Behavioral intervention
Diet — Mediterranean pattern
Whole-dietary-pattern intervention: olive oil, nuts, legumes, fish, vegetables, low processed meat. Effects are attributed to the pattern, not to any isolated nutrient.
Last reviewed 2026-10-22
What the evidence shows
The Mediterranean dietary pattern has hard-endpoint randomized evidence (PREDIMED) for cardiovascular event reduction — unusual among dietary interventions, which are dominated by observational data. It is graded at the pattern level. Single-nutrient claims extracted from these trials do not inherit this grade: the trial randomized the whole pattern, so the evidence attaches to the pattern.
What was actually studied
Trial protocols specify pattern adherence scored against a checklist, with supplemental extra-virgin olive oil or mixed nuts in the randomized arms.
Cautions and limitations
Dietary adherence in trials is self-reported and imperfectly blinded. PREDIMED was re-analysed and re-published in 2018 after randomization irregularities at some sites; the primary conclusion held but the effect estimate should be read as an upper bound.
Systems affected
Documented combinations
No documented combinations on record yet. That is a statement about the literature, not a statement of safety.