Researchers used a sophisticated statistical method called target trial emulation to compare three diets over 20 years in more than 12,000 high-risk US adults. People who consistently followed a Mediterranean diet had a 28% absolute cardiovascular disease risk, compared to 36% on a low-fat diet and 31% on the AHA-2020 dietary guidelines. That translates to a 21% lower relative risk for Mediterranean versus low-fat eating. Even the AHA diet outperformed low-fat, cutting risk by 13%. These findings are notable because most prior Mediterranean diet research has been conducted in European populations, leaving questions about whether the same benefits apply to Americans. This study suggests they do — and the advantage holds even in a general population without elevated cardiovascular risk.
