THE Mediterranean eating plan is best at preventing heart disease, better even than a low-fat diet.

That's according to a massive review of nearly 200 scientific studies, just published in Archives of Internal Medicine. The Mediterranean diet and variations have made headlines repeatedly in the past few months.

The review suggested that the eating plan reduced the risk of heart disease by 37 percent, regardless of a person's exercise habits or weight.

A variation of the eating plan that includes nuts may be even more powerful. Spaniards who followed a Mediterranean plan with generous amounts of olive oil reduced heart disease risk by 40 percent; those who also ate an ounce of nuts a day had a whopping 70 percent drop in risk.

The nuts offered were a mix of almonds, hazelnuts and walnuts. That study, called PREDIMED, was convincing because it was both large and long-term, following 9,000 people over a year.

Another version of the Mediterranean diet that emphasized fewer starchy foods and more fiber reduced non-HDL cholesterol (bad cholesterol) by 8 percent in only 12 weeks. When a soy shake supplemented with sterols, hops and acacia was added to the plan, cholesterol levels dropped by 18 percent.

Past studies have linked the Mediterranean eating pattern to lower risks of diabetes, strokes, dementia, asthma, Parkinson's disease, rheumatoid arthritis and cancer.

MEDITERRANEAN PYRAMID

The Mediterranean diet is named for the region where it originated. It's high in fruits, vegetables, olive oil and seafood.

In 1993, a Boston nonprofit group, Oldways Preservation Trust, plus the Harvard School of Public Health and the World Health Organization, created a Mediterranean Diet Pyramid. Last month, they updated it to increase the emphasis on fish, seafood and spices.

According to Oldways, the eating plan:

Emphasizes plant-based foods such as fruits and vegetables, potatoes, breads and grains, beans, nuts and seeds

Recommends less-processed food and more seasonally fresh and locally grown foods to maximize vitamins and antioxidants

Uses olive oil to replace other fats such as butter and margarine

Allows daily cheese and yogurt

Allows fish, eggs and poultry a few times a week, and up to 16 ounces of red meat total in a month

Recommends fresh fruit as the typical daily dessert, and limits sweets to a few times per week

Urges regular physical activity