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About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study has found.

The findings, published on The New England Journal of Medicine’s website Monday, were based on the first major clinical trial to measure the diet’s effect on heart risks. The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

The diet helped those following it even though they did not lose weight and most of them were already taking statins, or blood-pressure or diabetes drugs to lower their heart-disease risk.

Scientists randomly assigned 7,447 people in Spain who were overweight, were smokers, or had diabetes or other risk factors for heart disease to follow the Mediterranean diet or a low-fat one in the study by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona, and his colleagues. One group was given a low-fat diet and counseled on how to follow it. The other two were counseled to follow a Mediterranean diet.

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One group assigned to a Mediterranean diet was given extra virgin olive oil each week and was told to use at least 4 tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was told to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful.

The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.

To assess compliance with the Mediterranean diet, researchers measured levels of a marker in urine of olive-oil consumption — hydroxytyrosol — and a blood marker of nut consumption — alpha-linolenic acid.

The participants stayed with the Mediterranean diet, the investigators reported. But those assigned to a low-fat diet did not lower their fat intake very much. So the study wound up comparing the usual modern diet, with its regular consumption of red meat, sodas and commercial baked goods, to a diet that shunned all that.

Estruch said he thought the effect of the Mediterranean diet was because of the entire package, not just the olive oil or nuts.

Rwanda has been so successful at fighting measles that next month it will be the first country to get donor support to move to the next stage — fighting rubella, too.

On March 11, it will hold a nationwide three-day vaccination campaign with a combined measles-rubella vaccine, hoping to reach nearly 5 million children up to age 14. It will then integrate the dual vaccine into its national health service.

Rubella, also called German measles, causes a rash that is similar to the measles rash, making it hard to tell the difference. In a pregnant woman, it can kill the fetus or cause birth defects.


Healthy older women shouldn’t bother with relatively low-dose dietary supplements, such as calcium and vitamin D pills in hopes of strong bones, say new recommendations from a government advisory group.

Both nutrients are crucial for healthy bones and specialists advise getting as much as possible from a good diet. The body also makes vitamin D from sunshine. If an older person has a vitamin deficiency or bone-thinning osteoporosis, doctors often prescribe higher-than-normal doses.

But for otherwise healthy postmenopausal women, adding modest supplements to their diet — about 400 international units of D and 1,000 milligrams of calcium — doesn’t prevent broken bones but can increase the risk of kidney stones, the U.S. Preventive Services Task Force said Monday.

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