Effect of the Mediterranean diet in cardiovascular prevention

The Mediterranean diet is the best evidence-based model for cardiovascular prevention. A large, strong, plausible, and consistent body of prospective evidence and trials is currently available to support the benefits of the Med Diet on cardiovascular health, both in primary and secondary prevention. The essential elements of the Med Diet include abundant use of extra-virgin olive oil, high consumption of plant-derived foods (fresh fruits, vegetables, legumes, tree nuts), moderate consumption of fish, whole grain cereals. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence. More solid evidence is needed to provide advice on alcohol intake based on sound evidence, without forgetting that alcohol is addictive, and the consumption pattern of alcoholic beverages is likely to play an important role as an effect modifier.