07 Jun Mediterranean Diet may reduce the risk of Heart Disease
I have been a fan of Mediterranean-style diets, both for my clients and myself, for many years. In fact, the results of a recent Spanish trial should get everyone interested in this healthy way of eating.
Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could have been attributed to factors other than diet.
What makes this new study so important is that the results come from a randomized controlled trial, what many consider to be the gold standard of medical research. Beginning in 2003, researchers recruited nearly 7,500 Spaniards to take part in the Prevención con Dieta Mediterránea trail. All participants were over age 55, and none had been diagnosed with heart disease—though all were at high risk for developing it.
One third of the volunteers were advised to adopt a Mediterranean-style diet and were given one litre a week of extra virgin olive oil. Another third adopted a Mediterranean-style diet and were given about an ounce a day of mixed nuts (walnuts, hazelnuts, and almonds). The third group was adopted a low-fat diet.
The trial was stopped early, after just under five years of follow-up, when the independent board charged with an ongoing review of the results determined that there had been significantly fewer heart attacks, strokes, and deaths from cardiovascular disease in the Mediterranean groups than in the low-fat diet group. The reduction was impressive: three fewer cardiovascular events per 1,000 people per year in the Mediterranean groups! This was statistically more than just significant, and the magnitude of the diet’s benefits startled experts.
A FLEXIBLE BLUEPRINT FOR HEALTHY EATING?
Rather than specifying a strict diet, this research shows that a flexible healthy eating pattern—no matter what it is called—can promote good health. Here are the guidelines that the volunteers in the Mediterranean groups were given:
One group assigned to a Mediterranean diet was given extra-virgin olive oil each week and was instructed to use at least 4 four tablespoons a day. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week.
They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.
They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.
The study’s participants were allowed seven glasses a week. Red wine has a substance called resveratrol that seems to protect against cardiovascular disease.
HOW TO EAT THE MEDITERRANEAN WAY
• olive oil: use abundantly for cooking and dressing dishes
• vegetables: at least two to three servings
• fruits: at least two to three daily servings
• beans: three or more weekly servings
• fish or seafood: three or more weekly servings
• nuts or seeds: at least one serving a week
• choose poultry instead of red meats or processed meats
• cook at least twice a week with tomato, garlic, and onion
• moderate alcohol intake (for those who drink alcohol)
• eat as desired: nuts, eggs, fish or seafood, low-fat cheese, chocolate (only black chocolate, with more than 50% cocoa), and whole-grain cereals.
• limit or eliminate: cream, butter, margarine, red meat, sugared beverages, pastries, bakery products (such as cakes, donuts, or cookies), premade sweets and desserts, French fries or potato chips, cured or fatty cheeses.
You could say that the Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother. Whole, minimally processed foods of almost any type can be included. “There really is nothing new under the sun!”
However, researchers were careful to say in their paper that while the diet clearly reduced heart disease for those at high risk for it, more research was needed to establish its benefits for people at low risk. But Dr. Estruch who led the trial said he expected it would also help people at both high and low risk, and suggested that the best way to use it for protection would be to start in childhood.
So overall, unless you’re committed to a diet big on junk and red meat, or you don’t like to cook, there is little downside to the Mediterranean Diet. However, as in most diets, it’s far from perfect, and it would be hyperbolic to say that it represents The Answer.
Fibre for Heart health
Sadly, cardiovascular disease, including heart disease and strokes, accounts for nearly half of all deaths. 48% in Europe and in the US it accounts for a third.
On the whole, and with a few diet and lifestyle adjustments, these figures could be dramatically reduced:
Fibre is particularly good for the heart. In fact the more you eat, the lower your risk of succumbing to cardiovascular disease.
A recent literature review has shown. Six studies looking at the relationship between dietary fibre and risk of cardiovascular disease revealed that insoluble fibre from whole grains such as oats and soluble fibre from nuts, cereals, fruits and vegetables lowers the risk of cardiovascular disease.
A significantly lower risk was observed with every additional 7g per day of fibre consumed. Just one extra serving of whole grains and one of beans, lentils, could be the most important nutrition recommendation of them all.
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