Category Archives: Mediterranean Diet

January 4, 2010 · 2:00 AM

Do Fruits and Vegetables Really Help Prevent Disease?

How many times have you heard how important it is to eat fruits  and vegetables?  Now, is it five or nine servings a day?  Why are fruits and veggies always lumped together?  What does a watermelon have in common with spinach?

The author of a 2004 article in the Journal of Postgraduate Medicine answered some of these questions.  Here are a few quotes from from the summary:

The intake of 400-600 g/d of fruits and vegetables is associated with reduced incidence of many common forms of cancer, and diets rich in plant foods are also associated with a reduced risk of heart disease and many chronic diseases of ageing.

These foods contain phytochemicals that have anti-cancer and anti-inflammatory properties which confer many health benefits. Many phytochemicals are colourful, and recommending a wide array of colourful fruits and vegetables is an easy way to communicate increased diversity of intake to the consumer. For example, red foods contain lycopene, the pigment in tomatoes, which is localized in the prostate gland and may be involved in maintaining prostate health, and which has also been linked with a decreased risk of cardiovascular disease. Green foods, including broccoli, Brussels sprouts and kale, contain glucosinolates which have also been associated with a decreased risk of cancer. Garlic and other white-green foods in the onion family contain allyl sulphides which may inhibit cancer cell growth. Other bioactive substances in green tea and soybeans have health benefits as well.

Consumers are advised to ingest one serving of each of the seven colour groups daily, putting this recommendation within the United States National Cancer Institute and American Institute for Cancer Research guidelines of five to nine servings per day. Grouping plant foods by colour provides simplification, but it is also important as a method to help consumers make wise food choices and promote health.

Asking U.S. consumers to eat one serving from each of seven fruit and vegetable color groups daily is a bit much.  I don’t see that happening.  But the suggestion is a start.  Darya Pino (Summer Tomato blog) probably does it every day, but I don’t know any others.  My simplified message: Eat a variety of colorful fruits and veggies daily.

Note that the very low-carb Ketogenic Mediterranean Diet provides 400 grams of vegetables and fruits daily, and I count seven colors (assuming you allow me to include black olives).  On the KMD document I list avocado, cucumber, and tomato under “vegetables,” but they are indeed fruits.  Heck, I guess olives are fruit, too.

“So, what’s your point, Parker,” you might well ask.  I don’t expect anyone to follow the Ketogenic Mediterranean Diet for life.  When it’s time to move on to a “Diabetic Mediterranean Diet,” I’m considering adding more options: traditional fruits and some colorful vegetables like purple beets, yellow corn, and orange carrots and sweet potatoes.

I still don’t know why “fruits and vegetables” are joined at the hip.  Legumes, grains, and dairy products all rate their very own category.  It’s just not fair.

Steve Parker, M.D.

Reference:  Heber, D.  Vegetables, fruits and phytoestrogens in the prevention of diseases.  Journal of  Postgraduate Medicine, 50 (2004): 145-9.

4 Comments

Filed under Fruits, Health Benefits, Vegetables

Tagged as , , , , ,

December 27, 2009 · 2:00 AM

Mediterranean Diet Linked to Lower Stomach Cancer Risk

"I just wish we'd found this cancer a year ago"

The Mediterranean diet is associated with a 33% reduction in stomach cancer, according to a study just published in the American Journal of Clinical Nutrition.

Stomach cancer (aka gastric cancer) is uncommon in the U.S.  Most cases are advanced and incurable at the time of diagnosis.  So prevention is ideal.

European investigators studied 485,000 people over the course of nine years, during which 449 cases of stomach cancer were found.  Surveys determined how closely the food consumption of study participants tracked nine key components of the Mediterranean diet.  Compared with people who had low adherence to the Mediterranean diet, those with high adherence had 33% less risk of developing stomach cancer.

The Mediterranean diet has long been associated with a lower risk of cancer: specifically, cancers of the breast, colon, prostate, and uterus.  We can add stomach cancer to the list now.

Steve Parker, M.D.

Reference:  Buckland, Genevieve, et al.  Adherence to a Mediterranean diet and risk of gastric adenocarcinoma within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study.  American Journal of Clinical Nutrition, December 9, 2009, epub ahead of print.  doi: 10.3945/ajcn.2009.28209

Comments Off on Mediterranean Diet Linked to Lower Stomach Cancer Risk

Filed under Health Benefits

Tagged as , , , ,

December 22, 2009 · 2:00 AM

Top 10 Diabetes Superfoods

The American Diabetes Association has published a list of  Top 10 Diabetes Superfoods.  They share a low glycemic index and provide key nutrients, according to the ADA.  Click the link for details.  Here they are in no particular order:

  • beans
  • dark green leafy vegetables
  • citrus fruit
  • sweet potatoes
  • berries
  • tomatoes
  • fish high in omega-3 fatty acids
  • whole grains
  • nuts
  • fat-free milk and yogurt

Regular readers here know I have no problem generally with regular or high-fat versions of dairy products.  An exception would be for people trying to lose weight while still eating lots of carbohydrates; the low- and no-fat versions could have lower calorie counts, which might help with weight management.

But compare non-fat and whole milk versions of yogurt in the USDA nutrient database.  One cup of non-fat fruit variety yogurt has 233 calories, compared to 149 calories in plain whole milk yogurt.  The “non-fat” version  reduced the fat from 8 to 2.6 g (not zero g) and replaced it with sugars (47 g versus 11 g). 

Unfortunately, your typical supermarket yogurts are low-fat yet loaded with sugar or high fructose corn syrup that impede weight loss.

Nevertheless, this superfoods list may give us some guidance in design of a Diabetic Mediterranean Diet.  Except for “fat-free,” everything else on the list is a component of the traditional healthy Mediterranean diet.  “Fat-free” is a modern invention and not necessarily an improvement.

Steve Parker, M.D.

2 Comments

Filed under Dairy Products, Fish, Fruits, Glycemic Index and Load, Grains, Health Benefits, legumes, Mediterranean Diet, nuts, Vegetables

Tagged as , , , , , , ,

December 3, 2009 · 8:07 PM

Is Olive Oil Less Healthy When Used for Cooking?

Cooking doesn’t destroy much of olive oil’s healthy properties, according to registered dietitian Karen Collins in a recent guest post at CalorieLab.

I’ve been wondering about this since olive oil plays such a prominent role in the Advanced Mediterranean and Ketogenic Mediterranean Diets.  I use room-temperature olive oil on my salads and vegetables, but also use it  to sauté vegetables, eggs, and meat. 

Olive oil is the major fat in the traditional Mediterranean diet.  It has heart-healthy and perhaps anti-cancer action related to monounsaturated fat and phenolic compounds that have antioxidant and anti-inflammatory properties.

Steve Parker, M.D.

1 Comment

Filed under Health Benefits, Mediterranean Diet

Tagged as , , , , , , ,

November 16, 2009 · 11:02 AM

Olive Oil in Mediterranean Diet Linked to Lower Body Weight

MPj04332860000[1]

The source of virgin olive oil

The University of Navarra in Spain reported recently that a diet rich in virgin olive oil reduces body weight, especially in those genetically inclined to gain weight.  Over one thousand research particpants were placed on a  Mediterranean diet and monitored by lead researcher, Ph.D. candidate Cristina Razquin:

This consisted of a high intake of fruit and vegetables and of non-refined cereals and fish, and the use of virgin olive oil as the main source of fatty food. Moreover, a high intake of legumes and nuts is recommended.

We’ll have more details when the research is published in a peer-reviewed scientific journal.  Olive oil is a type of fat.  This finding of lower body weight on an olive 0il-rich Mediterranean diet run counter to the generally accepted idea that dietary fat causes body fat.  Lower body weight is linked to lower risk of diabetes.

Steve Parker, M.D.

Reference:  A diet rich in virgin olive oil reduces body weight, according to research by the University of Navarra.  Press release, August 3, 2009.

Comments Off on Olive Oil in Mediterranean Diet Linked to Lower Body Weight

Filed under Mediterranean Diet, Overweight and Obesity

Tagged as , , , , ,

November 9, 2009 · 2:00 AM

Walnuts: More Evidence in Favor of Health Benefits

MPj03095770000[1]Nuts are a time-honored component of the Mediterranean diet and may contribute to the lower risk of cardiovascular disease  associated with the diet. 

Regular nut consumption lowers total cholesterol and LDL (“bad cholesterol”) by 5 to 15%, which would tend to lower heart disease risk.  Walnuts are particularly high in alpha-linolenic acid, an omega-3 fatty acid.

Bix over at Fanatic Cook links to three scientific studies showing that walnuts:

  • improved arterial function in people with type 2 diabetes
  • improved arterial function in people with high cholesterol eating a Mediterranean diet
  • decreased fasting insulin levels in people with type 2 diabetes
  • decreased LDL cholesterol in people with type 2 diabetes who were on a low-fat diet

The “dose” of walnuts in these studies was 1–2 ounces (28–56 g) daily.

For good reason, nuts have a prominent role in both the Advanced Mediterranean Diet and Ketogenic Mediterranean Diet. 

I don’t know Bix, but he or she seems to base many of his/her nutrition opinions on scientific principles, which I appreciate.

Steve Parker, M.D.

Comments Off on Walnuts: More Evidence in Favor of Health Benefits

Filed under coronary heart disease, Mediterranean Diet, nuts, Shameless Self-Promotion

Tagged as , , , , , , , , , ,

October 28, 2009 · 11:07 AM

Nuts: The Healthy Snack

MPj04031620000[1]Nut consumption is strongly linked to reduced coronary heart disease, with less rigorous evidence for several other health benefits, according to a recent article in the American Journal of Clinical Nutrition.

This is why I’ve included nuts as integral components of the Ketogenic Mediterranean Diet and the Advanced Mediterranean Diet.

Regular nut consumption is associated with health benefits in observational studies of various populations, within which are people eating few nuts and others eating nuts frequently.  Health outcomes of the two groups are compared over time.  Frequent and long-term nut consumption is linked to:

  • reduced coronary heart disease (heart attacks, for example)
  • reduced risk of diabetes in women (in men, who knows?)
  • less gallstone disease in both sexes
  • lower body weight and lower risk of obesity and weight gain 

The heart-protective dose of nuts is three to five 1-ounce servings a week.

Steve Parker, M.D.

Reference:  Sabaté, Joan and Ang, Yen.  Nuts and health outcomes: New epidemiologic evidence.  American Journal of Clinical Nutrition, 89 (2009): 1,643S-1,648S.

Comments Off on Nuts: The Healthy Snack

Filed under Health Benefits, Mediterranean Diet, Prevention of T2 Diabetes

Tagged as , , , , , , ,

October 22, 2009 · 1:45 AM

Mediterranean Diet Linked to Lower Depression Risk

Numerous media outlets in early October reported on a new study linking the Mediterranean diet with lower risk of depression.  Reuters is an example.

Researchers at the University of Navarra in Spain followed 10,000 university graduates over the course of four years, monitoring the onset of depression.  Food consumption was gauged via a food frequency questionnaire.

Compared to the study participants with very low adherence to the Mediterranean diet, those with high adherence were 30% less likely to develop depression.  As adherence to various components of the Mediterranean diet increased, the rate of depression dropped in stepwise fashion.  

The researchers suspect that it’s the overall dietary pattern, as opposed to any one single component of the Mediterranean diet, that reduces the risk of depression. 

Visit the Advanced Mediterranean Diet website to learn how eat Mediterrranean-style and decrease your risk of developing depression.

Steve Parker, M.D.

Reference: 

 Sanchez-Villegas, A., et al.  Association of the Mediterranean dietary pattern with the incidence of depression.  Archives of General Psychiatry, 66 (2009): 1,090-1,098.

Kelland, Kate.  Study shows Mediterranean diet cuts depression risk.  Reuters online, October 5, 2009.

Comments Off on Mediterranean Diet Linked to Lower Depression Risk

Filed under Health Benefits, Mediterranean Diet

Tagged as ,

October 7, 2009 · 5:57 PM

Parents, It’s 6 PM. Do You Know Where Your Teenager is?

MPj04384380000[1]The Los Angeles Times health blog (Booster Shots) reported on a study Sept. 23, 2009, that associates teenager attendance at family dinner with better academic performance and less abuse of alcohol and drugs. 

Leisurely family meals are characteristic of the traditional Mediterranean diet and may partially explain the health benefits of the diet.  Food for thought, no?

Steve Parker, M.D.

Comments Off on Parents, It’s 6 PM. Do You Know Where Your Teenager is?

Filed under Mediterranean Diet

Tagged as , , ,

September 13, 2009 · 3:41 AM

Low-Carb Mediterranean Diet Beats Low-Fat For Recent-Onset Type 2 Diabetes

MPj03417870000[1]A low-carbohydrate Mediterranean diet dramatically reduced the need for diabetic drug therapy, compared to a low-fat American Heart Association diet.  The Italian researchers also report that the Mediterranean dieters also lost  more weight over the first two years of the study.

Investigators suggest that the benefit of the Mediterranean-style diet is due to greater weight loss, olive oil (monunsaturated fats increase insulin sensitivity), and increased adiponectin levels.

The American Diabetes Association recommends both low-carbohydrate and low-fat diets for overweight diabetics.  The investigators wondered which of the two might be better, as judged by the need to institute drug therapy in newly diagnosed people with diabetes.

Methodology

Newly diagnosed type 2 diabetics who had never been treated with diabetes drugs were recruited into the study, which was done in Naples, Italy.  At the outset, the 215 study participants were 30 to 75 years of age, had body mass index over 25 (average 29.5), had average hemoglobin A1c levels of 7.73, and average glucose levels of 170 mg/dl.

Participants were randomly assigned to one of two diets:

  1. Low-carb Mediterranean diet (“MED diet”, hereafter):  rich in vegetables and whole grains, low in red meat (replaced with poultry and fish), no more than 50% of calories from complex carbohydrates, no less than 30% of calories from fat (main source of added fat was 30 to 50 g of olive oil daily).  [No mention of fruits or wine.  BTW, the traditional Mediterranean diet derives 50-60% of energy from carbohydrates.]
  2. Low-fat diet based on American Heart Association guidelines:  rich in whole grains, restricted additional fats/sweets/high-fat snacks, no more than 30% of calories from fat, no more than 10% of calories from saturated fats.

Both diet groups were instructed to limit daily energy intake to 1500 (women) or 1800 (men) calories.

All participants were advised to increase physical activity, mainly walking for at least 30 minutes a day.

Drug therapy was initiated when hemoglobin A1c levels persisted above 7% despite diet and exercise.

The study lasted four years.

Results

By the end of 18 months, twice as many low-fat dieters required diabetes drug therapy compared to the MED dieters—24% versus 12%.

By the end of four years, seven of every 10 low-fat dieters were on drug therapy compared to four of every 10 MED dieters. 

The MED dieters lost 2 kg (4.4 lb) more weight by the end of one year, compared to the low-fat group.  The groups were no different in net weight loss when measured at four years: down 3–4 kg (7–9 lb).

Compared to the low-fat group, the MED diet cohort achieved significantly lower levels of fasting glucose and hemoglobin A1c throughout the four years.

The MED diet group saw greater increases in insulin sensitivity, i.e., they had less insulin resistance.

The MED group had significantly greater increases in HDL cholesterol and decreases in trigylcerides throughout the study.  Total cholesterol decreased more in the MED dieters, but after the first two years the difference from the low-fat group was not significantly different. 

The Mediterranean group’s intake of carbohydrates was 8-9% lower than baseline, monounsaturated fat was 5.5% higher than baseline, and polyunsaturated fat was 2.5% higher than baseline.  Compared with their baseline, the low-fat group didn’t make much change in these nutrient groups.  These numbers hold up for all four years of the study. 

Comments

The MED diet here includes “no more than 50% of calories from complex carbohydrates.”  The authors don’t define complex carbs.  Simple carbohydrates are monosaccharides and disaccharides.  Complex carbs are oligosaccharides and polysaccharides.  Another definition of complex carbs is “fruits, vegetables, and whole grains,” which I think is definition of complex carbs applicable to this study. 

The editors of the Annals of Internal Medicine conclude that:

A low-carbohydrate, Mediterranean-style diet seems to be preferable to a low-fat diet for glycemic control in patients with newly diagnosed type 2 diabetes.

I’m sure the American Diabetes Association will take heed of this study when they next revise their diet guidelines.  If I were newly diagnosed with type 2 diabetes, I wouldn’t wait until then.

This study dovetails nicely with others that show prevention of type 2 diabetes with the Mediterranean diet, reversal of metabolic syndrome—a risk factor for diabetes—with the Mediterranean diet (supplemented with nuts), and prevention of type 2 diabetes and pre-diabetes in people who have had a heart attack.

For instruction on how to lose weight with a Mediterranean-style diet, click here (it’s not the low-carb diet used in the study at hand).

For general information on Mediterranean eating, visit Oldways.

Steve Parker, M.D.

Reference:  Esposito, Katherine, et al.  Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes.  Annals of Internal Medicine, 151 (2009): 306-314.

1 Comment

Filed under Carbohydrate, Drugs for Diabetes, Mediterranean Diet

Tagged as , , , , , , ,