Original Article

Primary Prevention of Cardiovascular Disease

with a Mediterranean Diet Supplemented with
Extra-Virgin Olive Oil or Nuts
Ramón Estruch, M.D., Ph.D., Emilio Ros, M.D., Ph.D., Jordi Salas-Salvadó, M.D.,
Ph.D., Maria-Isabel Covas, D.Pharm., Ph.D., Dolores Corella, D.Pharm., Ph.D.,
Fernando Arós, M.D., Ph.D., Enrique Gómez-Gracia, M.D., Ph.D., Valentina Ruiz-
Gutiérrez, Ph.D., Miquel Fiol, M.D., Ph.D., José Lapetra, M.D., Ph.D., Rosa M.
Lamuela-Raventos, D.Pharm., Ph.D., Lluís Serra-Majem, M.D., Ph.D., Xavier
Pintó, M.D., Ph.D., Josep Basora, M.D., Ph.D., Miguel A. Muñoz, M.D., Ph.D., José
V. Sorlí, M.D., Ph.D., J. Alfredo Martínez, D.Pharm., M.D., Ph.D., Montserrat
Fitó, M.D., Ph.D., Alfredo Gea, D.Pharm., Ph.D., Miguel A. Hernán, M.D., Dr.P.H.,
Miguel A. Martínez-González, M.D., Ph.D., for the PREDIMED Study Investigators

N Engl J Med
Volume 378(25):e34
June 21, 2018
 Study Overview
• This report includes the reanalysis of data from a clinical trial showing a
lower rate of cardiovascular events among persons assigned to a
Mediterranean diet supplemented with extra-virgin olive oil or nuts than
among those assigned to a low-fat diet.
Kaplan–Meier Estimates of the Cumulative Incidence of End-Point Events in the Total Study
Population.

Estruch R et al. N Engl J Med

2018;378:e34
 Sensitivity Analyses of Each Mediterranean-Diet Group and the Control Group.

Estruch R et al. N Engl J Med 2018;378:e34

 Sensitivity Analyses of the Combined Mediterranean-Diet Groups and the Control Group.

Estruch R et al. N Engl J Med 2018;378:e34

Summary of Dietary Recommendations to Participants in the Mediterranean-Diet Groups and the
Control-Diet Group.

Estruch R et al. N Engl J Med

2018;378:e34
Baseline Characteristics of the Participants, According to Intervention Group.

Estruch R et al. N Engl J Med 2018;378:e34

Estimates of Cardiovascular Events, According to Intervention Group.

Estruch R et al. N Engl J Med

2018;378:e34
 Conclusions
• In this study involving persons at high cardiovascular risk, the incidence
of major cardiovascular events was lower among those assigned to a
Mediterranean diet supplemented with extra-virgin olive oil or nuts than
among those assigned to a reduced-fat diet.