Adherence to a Mediterranean dietary pattern may protect against coronary artery wall production of inflammatory mediators. This finding could provide a novel mechanistic explanation for the recognized lower coronary risk associated with a Mediterranean diet.

Objective: To assess the association between a first acute myocardial infarction and the consumption of fibre and fruit. Design: Hospital-based case -control study with incident cases. A validated semi-quantitative food frequency questionnaire (136 items) was used to assess food intake. Setting: Three third-level university hospitals in Pamplona (Spain). Subjects: Cases were subjects aged under 80, newly diagnosed with acute myocardial infarction. Each case patient (n ¼ 171) was matched to a control subject of the same gender and age (5 y bands) admitted to the same hospital. Results: An inverse association was apparent for the three upper quintiles of fibre intake. After adjustment for non-dietary and dietary confounders, an inverse linear trend was clearly significant, showing the highest relative reduction of risk (86%) for the fifth quintile (OR ¼ 0.14, 95% confidence interval: 0.03 -0.67). An inverse association was also apparent for fruit intake, but not for vegetables or legumes. Conclusions: Our data suggest that a substantial part of the postulated benefits of the Mediterranean diet on coronary risk might be attributed to a high intake of fibre and fruit.

Our results in a Mediterranean population with natural plant foods as the main source of folate provide further evidence to support the hypothesis that dietary folate intake may be an independent protective factor for myocardial infarction. The magnitude of the effect, its biological plausibility, and the consistency across studies offer support for a causal association.

SummaryBackground: Although international comparisons have consistently found an inverse association between wine and coronary heart disease, few epidemiologic studies are available in Southern Europe. We assessed the association of wine, red wine, and the pattern of drinking wine during meals with the risk of myocardial infarction.Hypothesis: We specifically evaluated three hypotheses: (1) Is the protection against incidence of nonfatal myocardial infarction stronger for wine than for other alcoholic beverages? (2) Does the wine consumed during meals represent a more beneficial pattern of alcohol consumption? (3) Is red wine more advantageous than other types of wine?Methods: A case-control study (171 cases, 171 matched controls) was conducted in Spain. Multiple dietary and nondietary potential confounders were assessed.Results: Exposure to wine, red wine, and wine during meals was associated with risk reductions similar to those of other alcoholic beverages (point estimates of the odds ratio for low and high intake were 0.48 and 0.38 for wine; 0.42 and 0.55 for other beverages). However, after controlling for total alcohol intake, wine consumption (g/day) improved the prediction of a myocardial infarction.Conclusions: Our data showed that red wine or drinking wine during meals was similar to alcohol from other sources