'There is more than one heart healthy diet'

If salmon, olive oil and walnuts aren't your cup of tea, don't sweat it.

A more conventional diet that also restricts saturated fat was just as good at preventing heart attacks, strokes and death among heart patients as the more trendy Mediterranean style diet, according to research.

"I'm not trashing fish," said lead author Katherine Tuttle, a cardiologist and researcher with the University of Washington School of Medicine. "The good news is there is more than one heart healthy diet."

Tuttle said the study is the first head-to-head comparison of the more traditional American Heart Association diet and the Mediterranean diet in heart attack patients in what she called "real life" circumstances.

Both diets actually are very similar in that they restrict cholesterol and saturated fat, which comes from meat and dairy products, but the Mediterranean diet recommends up to five servings of fish a week and other foods high in omega-3 fats such as canola oil, olive oil, walnuts and avocados. The Heart Association diet recommends two servings of fish a week.

Both diets also emphasize large amounts of fruits and vegetables and whole grains.

The study involved about 200 people with an average age of 58 who had a recent heart attack.

The patients went on either of the two diets and received continuing nutrition counseling. A third group did not receive extensive counseling.

Over the course of about four years, an equal number of those from the two diet groups, about 83 percent, had survived and had not experienced a heart attack, stroke, unstable angina or hospitalization for heart failure, compared with 53 percent of the other group. The two diet groups also had about the same improvement in HDL cholesterol (the good kind) and triglycerides, a type of unhealthy fat found in the blood.

"We couldn't validate the superiority of the Mediterranean diet," said Tuttle, a cardiologist at Sacred Heart Medical Center in Spokane, Wash. "Both groups did very well."

Doctors not connected with the study said it did not have enough patients and was not long enough to conclude the fish and other sources of omega-3 fats were not important.

"People generally want to live longer than four years," said Raymond Gibbons, a cardiologist with the Mayo Clinic and president of the Heart Association.

He said the Heart Association was not about to change its recommendation to eat fish.

What the study shows is that counseling heart patients on proper diet over a number of years can have a big impact on their health, said Robert Eckel, a professor of medicine with the University of Colorado at Denver Health Sciences Center.

"Intervention by a dietician is an important part of the success of this story," he said.