Nutrition versus statins in primary prevention: Where do we stand now?

It is undeniable that cardiovascular disease (CVD) remains a significant global health burden. Existing strategies for prevention and therapy against CVD account for an individual’s cardiovascular risk, which is evaluated using traditional risk factors such as blood cholesterol levels. Statins are currently the most efficient and well-documented drug used for therapeutic use for lowering cholesterol levels, and thus lowering an individual’s risk of CVD. However, there are concerns over their safety and their actual benefit for the prevention of mortality. On the other hand, sufficient scientific evidence supports the promotion of healthy dietary patterns and lifestyles against CVD, other inflammation-related chronic disorders, and even all-cause mortality. We believe that primordial and primary prevention strategies should focus on diet, lifestyle, and behavioral changes for better cardiovascular health. Research shows that nutritional research and dietary recommendations need to move away from the focus of individual nutrients and should look to altering dietary patterns and lifestyle choices for better cardiovascular outcomes. In particular, dietary patterns such as the Mediterranean diet that are based on high consumption of fruit, vegetables, legumes, and nuts as well as moderate consumption of dairy products and low consumption of red meats are associated with low incidence of CVD and mortality. We suggest that national and international policies and guidelines need to move away from the Western-style diet and promote prudent dietary patterns similar to the Mediterranean diet.