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Twin study shows Mediterranean-style diet improves heart function

Study highlights:
  • Following a Mediterranean-style diet may reduce the risk of heart disease by maintaining heart rate variability.
  • The more a participant’s eating pattern matched a Mediterranean-style diet, the greater his heart rate variability.
  • Genes do not entirely control heart rate variability, indicating that a Mediterranean-style diet could help people with a family history of heart disease.

A study of twins shows that even with genes that put them at higher risk of cardiovascular disease, eating a Mediterranean-style diet can improve heart function, according to research reported in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

Using data from the Emory Twins Heart Study, researchers found that men eating a Mediterranean-style diet had greater heart rate variability (HRV) than those eating a Western-type diet. Heart rate variability refers to variation in the time interval between heart beats during everyday life – reduced HRV is a risk factor for coronary artery disease and sudden death.

“This means that the autonomic system controlling someone’s heart rate works better in people who eat a diet similar to a Mediterranean diet,” said Jun Dai, M.D., Ph.D., study author and assistant professor of nutrition and epidemiology at Indiana University in Bloomington.

Eating a Mediterranean-style diet — one characterized by low saturated fats and high in fish, fruits, vegetables, legumes, nuts, olive oil, cereals and moderate alcohol consumption — reduces a person’s heart disease risk. But until now, the way the diet helps reduce the risk of coronary disease remains unknown.

Dai and her colleagues analyzed dietary data obtained from a food frequency questionnaire and cardiac data results from 276 identical and fraternal male twins. They scored each participant on how closely his food intake correlated with the Mediterranean diet; the higher the score, the greater the similarity to a Mediterranean-style diet.

To measure HRV, participants had their heart’s electrical activity continuously measured and recorded with a Holter Monitor, a portable, battery operated electrocardiogram device.

Using twins allowed team members to assess the influence of the diet on HRV while controlling for genetic and other familial influence.

Among the study’s key findings:

- Measurements of HRV showed that the higher a person’s diet score, the more variable the heart beat-to-beat time interval — 10 percent to 58 percent (depending on the HRV measure considered) for men in the top Mediterranean diet score quarter compared to those in the lowest quarter; this equates to a 9 percent to 14 percent reduction in heart-related death.

- Genetic influence on HRV frequency ranged from 20 percent – 95 percent, depending on the HRV measure considered.

The study cannot be generalized to women or other ethnic groups because 94 percent of participants were non-Hispanic white males.

Co-authors are Rachel Lampert, M.D.; Peter W. Wilson, M.D.; Jack Goldberg, Ph.D.; Thomas R. Ziegler, M.D. and Viola Vaccarino, M.D., Ph.D., principal investigator of the Emory Twins Heart Study.

Individual author disclosures and funding sources are on the manuscript.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at

NR10 – 1091 (Circ Q&O/Dai)


American Heart Association Diet and Lifestyle Recommendations

Mediterranean Diet, Heart and Stroke Encyclopedia

Tagni McRae | EurekAlert!
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