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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, Delaye, J·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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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 › Cardiology and Cardiovascular Medicine › 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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Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease

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