For how we live.
People who eat nuts have lower rates of heart disease and early death in large cohorts, and a Mediterranean diet with nuts cut cardiovascular events in one trial. Most of the evidence is observational.
Spain's PREDIMED trial is the strongest randomised evidence that a dietary pattern lowers cardiovascular events. In 2018 its authors withdrew it over flawed randomisation and reissued corrected results.
A diet built to protect the brain looked powerful when researchers watched who chose to eat it. When they assigned it in a three-year trial, both groups improved by almost exactly the same amount.
The trial was designed to test non-inferiority against traditional dietary advice. It found superiority instead, with 62% versus 42% achieving a clinical response over six weeks.
A Spanish trial in 4,746 adults compared an energy-reduced Mediterranean diet plus exercise against the same diet eaten freely. Over six years the absolute gap was 12.0% versus 9.5%.