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It appears from this fairly detailed analysis of other
studies that diet
matters for heart and overall health. That is, less people
die or suffer
disease with some diets. Glycemic index and load appear to
matter little.
Fish fats are only mostly positive for health, but n-3 fats
are good. The
Mediterranean diet was less studied, is quite a complex
diet, but had
positive health effects, it seems.

Contemporary Reviews in Cardiovascular Medicine:

Impact of Dietary Patterns and Interventions on
Cardiovascular Health
Ignatius G.E. Zarraga and Ernst R. Schwarz

Circulation 2006 114: 961-73 [no abstract]

Excerpts:

TABLE 3. Studies of Dietary Interventions and Cardiovascular
Outcomes
======================================================
Type of Diet Study/Author Type of Study Patients Duration
Results
======================================================
GI/glycemic load-based diet Nurses' Health Study78
Prospective cohort
75,521 Women 10 y GL did not correlate directly with risk of
coronary
events.
GI/glycemic load-based diet Italian Case-Control
Study79 Case-control
881 Italian post-acute MI patients 4 y GI/GL did not
correlate with risk of
acute MI, except in subgroup of patients >60 y of age and
those who were
overweight/obese, in whom higher GI translated to higher
odds ratios for MI.
GI/glycemic load-based diet Zutphen Elderly Study25
Prospective cohort
646 Dutch men 64-84 y of age without diabetes or CAD 10 y GI
did not
correlate with risk of coronary events.
Vegetarian diet Health Food Shoppers Study80,81
Prospective cohort 10
736 Subjects (43% vegetarians) 18 y Vegetarian diet resulted
in a trend
toward a lower ratio of mortality rate from ischemic heart
disease to total
death rate, 0.85 (95% CI, 0.71-1.01) in Health Food Shopper
Study; 0.86 (95%
CI, 0.67-1.12) in Oxford Vegetarian Study; 0.75 (95% CI,
0.41-1.37) in
EPIC-Oxford Study - - but had no effect on all-cause
mortality rate.
Vegetarian diet Oxford Vegetarian Study81,82
Prospective cohort 11
045 Subjects (42% vegetarians) 16 y
Vegetarian diet EPIC-Oxford Study81 Prospective
cohort 55 041
Subjects (32% vegetarians) 6 y
Low-fat, vegetable-enriched diet Women's Health
Initiative Randomized
Controlled Dietary Modification Trial83 Randomized trial 48 835
Postmenopausal women 8 y Sessions to promote low fat intake
(<20% of total
calories) and high intake of vegetables/fruits (>5
servings/d) and grains
(>6 servings/d) resulted in dietary changes that were short
of the goals and
had no effect on rates of coronary events and fatal/nonfatal
stroke.
PUFA-enriched diet Finnish Mental Hospital Study84
Controlled trial
with crossover design 676 Men without CAD 12 y Replacement
of milk fat by
soybean oil and substitution of a special PUFA-enriched
margarine for butter
resulted in significant decrease in mortality from coronary
events.
PUFA-enriched diet Wadsworth Veterans Administration
Hospital Study85
Randomized trial 800 Men, mostly in their 60s or 70s; most
had no evidence
of CAD 8 y PUFA-rich vegetable oil substituted for 2/3 of
animal fat
resulted in 31% decrease in rate of combined events - - MI,
CVA, peripheral
vascular disease requiring amputation (P<0.05) - - and 18%
decrease in rate
of MI (P=NS).
PUFA-enriched diet Paul Leren Oslo Study86 Controlled
trial 412 Male
survivors of MI 5 y Lower saturated fat/cholesterol intake
and higher PUFA
intake resulted in significant decrease in rate of second MI
at 5 y (16% in
intervention group vs 26% in control group; P<0.03). Rate of
fatal MI
continued to be significantly lower in intervention group
after 11 y of
follow-up.
PUFA-enriched diet British Medical Research Council
Soybean Oil Trial87
Randomized trial 400 Men with recent MI 5 y Lower saturated
fat intake and 3
oz soya bean oil daily resulted in nonsignificant decrease
in rate of MI.
PUFA-enriched diet Minnesota Coronary Survey88
Randomized trial 4393
Men, 4664 women 384 d (~1 y) No difference in rates of
cardiovascular
events, cardiovascular mortality, and total mortality
between "fat-control"
group (18% saturated fat, 5% PUFA, 16% MUFA, 446 mg
cholesterol/d) and
"fat-treatment" group (9% saturated fat, 15% PUFA, 14% MUFA,
166 mg
cholesterol/d).
n-3 PUFA-enriched diet DART89 Randomized trial 2033
Post-MI men 2 y
Fatty fish twice weekly (goal: 500-800 mg/d n-3 PUFAs)
resulted in 29%
decrease in all-cause mortality rate and 27% decrease in
fatal MI rate.
n-3 PUFA-enriched diet GISSI-Prevenzione90 Randomized
trial 11 324
Survivors of recent (<3 mo) MI 3.5 y 1 g/d n-3
PUFAs/fish-oil supplements
(vs placebo) resulted in 20% decrease in mortality rate, 30%
decrease in
cardiovascular mortality rate, and 46% decrease in sudden
deaths.
n-3 PUFA-enriched diet JELIS91 Randomized trial 18 645
Patients with
hypercholesterolemia 4.5 y 1.8 g/d EPA and statin (vs statin
alone) resulted
in 19% decrease in composite end point of sudden cardiac death,
fatal/nonfatal MI, and unstable angina but had no effect on
the rate of
sudden cardiac death.
n-3 PUFA-enriched diet SOFA92 Randomized trial 546
Patients with an ICD
1 y 2 g/d fish oil, the equivalent of 3-4 fish meals/wk (vs
sunflower oil),
had no effect on frequency of ICD therapy for VT/VF and
all-cause mortality
rate. In the subgroup of post-MI patients, intervention
resulted in a trend
toward longer survival free from VT/VF.
n-3 PUFA-enriched diet Burr et al93 Randomized
(unblinded) trial 3114
Men with angina 9 y 2 portions/wk of fatty fish or 3 g/d
fish oil (vs no
change in intake of fish) resulted in increase in risk of
sudden death
(hazard ratio, 1.54; 95% CI, 1.06-2.23).
n-3 PUFA-enriched diet Raitt et al94 Randomized,
blinded trial 200
Patients with ICD placed for VT/VF (outside the setting of
an acute MI);
mean LVEF, 36% 2 y 1.8 g/d fish oil (vs olive oil) resulted
in trend toward
higher incidence of VT/VF and significant increase in rate
of recurrent
VT/VF episodes. Among patients with VT as qualifying rhythm
for entry into
trial, intervention resulted in significant - in VT/VF
occurrence.
Mediterranean diet Lyon Diet Heart Study95 Randomized
trial 605 Post-MI
patients 46 mo Mediterranean diet (vs prudent Western-style
diet) resulted
in significant decrease in combined end point of cardiac
death and nonfatal
MI (1.2%/yr vs 4.1%/yr; RRR 70%).
Mediterranean diet European Prospective Investigation
into Cancer and
Nutrition96 Prospective cohort 22 043 Greeks 44 mo Every
2-point increase in
score of adherence with Mediterranean diet was associated
with 25% decrease
in total mortality.
======================================================
GL indicates glycemic load; CI, confidence interval; CVA,
cerebrovascular accident; ICD, implantable
cardioverter-defibrillator; VT,
ventricular tachycardia; VF, ventricular fibrillation; LVEF,
left
ventricular ejection fraction; and RRR, relative risk reduction.