealthNutritional Studies and DietLipoproteins and Cardiovascular Health

Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease

de Lorgeril, M, Renaud, S, Salen, P, Monjaud, I, Mamelle, N, Martin, J.L, Guidollet, J, Touboul, P +1 more·1994·The Lancet
DOI 10.1016/s0140-6736(94)92580-1
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Abstract

In a prospective, randomised single-blinded secondary prevention trial we compared the effect of a Mediterranean alpha-linolenic acid-rich diet to the usual post-infarct prudent diet. After a first myocardial infarction, patients were randomly assigned to the experimental (n = 302) or control group (n = 303). Patients were seen again 8 weeks after randomisation, and each year for 5 years. The experimental group consumed significantly less lipids, saturated fat, cholesterol, and linoleic acid but more oleic and alpha-linolenic acids confirmed by measurements in plasma. Serum lipids, blood pressure, and body mass index remained similar in the 2 groups. In the experimental group, plasma levels of albumin, vitamin E, and vitamin C were increased, and granulocyte count decreased. After a mean follow up of 27 months, there were 16 cardiac deaths in the control and 3 in the experimental group; 17 non-fatal myocardial infarction in the control and 5 in the experimental groups: a risk ratio for these two main endpoints combined of 0.27 (95% CI 0.12-0.59, p = 0.001) after adjustment for prognostic variables. Overall mortality was 20 in the control, 8 in the experimental group, an adjusted risk ratio of 0.30 (95% CI 0.11-0.82, p = 0.02). An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets in the secondary prevention of coronary events and death.

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Crossref · 10.1016/s0140-6736(94)92580-1

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  • The Lyon Diet Heart Study was the first randomized clinical trial showing a protective effect of a Mediterranean-style diet against major cardiovascular events, specifically coronary recurrence rate after a first myocardial infarction.

    “The first randomized clinical trial showing a protective effect of a Mediterranean-style diet against major cardiovascular events (i.e., coronary recurrence rate after a first myocardial infarction) was the Lyon Diet Heart Study.”

    From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [21]

  • In the Lyon Diet Heart Study, there were 16 cardiac deaths in the control group and 3 in the experimental group, 17 nonfatal myocardial infarctions in the control group and 5 in the experimental group, and overall mortality was 20 in the control group and 8 in the intervention group.

    “there were 16 cardiac deaths in the control and 3 in the experimental “Mediterranean α-linolenic acid–rich diet” group; 17 nonfatal myocardial infarction in the control and 5 in the experimental groups; overall, mortality was 20 in the control, 8 in the intervention group (21).”

    From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [21]

  • In the Lyon Diet Heart Study, after a 27-month average follow-up, the trial was stopped early because the Mediterranean diet group had a significant 70% reduction in all-cause mortality due to a 73% reduction in coronary heart disease mortality and analogous major reductions in nonfatal complications.

    “After a 27-month average follow-up, the trial was stopped early because the Mediterranean diet group had a significant 70% reduction in all-cause mortality due to a 73% reduction in coronary heart disease mortality and analogous major reductions in nonfatal complications (21).”

    From Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms (2018) · cites this paper as [21]

  • Mediterranean-style diets tend to be relatively high in unsaturated fat, particularly from extra-virgin olive oil.

    “They tend to be relatively high in unsaturated fat, particularly from extravirgin olive oil.”

    From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [21]

  • In the Lyon Diet Heart Study, regular consumption of ALA (canola oil) significantly reduced cardiac deaths and nonfatal CHD.

    “The Lyon Diet Heart Study found regular consumption of ALA (canola oil) significantly reduced cardiac deaths and nonfatal CHD (163)”

    From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [163]

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Authors
de Lorgeril, M., Renaud, S., Salen, P., Monjaud, I., Mamelle, N., Martin, J. L., Guidollet, J., Touboul, P., & Delaye, J.
Affiliations
  • Inserm (FR)
  • Laboratoire Univers et Théories (FR)
ORCID
Martin, J.L
Venue
The Lancet
Publisher
Elsevier BV
Published
1994-06
Volume
343
Issue
8911
Pages
1454-1459
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(94)92580-1
OpenAlex
W2030042443
Cited by
2,122
References
30
Citations by year
2026: 10 · 2025: 28 · 2024: 38 · 2023: 47 · 2022: 50 · 2021: 69 · 2020: 56 · 2019: 43 · 2018: 59 · 2017: 53 · 2016: 58 · 2015: 58 · 2014: 78 · 2013: 75 · 2012: 74
FWCI
60.21
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Keywords
alpha-linolenic acid, Mediterranean diet, secondary prevention, coronary artery disease, myocardial infarction, oleic acid, linoleic acid, plasma fatty acids, cardiac mortality, nonfatal myocardial infarction, vitamin E, vitamin C, albumin, granulocyte count
MeSH terms
Coronary Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Proportional Hazards Models, Survival Analysis, Single-Blind Method, alpha-Linolenic Acid

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