Category Archives: Mediterranean Diet

Mediterranean Diet Once Again Linked to Lower Risk of Type 2 Diabetes

Conquer Diabetes and Prediabetes, Steve Parker MD

Olive oil and vinegar

And eating low glycemic load helps, too, according to an article at MedPageToday. The 22,000 Greek study participants were followed for 11 years. From the article:

The findings suggest that eliminating or strictly limiting high glycemic load foods such as those high in refined sugars and grains and following the largely plant-based Mediterranean diet, which emphasizes vegetables, fruits, nuts and legumes, can have a significant impact on diabetes risk, La Vecchia said.

“The impact of the diets was synergistic,” he told MedPage Today. “The message is that eating a largely Mediterranean diet that is also low in glycemic load is particularly favorable for preventing diabetes.”

Spanish researchers found the same thing a few years ago.

The Mediterranean diet is also healthy for those who already have type 2 diabetes.

The Low-Carb Mediterranean Diet may be the ideal way of eating for diabetics.

Steve Parker, M.D.

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Filed under Glycemic Index and Load, Health Benefits, Mediterranean Diet, Prevention of T2 Diabetes

Canadian Study Finds Abdominal Obesity Health Markers Much Improved With Mediterranean Diet and High-Intensity Interval Training

…according to the Heart and Stroke Foundation. Some quotes:

The study found an average reduction in waist circumference of eight centimeters, a reduction in systolic blood pressure of 6 mm Hg and an aerobic fitness improvement of 15 per cent over the first nine months of the study.

Improvements in waist circumference, blood pressure and fitness can lead to numerous other health benefits including a reduced risk of developing high blood pressure, as well as improving osteoarthritis symptoms, quality of life, physical functioning, and cognition.

The high-intensity interval training was done two or three times a week over 20-30 minutes each session. Click for an example of HIIT on a stationary bike. More basic info on HIIT.

The classic Mediterranean diet has too many carbohydrates for many diabetics, although it’s better for them than the Standard American Diet. That’s why I devised the Low-Carb Mediterranean Diet.

Steve Parker, M.D.

Steve Parker MD, low-carb diet, diabetic diet

Olives, olive oil, and vinegar: classic Mediterranean foods

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Filed under Exercise, Health Benefits, Mediterranean Diet, Overweight and Obesity

Yet Another Study Links Long Life Span to the Mediterranean Diet

…by Johns Hopkins researchers.

Six thousand Americans were followed over eight years, with attention to heart disease and death. Significantly lower death rates were seen in nonsmokers, and those maintaining a healthy weight, exercising regularly, and eating the Mediterranean diet. The more adherence to those healthy factors, the lower the risk of death

h/t Lyle J. Dennis, M.D.

Reminder: Conquer Diabetes and Prediabetes is now available on Kindle and other ebook formats. That’s where you’ll find the full Low-Carb Mediterranean Diet.

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Filed under Health Benefits, Longevity, Mediterranean Diet

Experts Debate Composition of the Mediterranean Diet

…but they have some good ideas as to the healthy components, according to a report in MedPageToday. A sample:

Through a subtractive statistical technique, the EPIC investigators calculated that the biggest chunk of the health advantage—24%—came from moderate alcohol consumption (predominantly wine).

The other relative contributions were:

  • 17% from low consumption of meat and meat products
  • 16% from high vegetable consumption
  • 11% from high fruit and nut consumption
  • 11% from high monounsaturated-to-saturated lipid ratio (largely due to olive oil consumption)
  • 10% from high legume consumption

Here’s my definition of the Mediterranean diet.

Steve Parker, M.D.

Reference:
Sofi F, et al “Ideal consumption for each food group composing Mediterranean diet score for preventing total and cardiovascular mortality” EuroPRevent 2013; Abstract P106.

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Filed under Alcohol, Fruits, legumes, Mediterranean Diet, nuts, olive oil, Vegetables

Should Diabetics Avoid or Seek Fruit?

Advanced Mediterranean Diet, paleo diet, paleobetic diet

Grapes probably destined for wine

Newly diagnosed type 2 diabetics have no need to avoid fruit …according to an article in Nutrition Journal.  Fruit is a prominent component of the Mediterranean and paleo diets.  It can be good for us, containing phytonutrients, fiber, etc.  But fruit has the potential to increase blood sugars, too, which may be harmful over the long run.  So whadda you do?

Researchers took newly diagnosed type 2 diabetics and split them into two groups. One group was told to eat at least two pieces of fruit daily, the other was told to eat no more than two pieces.

The researchers conclusions:

A recommendation to reduce fruit intake as part of standard medical nutrition therapy in overweight patients with newly diagnosed type 2 diabetes resulted in eating less fruit. It had however no effect on HbA1c, weight loss or waist circumference. We recommend that the intake of fruit should not be restricted in patients with type 2 diabetes.

Read the full research report.

PS: I haven’t read the full report yet.

Steve Parker, M.D.

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Filed under Fruits, Mediterranean Diet, Paleo diet

E-mail Interview With a Low-Carb Friendly Dietitian

Conquer Diabetes and Prediabetes, Steve Parker MD

Brain food that won’t spike blood sugars

I received an email from a registered dietitian (FS) in May, 2013. She had some reasonable questions for me and I thought you might be interested in my answers. Here’s her email first:

So funny that you happened to comment on my blog post today because I’d already planned to email you. I’m writing an article on low-carbohydrate diets for Diabetes Self Management magazine and was hoping to ask you a few questions about your experience treating your patients with the Diabetic Mediterranean and Ketogenic diets. We could do it via e-mail if you like. What I’d really like to know is how many of your patients were/are successful in sticking to the diet long term and what type of feedback you’ve received from them, along with any other information you feel is pertinent. Also, what carb range to you recommend for your diabetic patients?

My response:

Dear F,

First, let me explain a little about my medical practice. I’m a full-time hospitalist, meaning I treat adult patients only in the hospital setting. Nearly all of my patients come in through the emergency department. I treat a great variety of problems, like pneumonia, heart failure, cellulitis, pancreatitis, urinary tract infections, headaches, strokes, GI tract bleeding, cholecystitis, altered mental status, out of control diabetes, etc. My training is in Internal Medicine.

By the way, I work in Scottsdale, Arizona, which is a fairly sophisticated and affluent community. My two hospitals employ some dietitians who receptive to very-low-carb eating.

As it turns out, 30% of my hospitalized patients happen to have diabetes, at least 95% of which is type 2. This is typical for non-pediatric hospitalists. Nearly all of these diabetics have an established diagnosis of diabetes and a relationship with an outpatient doctor who is treating it. I usually ask them, “Are you on any special diet, or do you pretty much eat whatever you want?” Half of them say “nothing special; I eat what I want”! Three out of 10 respond that they “avoid sweets and desserts” or something similar. One or two of every 10 report they make a strong effort to reduce carb consumption below the usual American level (250-300 g/day). No more than five of every 100 has ever heard of Dr. Richard Bernstein’s Diabetes Solution. (I consider Dr. B the founder and leader of the modern carbohydrate-restricted diabetes diet movement.) No more than one of every 100 follows Dr. Bernstein’s or a similar very-low-carb or ketogenic diet.

Once these patients leave the hospital, I cannot follow them in a clinic setting. I wish I could. I see many of them in the hospital only once, which is not much time to develop a trusting relationship. Perhaps surprisingly, I don’t often do a “hard sell” for a low-carb diet, even though that’s what I’d follow if I had diabetes of either type. People have to be ready to make a change in hard-wired eating behavior, like an alcoholic is ready to quit drinking only when he’s hit “rock bottom.” For someone with diabetes, that rock bottom point is typically at the time of initial diagnosis or when a major complication hits (such as neuropathy, kidney impairment, or retinopathy). They’re more receptive to change then. All of my hospitalized diabetics get a business card referring them to my Low-Carb Mediterranean Diet website (Diabetic Mediterranean Diet).

Since I have no outpatient clinic, I have no way of knowing how many of them adopt a low-carb way of eating. I do get unsolicited emails from diabetics who have adopted the Low-Carb Mediterranean Diet or Ketogenic Mediterranean Diet, and they report satisfying results with weight management and glucose control. Problem is, as mentioned, I don’t know the denominator. Not once in two years has anyone ever contacted me to report they were harmed by the diets or that they didn’t help at all with glucose control.

I’m convinced you can get good nutrition eating low-carb and very-low-carb. By “low-carb,” I mean under 130 g/day, and “very-low-carb” is under 50 or so. An added benefit for diabetics is that they may be able to avoid the cost and toxicity of some diabetes drugs. We have no long-term toxicity data on most of our diabetes drugs. (Insulin and metform are safe long-term.)

Whether a diabetic goes with Dr. Bernstein’s, my Low-Carb Mediterranean Diet, or Dr. Atkins’ Diabetes Revolution, I think they’re going to be better off over the long run compared to eating a typical “diabetic” diet that has 200+ grams of net carbs. Of course, I have no hard proof. We may never have it. Of those who choose LCMD, I have no data on how many of them actually follow it long-term. Hey, I finally answered one of your questions!

If one of my diabetics prefers to eat Bernstein or Atkins-style over my program, I have no problem with that at all. (The Atkins program recommends some nutritional supplements that I’m not convinced are necessary or even minimally helpful.)

How many diabetics stick with a carb-restricted diet (e.g., under 130 g/day) long-term, more than 2-3 months? My guesstimate is only two or three out of ten. The problem is that we live in a highly carb-centric culture: temptation abounds, we form firm dietary habits in childhood, carbs are cheap, and, frankly, many taste very good.

Incidentally, I don’t have diabetes but I strive to keep my digestible (or net) carbs in the range of 60 to 80 grams/day. The carb restriction helps me control my weight, and I’m seeing some preliminary evidence that it may help with prevention of dementia and mild cognitive impairment.

The long-term carbohydrate intake range I recommend for diabetics is 60-80 g of net or digestible carb daily. Twenty or 30 g/day (a la Bernstein or my Ketogenic Mediterranean Diet) can help overweight diabetics lose the excess fat a little quicker and easier. But 30 d/day over the long run is extremely difficult for all but the most highly motivated. If I had type 1 diabetes, I’d give 30 g/day a serious try, like Dr. Bernstein. Competitive endurance athletes may need more than 100 g/day. Some mild type 2′s may be able to adequately handle over 80 g/day depending on degree of residual pancreas beta cell function. It bothers me to see a type 2 diabetic taking 4-5 diabetes drugs just so they can control diabetes while eating a high-carb diet (e.g., over 200 g/day). Again, we don’t know the long-term effects of most of these drugs.

I’m sorry for being so long-winded! I hope this helps. Email me soon if you have more questions and I’ll respond w/in 24h. Or call me at xxx-xxx-xxxx. Please keep up the good work. In turn, I’ll keep doing my little part to turn around this carb-centric culture. At least until the science dictates otherwise.

Sincerely,

-Steve

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Filed under Carbohydrate, ketogenic diet, Mediterranean Diet, Prediabetes

Periodic Tests, Treatments, and Goals for PWDs (Persons With Diabetes)

If you don't like your physician, find a new one

If you don’t like your physician, find a new one

So, you’ve got diabetes. You’re trying to deal with it or you wouldn’t be here. You’ve got a heck of a lot of medical information to master.

Unless you have a good diabetes specialist physician on your team, you may not be getting optimal care. Below are some guidelines you may find helpful. The goal is to prevent diabetes complications. Many primary care physicians will not be up-to-date on the guidelines. Don’t hesitate to discuss them with your doctor. Nobody cares as much about your health as you do.

Annual Tests

The American Diabetes Association (ADA) recommends the following items be done yearly (except as noted) in non-pregnant adults with diabetes. (Incidentally, I don’t necessarily agree with all ADA guidelines.) The complete ADA guidelines are available on the Internet.

  • Lipid profile (every two years if results are fine and stable)
  • Comprehensive foot exam
  • Screening test for distal symmetric polyneuropathy: pinprick, vibration, monofilament pressure sense
  • Serum creatinine and estimate of glomerular filtration rate (MDRD equation)
  • Test for albumin in the urine, such as measurement of albumin-to-creatinine ratio in a random spot urine specimen
  • Comprehensive eye exam by an ophthalmologist or optometrist (if exam is normal, every two or three years is acceptable)
  • Hemoglobin A1c at least twice a year, but every three months if therapy has changed or glucose control is not at goal
  • Flu shots

Other Vaccinations, Weight Loss, Diabetic Diet, Prediabetes, Alcohol, Exercise, Etc.

Additionally, the 2013 ADA guidelines recommend:

  • Pneumococcal vaccination. “A one time re-vaccination is recommended for individuals >64 years of age previously immunized when they were <65 years of age if the vaccine was administered >5 years ago.” Also repeat the vaccination after five years for patients with nephrotic syndrome, chronic kidney disease, other immunocompromised states (poor ability to fight infection), or transplantation.
  • Hepatitis B vaccination to unvaccinated adults who are 19 through 59 years of age.
  • Weight loss for all overweight diabetics. “For weight loss, either low-carbohydrate, low-fat calorie-restricted, or Mediterranean diets may be effective in the short-term (up to two years).” For those on low-carb diets, monitor lipids, kidney function, and protein consumption, and adjust diabetic drugs as needed. The optimal macronutrient composition of weight loss diets has not been established. (Macronutrients are carbohydrates, proteins, and fats.)
  • “The mix of carbohydrate, protein, and fat may be adjusted to meet the metabolic goals and individual preferences of the person with diabetes.” “It must be clearly recognized that regardless of the macronutrient mix, total caloric intake must be appropriate to weight management goal.”
  • “A variety of dietary meal patterns are likely effective in managing diabetes including Mediterranean-style, plant-based (vegan or vegetarian), low-fat and lower-carbohydrate eating patterns.”
  • “Monitoring carbohydrate, whether by carbohydrate counting, choices, or experience-based estimation, remains a key strategy in achieving glycemic control.”
  • Limit alcohol to one (women) or two (men) drinks a day.
  • Limit saturated fat to less than seven percent of calories.
  • During the initial diabetic exam, screen for peripheral arterial disease (poor circulation). Strongly consider calculation of the ankle-brachial index for those over 50 years of age; consider it for younger patients if they have risk factors for poor circulation.
  • Those at risk for diabetes, including prediabetics, should aim for moderate weight loss (about seven percent of body weight) if overweight. Either low-carbohydrate, low-fat calorie-restricted, or Mediterranean diets may be effective in the short-term (up to 2 years). Also important is exercise: at least 150 minutes per week of moderate-intensity aerobic activity. “Individuals at risk for type 2 diabetes should be encouraged to achieve the U.S. Department of Agriculture (USDA) recommendation for dietary fiber (14 g fiber/1,000 kcal) and foods containing whole grains (one-half of grain intake).” Limit intake of sugar-sweetened beverages.
  • “Adults with diabetes should be advised to perform at least 150 min/week of moderate-intensity aerobic physical activity (50–70% of maximum heart rate), spread over at least 3 days/week with no more than two consecutive days without exercise. In the absence of contraindications, adults with type 2 diabetes should be encouraged to perform resistance training at least twice per week.”
  • Screening for coronary artery disease before an exercise program is depends on the physician judgment on a case-by-case basis. Routine screening is not recommended.
Steve Parker MD, low-carb diet, diabetic diet

Olive, olive oil, and vinegar: classic Mediterranean foods

Obviously, some of my dietary recommendations conflict with ADA guidelines. The experts assembled by the ADA to compose guidelines were well-intentioned, intelligent, and hard-working. The guidelines are supported by 528 scientific journal references. I greatly appreciate the expert panel’s work. We’ve simply reached some different conclusions. By the same token, I’m sure the expert panel didn’t have unanimous agreement on all the final recommendations. I invite you to review the dietary guidelines yourself, discuss with your personal physician, then decide where you stand.

General Blood Glucose Treatment Goals

The ADA in 2013 suggests these therapeutic goals for non-pregnant adults:

  • Fasting blood glucoses: 70 to 130 mg/dl (3.9 to 7.2 mmol/l)
  • Peak glucoses one to two hours after start of meals: under 180 mg/dl (10 mmol/l)
  • Hemoglobin A1C: under 7%
  • Blood pressure: under 140/80 mmHg
  • LDL cholesterol: under 100 mg/dl (2.6 mmol/l). (In established cardiovascular disease: <70 mg/dl or 1.8 mmol/l may be a better goal.)
  • HDL cholesterol: over 40 mg/dl (1.0 mmol/l) for men and over 50 mg/dl (1.3 mmol/l) for women
  • Triglycerides: under 150 mg/dl (1.7 mmol/l)

The American Association of Clinical Endocrinologists (AACE) in 2011 proposed somewhat “tighter” blood sugar goals for non-pregnant adults:

  • Fasting blood glucoses: under 110 mg/dl (6.11 mmol/l)
  • Peak glucoses 2 hours after start of meals: under 140 mg/dl (7.78 mmol/l)
  • Hemoglobin A1C: 6.5% or less

The ADA reminds clinicians, and I’m sure the AACE guys agree, that diabetes control goals should be individualized, based on age and life expectancy of the patient, duration of diabetes, other diseases that are present, individual patient preferences, and whether the patient is able to easily recognize and deal with hypoglycemia. I agree completely.

Steve Parker, M.D.

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Filed under Diabetes Complications, Exercise, Fat in Diet, Fiber, Mediterranean Diet, Overweight and Obesity, Prediabetes, Prevention of T2 Diabetes

Dr. Sigurdsson’s Thoughts on the Best Diet for Diabetes

"Vegan? Vegetarian? Mediterranean? Low-Carb? ADA? Low GI?  SAD?

“Vegan? Vegetarian? Mediterranean? Low-Carb? ADA? Low GI? SAD?

Remember that recent report on the best diet for diabetes from American Journal of Clinical Nutrition?  I didn’t think so.  Here’s Dr. Axel Sugurdsson’s summary:

Ajala and coworkers conclude that their review provides evidence that modifying the amount of macronutrients can improve glycemic control, weight and lipids in type 2 diabetes. In their analysis, low carbohydrate diets appeared to provide superior weight loss, better control of blood glucose, and better lipid profile, compared with low fat diets. The authors also conclude that vegan and vegetarian diet may improve glucose control and promote weight loss in type 2 diabetes.

Here’s the verbatim conclusion of the researchers from the article abstract:

Low-carbohydrate, low-GI, Mediterranean, and high-protein diets are effective in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management.

No mention of vegan and vegetarian diets per se.

And now Dr. Sigurdsson’s concluding opinion:

What is the best diet for diabetes?  Although, there is probably not a simple answer,  the question reflects one of the main challenges of modern medicine. It is likely that our dietary recommendations will have to be tailored to the needs of the individual. A one-size-fits-all approach is unrealistic. Although not providing any definitive answers, the study by Ajala and coworkers is an important contribution to our understanding of this highly important issue.

Read the rest.

I’ve reviewed some of the literature supporting vegetarian diets for diabetes.  I’ve seen some evidence that the paleo diet may be beneficial.  Regular readers here know that I currently favor a carbohydrate-restricted Mediterranean-style diet for control of diabetes.

Steve Parker, M.D.

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Filed under Carbohydrate, Mediterranean Diet, Vegetarian Diet

Dietitians’ Views on Mediterranean Diet for Diabetes

An eating pattern similar to the traditional Mediterranean diet can be integrated with existing national guidelines for the management of diabetes, blood pressure, and cholesterol. Existing data suggest that the Mediterranean diet has health benefits, including improved glycemic control and reduced cardiovascular risk, and may offer benefits to diabetes patients and clinicians alike in terms of palatability, ease of explanation and use, and promotion of improved health.

Olive oil and vinegar

Olive oil and vinegar

This excerpt is from an article by three dietitians writing in Diabetes Spectrum in 2009.  Click through for details if interested.

—Steve

Reference:  doi: 10.2337/diaspect.24.1.36  Diabetes Spectrum January 1, 2011 vol. 24, no. 1, p.36-40

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Filed under Health Benefits, Mediterranean Diet

Low-Carb Research Update

“What about that recent study in American Journal of Clinical Nutrition…?”

As much as possible, I base my nutrition and medical recommendations on science-based research published in the medical literature.  Medical textbooks can be very helpful, but they aren’t as up-to-date as the medical journals.

In the early 2000s, a flurry of research reports demonstrated that very-low-carb eating (as in Dr. Atkins New Diet Revolution) was safe and effective for short-term weight management and control of diabetes.  I was still concerned back then about the long-term safety of the high fat content of Atkins.  But 80 hours of literature review in 2009 allowed me to embrace low-carbohydrate eating as a logical and viable option for many of my patients.  The evidence convinced me that the high fat content (saturated or otherwise) of many low-carb diets was little to worry about over the long run.

By the way, have you noticed some of the celebrities jumping on the low-carb weight-management bandwagon lately?  Sharon Osbourne, Drew Carey, and Alec Baldwin, to name a few.

My primary nutrition interests are low-carb eating, the Mediterranean diet, and the paleo diet.  I’m careful to stay up-to-date with the pertinent scientific research.  I’d like to share with you some of the pertinent research findings of the last few years.

Low-Carb Diets

  • Low-carb diets reduce weight, reduce blood pressure, lower triglyceride levels (a healthy move), and raise HDL cholesterol (another good trend).  These improvements should help reduce your risk of heart disease.  (In the journal Obesity Reviews, 2012.)
  • Dietary fat, including saturated fat, is not a cause of vascular disease such as heart attacks and atherosclerosis (hardening of the arteries).  (Multiple research reports.)
  • If you’re overweight and replace two sugary drinks a day with diet soda or water, you’ll lose about four pounds over the next six months.  (American Journal of Clinical Nutrition, 2012.)
  • United States residents obtain 40% of total calories from grains and added sugars.  Most developed countries are similar.  Dr. Stephan Guyenet notes that U.S. sugar consumption increased steadily “…from 6.3 pounds [2.9 kg] per person per year in 1822 to 107.7 pounds [50 kg] per person in 1999.  Wrap your brain around this: in 1822 we ate the amount of added sugar in one 12-ounce can of soda every five days, while today we eat that much sugar every seven hours.”
  • A very-low-carb diet improves the memory of those with age-related mild cognitive impairment. Mild cognitive impairment is a precursor to dementia.  (University of Cincinnati, 2012.)
  • High-carbohydrate and sugar-rich diets greatly raise the risk of mild cognitive impairment in the elderly. (Mayo Clinic study published in the Journal of Alzheimers’ Disease, 2012.)
  • Compared to obese low-fat dieters, low-carb dieters lose twice as much fat weight.  (University of Cincinnati, 2011.)
  • Diets low in sugar and refined starches are linked to lower risk of age-related macular degeneration in women.  Macular degeneration is a major cause of blindness.  (University of Wisconsin, 2011.)
  • A ketogenic (very-low-carb) Mediterranean diet cures metabolic syndrome (Journal of Medicinal Food, 2011.)
  • For type 2 diabetics, replacing a daily muffin (high-carb) with two ounces (60 g) of nuts (low-carb) improves blood sugar control and reduces LDL cholesterol (the “bad” cholesterol). (Diabetes Care, 2011.)
  • For those afflicted with fatty liver, a low-carb diet beats a low-fat diet for management. (American Journal of Clinical Nutrition, 2011.)
  • For weight loss, the American Diabetes Association has endorsed low-carb (under 130 g/day) and Mediterranean diets, for use up to two years. (Diabetes Care, 2011.)
  • High-carbohydrate eating doubles the risk of heart disease (coronary artery disease) in women.  (Archives of Internal Medicine, 2010.)
  • One criticism of low-carb diets is that they may be high in protein, which in turn may cause bone thinning (osteoporosis).  A 2010 study shows this is not a problem, at least in women.  Men were not studied.  (American Journal of Clinical Nutrition.)
  • High-carbohydrate eating increases the risk of developing type 2 diabetes (American Journal of Clinical Nutrition, 2010.)
  • Obesity in U.S. children tripled from 1980 to 2000, rising to 17% of all children.  A low-carb, high-protein diet is safe and effective for obese adolescents.  (American Journal of Clinical Nutrition, 2010.)

Mediterranean Diet

The traditional Mediterranean diet is well established as a healthy way of eating despite being relatively high in carbohydrate: 50 to 60% of total calories.  It’s known to prolong life span while reducing rates of heart disease, cancer, strokes, diabetes, and dementia.  The Mediterranean diet is rich in fresh fruits, vegetables, nuts and seeds, olive oil, whole grain bread, fish, and judicious amounts of wine, while incorporating relatively little meat.  It deserves your serious consideration.  I keep abreast of the latest scientific literature on this diet.

  • Olive oil is linked to longer life span and reduced heart disease.  (American Journal of Clinical Nutrition, 2012.)
  • Olive oil is associated with reduced stroke risk.  (Neurology, 2012).
  • The Mediterranean diet reduces risk of sudden cardiac death in women.  (Journal of the American Medical Association, 2011.)
  • The Mediterranean diet is linked to fewer strokes visible by MRI scanning.  (Annals of Neurology, 2011.)
  • It reduces the symptoms of asthma in children.  (Journal of the American Dietetic Association, 2011.)
  • Compared to low-fat eating, it reduces the incidence of type 2 diabetes by 50% in middle-aged and older folks.  (Diabetes Care, 2010.)
  •  A review of all available well-designed studies on the Mediterranean diet confirms that it reduces risk of death, decreases heart disease, and reduces rates of cancer, dementia, Parkinson’s disease, stroke, and mild cognitive impairment.  (American Journal of Clinical Nutrition, 2010.)
  • It reduces the risk of breast cancer.  (American Journal of Clinical Nutrition, 2010.)
  • The Mediterranean diet reduces Alzheimer’s disease.   (New York residents, Archives of Neurology, 2010).
  • It slows the rate of age-related mental decline.  (Chicago residents, American Journal of Clinical Nutrition, 2010.)
  • In patients already diagnosed with heart disease, the Mediterranean diet prevents future heart-related events and preserves heart function.  (American Journal of Clinical Nutrition, 2010.)

Clearly, low-carb and Mediterranean-style eating have much to recommend them.  Low-carb eating is particularly useful for weight loss and management, and control of diabetes, prediabetes, and metabolic syndrome.  Long-term health effects of low-carb eating are less well established.  That’s where the Mediterranean diet shines.  That’s why I ask many of my patients to combine both approaches: low-carb and Mediterranean.  Note that several components of the Mediterranean diet are inherently low-carb: olive oil, nuts and seeds, fish, some wines, and many fruits and vegetables.  These items easily fit into a low-carb lifestyle and may yield the long-term health benefits of the Mediterranean diet.  If you’re interested, I’ve posted on the Internet a Low-Carb Mediterranean Diet that will get you started.

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary or exercise changes.

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Filed under Carbohydrate, Fat in Diet, Health Benefits, Heart Disease, ketogenic diet, Mediterranean Diet, nuts, olive oil, Stroke, Vegetables, Weight Loss