Modified Cretan Mediterranean diet in the prevention of coronary heart disease and cancer.

Prospective studies of the epidemiology of coronary heart disease (CHD) and cancer have shown that mortality from these diseases differs greatly among populations and that at least some of the differences are associated with differences in dietary habits [1, 2]. Mediterranean populations, for instance, are protected from CHD and certain cancers, and the particular composition of the Mediterranean (Med) diet has been put forth to explain this [3–5]. However, epidemiological studies only provide associations between the risk factors and clinical endpoints, not causal relationships. Several confounding factors may play a part in the associations. The economic situation and the presence or absence of extended social support systems have been proposed to explain the low prevalence of CHD in some Mediterranean countries. Although an effect of these factors cannot be totally excluded, data from Albania, where a low CHD rate was associated until recently with economic misery and modest health services, do not agree with this possibility [6, 7].