Mediterranean Diet Disappoints Once Again . . . . (Just Kidding!)
The Mediterranean diet has long been associated with lower risk of heart disease and stroke. A just-published research report reveals a couple reasons why the diet is protective: it reduces blood pressure and improves functioning of the critical cells lining of our blood vessels.
The cells that line the inside of our blood vessels, called endothelial cells, are important regulators of blood flow and health of the arteries overall. For example, harmful substances like LDL cholesterol and lipoprotein A have to pass through the endothelial cells before they can damage the inside of our arteries, leading to atherosclerosis. One common test of endothelial function is flow-mediated dilation (see Moens reference below for details). Dilation means "to open up." Dilated arteries allow more blood flow to our tissues. Generally, more blood flow is better than minimal or sluggish flow.
[Please forgive me if this sounds too text-booky; it's just a little complicated.]
People with abdominal or central obesity - exemplified by the classic "beer-gut" appearance - are prone to develop heart disease. Greek researches found 90 experimental subjects with abdominal obesity, but without heart disease, and had half of them eat a traditional Mediterranean-style diet while the other half ate a regular diet for two months.
The scientists found that the Mediterranean diet group had a significant increase in flow-mediated dilation, and diastolic blood pressure (the bottom or second number) dropped by 6 points, which would tend to protect against heart disease.
If you'd like a chance to improve your longevity while reducing your risk of heart disease, stroke, cancer, and dementia, visit the Oldways website and their new blog, The Oldways Table, for info on eating Mediterranean-style.
-Steve Parker, M.D.
References:
Rallidis, L.S., et al. Close adherence to a Mediterranean diet improves endothelial function in subjects with abdominal obesity. American Journal of Clinical Nutrition, 90 (2009): 263-268.
Moens, A.L., et al. Flow-mediated vasodilation: a diagnostic instrument, or an experimental tool? Chest, 127 (2005): 2,254-2,263.
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Posted by: Mooreganics | Jul 21, 2009 10:22:36 AM
You title really caught me off guard until I read the "just kidding" :). I have really enjoyed incorporating the Mediterranean cuisine into our family meals. Always so flavorful and colorful.
Posted by: Todd | Jul 21, 2009 12:34:59 PM
What is your opinion? - is the diet that's best for your heart also best for your cholesterol levels?
Posted by: Steve Parker, M.D. | Jul 22, 2009 1:57:32 PM
Hi, Todd.
The bulk of the evidence supports the Mediterranean diet as the best one for heart health, for the general public. [Not to mention longevity and cancer prevention, which I just did.]
Dr. Dean Ornish has a total lifestyle/vegetarian diet program that probably also reduces heart disease. But we have much more data on the Mediterranean diet, and it's much more acceptable to the average person who is not going to participate in Ornish's group meetings, vegetarian diet, meditation exercises, etc.
Compared to the standard American diet, the Mediterranean diet tends to move cholesterol levels in the right direction. The moves may not be dramatic, admittedly.
The heart-healthiest diet doesn't necessarily have to improve cholesterol levels the most. Remember that LDL cholesterol levels that are too low are associated with higher mortality rates.
For average Americans with near-normal cholesterol levels, the Mediterranean diet is the best for heart health and longevity.
I'm certainly open to evidence-based opinions to the contrary.
-Steve
[If you're under treatment for high cholesterol or high triglycerides or heart disease, follow your personal physician's advice, and talk to your personal dietitian/nutritionist before making any dietary changes.]
Posted by: Todd | Jul 22, 2009 3:59:38 PM
Thanks for that informative reply. My cholesterol is on the high side, but not terrible. I bought Dean Ornish's "The Spectrum" and followed his recommendations for a low fat diet, and my cholesterol went into the normal range, but it isn't very fun (and I find it hard to follow when traveling). The Mediterranean diet seems more fun, but of course I want my cholesterol to stay in the normal range.
Posted by: Brian Young | Jul 25, 2009 5:31:31 AM
At age 13 I had rheumatic fever which left me with heart valve damage. For years I was downgraded for insurance purposes but in 1985 I took up cycle racing and 2 years later there was no evidence of the heart murmur. Heavy training had repaired it because the aerobic effort needed for this sport increases the size of the heart considerably. So excercise really does matter!
Posted by: Steve Parker, M.D. | Jul 25, 2009 1:50:12 PM
Wow! What a story, Brian. You have escaped the surgeon's cold, healing steel (the scalpel).
Posted by: June Cheatwood | Jul 27, 2009 5:15:33 AM
Dr. Parker, I hope you can answer this question about nutrition labeling. Take the amount of fiber in oatmeal as an example. The label says one serving provides 15% of the needed daily fiber, but like all labels, this is based on a 2000-calorie-a-day diet. So what percent if a person eats only 1000 calories? I think the answer is 30%, correct? --the same amount of oatmeal would be twice as large a PERCENT of the total food if total food is only half as much? Probably not knowing how to adjust our consumption for eating less than 2000 calories a day is a big reason why people who try hard to eat right are not succeeding--labels mislead rather than help. It could even be dangerous when it comes to fat content of foods?
Posted by: batch250 | Jul 27, 2009 5:49:27 PM
In response to Jean's post:
it would seem that you would need 4.5 servings of oatmeal to get 30g of fiber no matter what your daily intake of calories is assuming all adults need 30g of fiber/day.
In response to Mediterranean Diet:
My health suffered while recuperating from an injury. My weight, blood pressure, and total cholesterol all increased. I then followed a diet which included heart healthy food and very much limited things that were deemed to be "bad". I got information from many books and websites. I exercise every day for 60 - 90 min and don't smoke. In seven months my weight dropped from 204 to 165lbs. My LDL cholesterol dropped by 47%, my HDL increased by 11% and my triglycerides decreased by 47%. My blood pressure decreased from 143/94 to an average of about 115/75 without medication. I am 63 years old. My diet would very easily fit in to the DASH or Mediterranean diet. My Doctor was blown away by the improvement these changes in lifestyle brought about.
Posted by: Steve Parker, M.D. | Jul 30, 2009 7:23:50 PM
Batch250 -
Great improvements! I know it took (and still takes) a lot of work on your part. Generally speaking, the traditional Mediterranean diet is healthier than the standard American diet, regardless of changes in blood tests and blood pressures.
June -
Your math (30%) is correct. Several expert nutriton panels recommend we eat 25-35 grams of fiber daily. It's a guideline for average people. Very few adults who aren't trying to lose weight live on 1000 calories a day. So that's not average. But it's not rare either, just uncommon.
I know tiny healthy women who weigh 104 pounds. I know large healthy men who weigh 208 pounds. Its not accurate to say they both need 30 grams of fiber daily for optimal health. The woman may just need 10-20 grams; the man, 35-40 grams.
Hope that helps.
-Steve
