Mediterranean diet cuts risk of heart attacks and strokes

 

Eating a Mediterranean diet rich in extra virgin olive oil or nuts could cut the chances of heart attacks and strokes in high-risk groups by as much as 30 per cent, research has suggested.

The findings, published online by the New England Journal of Medicine, could give hope to smokers and diabetes sufferers amongst others.

The group of researchers, led by Professor Ramon Estruch, a professor of medicine at Barcelona University, examined 7,447 men aged 55 to 88 and women aged 60 to 80 between 2003 and 2009.

None of those tested suffered from any form of cardiovascular disease, but were all at risk of it due to having Type 2 diabetes, high blood pressure, increased levels of unhealthy cholesterol, or were smokers.

The study also confirmed that a Southern European diet rich in fruit and vegetables, fish, wine, and small amounts of red meat and dairy products offers protection against heart problems.

In the report, authors claim: "The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern Europe or the United States."

The report added that those on the diet saw their chances of suffering from a stroke were significantly reduced.

Written by Martin Lambert

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Tasty diet cuts heart disease, study finds

A Mediterranean diet rich in fruits, vegetables, olive oil and a little wine can cut the risk of heart attacks and strokes by 30 percent, researchers reported on Monday in a study that shows the real-life benefits of a diet long encouraged by doctors.

The results were so startling that the study was cut short after less than five years, and the results rushed to publication in the New England Journal of Medicine.

"A Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events," the researchers, led by Dr. Ramon Estruch of the Carlos III Health Institute in Barcelona, wrote.

The study was done in Spain, where people already supposedly eat the Mediterranean diet -- which is characterized by lots of salad, fruit, vegetables, nuts, a little fish, a little lean meat, a small amount of cheese and olive oil.  Wine is also served at meals. But the 7,400 volunteers in the trial got extra counseling, and either a weekly supply of extra-virgin olive oil or mixed nuts.

Many studies have shown that people who eat a Mediterranean diet are less likely to die of heart disease. This one was powerful because it randomly assigned people to eat such a diet as part of their normal lives over several years.

The 7,400 patients aged 55 to 80 were all high risk of heart disease because of diabetes, a family history of heart disease, high blood pressure, unhealthy cholesterol levels or they were overweight or smokers.

They were randomly assigned to one of three groups: a Mediterranean diet with extra-virgin olive oil added; the same diet but with mixed nuts; or just a standard diet with advice to cut fat. They were given either a liter of olive oil per week (for the olive oil group), 30 grams of walnuts, hazelnuts and almonds (for the nut group), or little non-food presents for the control group.

They all got individual and group counseling.

After nearly five years, 58 people who simply followed a low-fat diet had strokes, but just 32 people did if they ate a Mediterranean diet with nuts, and 49 who followed the Mediterranean diet with extra olive oil. The Mediterranean diet also cut the risk of heart attack.

Thirty people died from heart disease in the control group, compared to 31 who ate the Mediterranean diet with nuts and 26 who at the Mediterranean diet with olive oil.

But the people who ate a Mediterranean diet were less likely to die overall in the five years, compared to those in the control group. Overall, the Mediterranean diets cut the risk of heart disease death, heart attacks and strokes by 30 percent, the researchers calculated.

"This is another piece of evidence for the benefits of diets containing 'good' fats such as those in olive oil and nuts," said nutrition expert Marion Nestle of New York University. 

"I wonder whether they plan to continue the trial for a longer time—I didn't see any comment on that—because a few more years might give greater clarity," Nestle added in an e-mail.

There are lots of reasons why a Mediterranean-style diet might reduce heart disease. Researchers had noticed that people in Northern Europe, who eat butter and lard more than olive oil, were more likely to die of heart disease than their Southern European neighbors, even if they were just as overweight and exercised the same amount.  A study of the diet's benefits published back in the 1960s showed the diet cut the rate of strokes and heart attacks, probably because it lowered cholesterol levels.

Olive oil and nuts contain monounsaturated fats, which are better for artery health than the saturated fats found in butter, meat and lard. The diet is also high in fiber and vitamins such as A, C and E, as well as minerals.  Walnuts and fish are rich in omega-3 fatty acids, which have been shown to benefit heart health. And reducing meat has been shown to cut the risk of both heart disease and cancer.

By Maggie Fox, Senior Writer, NBC News

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The Most Sensual Diet

The health benefits of the lusty Mediterranean diet have been touted for years but perhaps never as persuasively as in the recent New York Times article written by Gina Kolata. A regime of olive oil, fish, nuts, beans, vegetables, fruit, and wine (a glass a day), has been proven to reduce heart attacks and strokes among people at high risk for them in a statistically significant way in a study conducted by Dr. Ramon Estruch, a professor of medicine at the University of Barcelona. The magnitude of the findings was so illuminating that the study ended five years earlier than anticipated. The study affirmed that following a Mediterranean diet as described above had enormous benefits while, quite astonishingly, following a low-fat diet "was not shown in any rigorous way to be helpful." In addition to eating fish, fruits, vegetables, and legumes, the 7447 participants in the study were also advised to reduce their intake of dairy, processed meats, and commercially processed sweets.

The Mediterranean plan is not so much about weight loss as it is a formula for living longer. It is also so much easier and enjoyable to maintain than many other diet plans which eliminate large swaths of fresh food groups. It is "inclusive" rather than extreme and faddish. This cuisine naturally exists in areas whose coastlines hug the Mediterranean, including Spain, Greece, Cyprus, parts of Italy and France, and many Middle Eastern countries. And it would behoove us all to take a look at Nancy Harmon Jenkins seminal book called "The Mediterranean Diet," written almost 20 years ago. It is as valid as ever and the most sensual way I know to take charge of your health every single day.

Interestingly, at the same time the results of this study are circling the globe, we are reading Michael Moss's new book, Salt Sugar Fat: How the Food Giants Hooked Us. Mr. Moss is a Pulitzer Prize-winning investigative reporter who implores us to fight back from the pernicious addictiveness of processed food created by big food companies. Moss demonstrates how food scientists use cutting-edge technology to calculate the "bliss point" of sugary drinks or enhance the "mouthfeel" of fat by altering its chemical composition. Personally I find a pile of fat asparagus grilled on rosemary branches and doused with extra-virgin olive oil far more enticing than any bag of chips or doodles. And a sweet ripe pear with a handful of walnuts (also in the news this week) make a pretty alluring alternative to Ring Dings.

Many of my cookbooks incorporate this Med-Rim style of eating but it is especially evident in Healthy 1-2-3; Eat Fresh Food; and in hundreds of recipes in Radically Simple: Brilliant Flavors with Breathtaking Ease. Here is one of my favorites.

Pasta Rustica with Sole, Black Olives & White Wine (adapted from Radically Simple)

Here's the whole Mediterranean diet rolled up into one quick little meal -- pasta, wine, olive oil, olives, garlic, lemon zest and fish: perhaps the world's healthiest dish. Sometimes I make it in a wok, where it cooks up really quickly.

8 ounces dried penne pasta
3 large ripe plum tomatoes
2 large yellow tomatoes
1/3 cup extra-virgin olive oil
2 large garlic cloves, minced
½ cup dry white wine
½ cup finely chopped parsley
1/3 cup slivered fresh basil leaves
1 tablespoon grated lemon zest
12 ounces lemon sole, cut in ½-inch strips
16 pitted kalamata olives

Bring a large pot of salted water to a boil. Cook the pasta 12 minute until tender.
Drain well. Meanwhile cut all the tomatoes into ½-inch pieces. Heat the oil in a wok or large skillet. Add the garlic and cook 30 seconds but do not brown. Add the tomatoes, wine, half the parsley, the basil, lemon zest and 1 teaspoon salt. Cook 3 minutes over high heat. Add the fish and olives. Cook 2 minutes until the fish is hot and opaque. Add the cooked pasta to the skillet and heat 2 minutes until hot. Divide among 4 bowls and garnish with remaining parsley. Serves 4

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Mediterranean diet may be best for diabetes

Diets lean on meat and rich in healthy fats like olive oil were most effective at promoting weight loss and lowering blood sugar among people with diabetes in a review of evidence from the last 10 years.

Benefits were also seen with diets low in carbohydrates, high in protein or low in simple sugars.

"If you look at different types of diets, these four can improve various aspects of diabetes control," lead author Dr. Olubukola Ajala, a diabetes specialist at Western Sussex Hospitals in the UK, told Reuters Health.

More than 24 million Americans have type 2 diabetes. People with the disease cannot store glucose in their cells effectively, and their blood sugar levels can go dangerously high. Lifestyle changes like weight loss and cutting calorie intake can improve blood sugar control and reduce the risk of complications from the disease, but it has not been clear which diet plans work best.

Ajala and her colleagues reviewed the results of 20 studies comparing the effect of seven popular diets on adults with type 2 diabetes. Mediterranean diets, low-carb diets, high-protein diets and low glycemic index diets - which rank foods by how quickly their carbs turn into glucose - all lowered participants' blood sugar.

After following the diet for at least six months, the people on a Mediterranean eating plan also lost an average of 4 pounds. No other diet had a significant impact on weight, according to the findings published in the American Journal of Clinical Nutrition.

"We were quite surprised by the Mediterranean diet in particular," Ajala said. "I would have thought that low-carb would have been the best for losing weight, but Mediterranean seems to be better."

A Mediterranean-style diet emphasizes fruits, vegetables and legumes, whole grains, fish, and using olive oil and herbs in place of butter and salt. Saturated fats from red meat and dairy products are typically less than eight percent of total calories consumed.

Other studies have linked Mediterranean diets with reduced risks of cancer, Alzheimer's disease, Parkinson's disease and death from heart attack (see Reuters Health story of November 25, 2011: reut.rs/vkSAAP).

Though the review found no evidence that vegetarian, vegan or high-fiber diets aided in weight loss, they might still have promise for improving blood sugar control, the report notes.

In addition, low-carb, low-glycemic and Mediterranean diets all led to increases in markers of heart health - "good" cholesterol rose by 4 percent to 10 percent, and triglycerides fell by up to 9 percent.

The authors caution that the study could not tease apart the beneficial effects of weight loss - versus the types of foods consumed - in the results seen with some of the diets.

"One has to take this with a pinch of salt," Ajala said.

"Weight loss is important, but so is nutrient quality," Katherine Zeratsky, a registered dietician at the Mayo Clinic in Rochester, Minnesota, told Reuters Health.

Portion control and sustainability are the most important elements of a diet plan for type 2 diabetes, according to Zeratsky, who was not involved in the study. She thinks Mediterranean diets may be more successful because they are easier to maintain than restrictive low-carb or high-protein diets.

"I think we're all still recovering from that low-fat diet phase of the 1990s," Zeratsky said. Olive oil makes food more palatable and satisfying, and may curb the urge to snack later in the day, she added.

But a Mediterranean diet is not the only way to achieve weight loss and improve heart health, Zeratsky said.

It's more important to take a balanced approach, including fruits and vegetables, eating moderate portions and talking to a doctor before embarking on a plan.

"It's not just about dumping olive oil on a salad," Zeratsky said.

By Kathryn Doyle

Wed Feb 6, 2013 12:36pm EST

SOURCE: bit.ly/YKssI8 American Journal of Clinical Nutrition, January 30, 2013.

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Should You Switch to a Mediterranean Diet?

A rigorous study released earlier this week showed thata Mediterranean diet lowered the risk of heart attack and stroke in people in Spain. But do these findings mean you should revamp your diet? Experts say the Mediterranean diet is indeed "one of the healthiest diets on the planet," said Katherine Tallmadge, a dietitian and the author of "Diet Simple" (LifeLine Press, 2011).

But if you want to switch, you should first know exactly what eating a Mediterranean diet really means.

"You don’t just pour olive oil all over your dishes and think you're eating the Mediterranean diet," Tallmadge said.

Traditionally, a Mediterranean diet is a plant-based diet, meaning it's high in fruits, vegetables whole grains, and legumes as well as fish, and very low in saturated fat and animal fat, Tallmadge said. Studies showing its benefits go back to the 1950s Tallmadge explained. But even people in the Mediterranean are moving away from this traditional diet, and adding more cheese and animal fat products to their meal plan, she said.

The main sources of fat in the traditional Mediterranean dietdiet come from olive oil, nuts and fish, and these foods are eaten in moderation, said Heather Mangieri, a nutrition consultant and spokesperson for the American Dietetic Association. In the new study, people ate a handful of nuts each day, Mangieri said.

Because Americans today eat a relatively poor diet nutrition-wise, even just incorporating a few aspects of the Mediterranean diet into their current way of eating would be a "massive improvement over what Americans are eating now," said Deborah Enos, a certified nutritionist and a health coach in the Seattle area.

Mangieri agreed, saying that the best way to switch to a traditional Mediterranean diet, is to start slowly by making a few changes, such as increasing the number of fruits and vegetables you consume every dayand eating a serving of fish once a week.

While nuts and seeds are a source of omega-3 fatty acids, a type of "healthy fat," it's not clear how much of this healthy fat we actually get by eating them, Mangieri said. That's because these foods actually contain alpha-linolenic acid, a compound our bodies convert to omega-3 fatty acids. It's unclear how efficient this process is, so the total amount of omega-3s we get from nuts and seeds may not be very much. Because of this, the best sources of omega-3s are fatty fish such as salmon, sardines and trout. Fish like salmon have more calories than white-fleshed fish, so limit your portion of the fatty fish to 3 to 4 ounces a serving, Mangieri said

Studies also show that the olive oil sold in the United States may not be as healthful as olive oils sold in Mediterranean countries, Tallmadge said. Good quality olive oil — that has been freshly harvested and minimally processed (extra virgin) — is high in compounds called polyphenols, which are thought to be responsible for the oil's health benefits, Tallmadge said. But a recent study from the U.S. Department of Agriculture found that olive oils sold in the United States were low in polyphenols, she said.

There are no quality standards for olive oil sold in the U.S., Tallmadge added. But looking for an olive oil that says it's been harvested within the last year may increase the chance that it's higher in polyphenols, she said.(The level of polyphenols decreases with time).

It's important to note that the people in the new study were at risk for heart disease, so it's not clear if the results apply to healthy people. Also, the study did not consider exercise, which is an important part of a healthy lifestyle. "It’s a whole package deal," Mangieri said.

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