Category Archives: Mediterranean Diet

November 15, 2019 · 7:00 AM

Mediterranean Diet Reduces Need For Diabetes Medications

diabetic mediterranean diet, Steve Parker MD

Pharmacist counting pills

From Diabetes Care:

OBJECTIVE

To examine the effects of two Mediterranean eating plans (Med-EatPlans) versus a low-fat eating plan on the need for glucose-lowering medications.

RESEARCH DESIGN AND METHODS

From the Prevención con Dieta Mediterránea (PREDIMED) trial, we selected 3,230 participants with type 2 diabetes at baseline. These participants were randomly assigned to one of three eating plans: Med-EatPlan supplemented with extra-virgin olive oil (EVOO), Med-EatPlan supplemented with mixed nuts, or a low-fat eating plan (control). In a subgroup (15%), the allocation was done in small clusters instead of using individual randomization, and the clustering effect was taken into account in the statistical analysis. In multivariable time-to-event survival models, we assessed two outcomes: 1) introduction of the first glucose-lowering medication (oral or injectable) among participants on lifestyle management at enrollment and 2) insulin initiation.

RESULTS

After a median follow-up of 3.2 years, in multivariable analyses adjusting for baseline characteristics and propensity scores, the hazard ratios (HRs) of starting a first glucose-lowering medication were 0.78 (95% CI 0.62–0.98) for Med-EatPlan + EVOO and 0.89 (0.71–1.12) for Med-EatPlan + nuts, compared with the control eating plan. After a median follow-up of 5.1 years, the adjusted HRs of starting insulin treatment were 0.87 (0.68–1.11) for Med-EatPlan + EVOO and 0.89 (0.69–1.14) for Med-EatPlan + nuts compared with the control eating plan.

CONCLUSIONS

Among participants with type 2 diabetes, a Med-EatPlan + EVOO may delay the introduction of new-onset glucose-lowering medications. The Med-EatPlan did not result in a significantly lower need for insulin.

Source: Effects of a Mediterranean Eating Plan on the Need for Glucose-Lowering Medications in Participants With Type 2 Diabetes: A Subgroup Analysis of the PREDIMED Trial | Diabetes Care

Steve Parker, M.D.

low-carb mediterranean diet

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November 14, 2019 · 7:00 AM

Mediterranean Diet and Good Blood Sugar Levels Improve Brain Function in Type 2 Diabetes

MRI scan of brain

From Diabetes Care:

CONCLUSIONS

Both adhering to a Mediterranean diet and effectively managing type 2 diabetes may support optimal cognitive function. Healthy diets, in general, can help improve memory function among adults without type 2 diabetes.

Source: The Mediterranean Diet and 2-Year Change in Cognitive Function by Status of Type 2 Diabetes and Glycemic Control | Diabetes Care

Steve Parker, M.D.

low-carb mediterranean diet

Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords.com.

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November 12, 2019 · 10:57 PM

Is It the Olive Oil That Make the Mediterranean Diet So Healthy?

I like this Newman’s Own dressing. First ingredient is olive oil blend, unlike most commercial vinaigrettes that first list water or canola oil. In 2019 they changed the formula and I don’t like it as much.

C-reactive protein and interleukin-6 are measurable blood markers of inflammation in our bodies. Inflammation may be the cause of diseases like hypertension, strokes, hardening of the arteries (atherosclerosis), and heart attacks. One theory holds that if you can reduce the level of the inflammatory markers, your risk of the aforementioned illnesses will be lower.

Olive oil is a key component of the healthy Mediterranean diet. Could that healthfulness be mediated by anti-inflammatory effects of olive oil?

Fr0m the journal Nutrition:

[Randomized controlled trials] reveal beneficial effects of olive oil by reducing levels of inflammation markers. Olive oil taken on a regular basis can be a good dietary fat alternative, especially to manage IL-6 [interleukin-6]. However, further research is required to clarify the effects of olive oil consumption on inflammation comparing to other fats. Moreover, olive oil daily dosage, different time-length intervention and follow-up periods should be taken into consideration.

Source: Is olive oil good for you? A systematic review and meta-analysis on anti-inflammatory benefits from regular dietary intake – ScienceDirect

These researchers found no consistent effect of olive oil on C-reactive protein (CRP).

Steve Parker, M.D.

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October 9, 2019 · 11:51 AM

Low-Carb Mediterranean Diet Beats Low-Fat Diet for Reduction of Liver Fat

Excessive fat in the liver can lead to hepatitis and eventually cirrhosis. Don’t be that guy.

From the study abstract:

Methods

In an 18-month weight-loss trial, 278 participants with abdominal obesity/dyslipidemia were randomized to low-fat (LF) or Mediterranean/low-carbohydrate (MED/LC+28g walnuts/day) diets with/without moderate physical activity (PA). HFC and abdominal fat-depots were measured using magnetic-resonance-imaging at baseline, after 6 (sub-study, n=158) and 18-months.

Results

Of 278 participants [age=48yr;88% men; body-mass-index=30.8kg/m2; mean HFC =10.2%,(range:0.01%-50.4%)], retention rate was 86.3%. %HFC substantially decreased after 6 [-6.6% absolute-units (-41% relatively)] and 18-months [-4.0% absolute-units (-29% relatively);p<0.001 vs. baseline]. Reduction of HFC associated with decreases in VAT beyond weight loss. After controlling for VAT loss, decreased %HFC remained independently associated with reductions in serum gamma-glutamyl-transferase and alanine-aminotransferase, circulating chemerin, and HbA1c (p<0.05). While reduction of HFC was similar between PA groups, compared to LF diet, MED/LC induced a greater %HFC decrease (p=0.036) and greater improvements in cardiometabolic risk parameters (p<0.05), even after controlling for VAT changes. Yet, the greater decreases induced by MED/LC compared to LF diets in triglycerides, TG/HDL ratio and cardiovascular risk score were all markedly attenuated when controlling for HFC changes.

Source: The Beneficial effects of Mediterranean diet over low-fat diet may be mediated by decreasing hepatic fat content – Journal of Hepatology

h/t DietDoctor

Hey, I know of  a low-carb Mediterranean diet!

low-carb mediterranean diet

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September 26, 2019 · 4:21 PM

World Health Organization Recommends Mediterranean Diet to Reduce Dementia Risk

Steve Parker MD, low-carb diet, diabetic diet

Olives, olive oil, and vinegar: classic Mediterranean foods

Two quotes:

In guidelines released Tuesday, WHO issued its first recommendations to reduce the risk of dementia globally. They include regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure and eating a healthy diet — particularly a Mediterranean one.

***

“The Mediterranean diet is the most extensively studied dietary approach, in general as well as in relation to cognitive function,” the report said. “Several systematic reviews of observational studies have concluded that high adherence to the Mediterranean diet is associated with decreased risk of mild cognitive impairment and Alzheimer’s Disease, but modest adherence is not.”

Source: New global guidelines to reduce risk of dementia released

Steve Parker, M.D.

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September 19, 2019 · 9:17 PM

Low-Calorie Mediterranean Diet Helps With Metabolic Syndrome and T2 Diabetes

“PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.”

Source: Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial | Diabetes Care

Steve Parker, M.D.

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August 6, 2019 · 3:35 PM

Mediterranean Diet Associated with 41% Risk Reduction for Age-Related Macular Degeneration, a Common Cause of Blindness

Photo of the retina at the back of the eyeball, where macular degeneration occurs

Not news to me…

“Protecting a patient’s eyes may be more heavily influenced by diet than previously thought. A new study, which analyzed data from a pair of previous study populations, found that people aged 55 and over who maintained a Mediterranean-style diet reduced their risk of developing late-stage age-related macular degeneration (AMD) by 41%.”

Source: Mediterranean Diet Associated with 41% Risk Reduction for AMD | MD Magazine

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July 20, 2019 · 6:18 PM

Have I Been Wrong About the Mediterranean Diet for the Last 12 years?

Bastian is also skeptical about the health benefits of judicious alcohol consumption. Fair enough.

Hilda Bastian at PLOS Blogs wrote about the recent retraction of a PREDIMED sub-study published in the New England Journal of Medicine in 2013. The suspect conclusion of that study was: “Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events.”

From Ms Bastian:

A very influential nutrition trial just tanked. It was retracted from the New England Journal of Medicine (NEJM) on 13 June, and re-published with new analyses and toned-down conclusions. Both Gina Kolata, writing in the New York Times, and Alison McCook, writing at NPR, imply, at least to some extent, that it might make no difference to the evidence. But I disagree.

Here’s what’s happened to the trial, and where I think it leaves the overall evidence. Called PREDIMED, it was a multi-center trial from Spain, with the NEJM final report published in 2013. Altogether, 7,447 people at risk of cardiovascular disease (CVD) – heart attack and stroke – were reported as randomized to one of 3 groups:

  • Mediterranean diet with free olive oil provided, along with individual and group training sessions at the start, and then quarterly;
  • Mediterranean diet with free nuts provided, along with individual and group training sessions at the start, and then quarterly;
  • Advice to reduce fat intake, with a leaflet – but after the first 3 years, people in this control group were also offered individual and group training sessions.

The primary endpoint for the trial was a composite one of major cardiovascular events: myocardial infarction, stroke, or CVD-related death. And the trial was stopped early. More people dropped out of the control group than the Mediterranean diet groups.There are several alarm bells here already, and we’ll come back to those.

Source: What Does the PREDIMED Trial Retraction & Reboot Mean for the Mediterranean Diet? | Absolutely Maybe

I encourage you to read Ms Bastian’s article if you enjoy such debates. I consider the 2013 PREDIMED sub-study to be one of numerous pieces of the nutritional puzzle.

I published the 2nd edition of my Advanced Mediterranean Diet in 2012, so the 2013 PREDIMED sub-study was not available to me. At the end of my book you’ll find not one, but 43 scientific references supporting the healthfulness of the Mediterranean diet.

Steve Parker MD, Advanced Mediterranean Diet

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My Conquer Diabetes and Prediabetes book was also based predominantly on those 43 studies.

low-carb mediterranean diet

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Steve Parker, M.D.

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July 18, 2019 · 10:07 PM

Healthful Mediterranean Diet Still Standing After All These Years

Dead whole fish aren’t very appealing to many folks

From Paul Greenberg’s opinion piece in the New York Times (July 19, 2018):

In 1953, not long before President Dwight Eisenhower suffered a heart attack in office, the social scientist Leland Allbaugh published “Crete: A Case Study of an Underdeveloped Area.” The landmark analysis of the eating patterns of an isolated Greek population strongly suggested that a calorie-limited diet high in fresh fruits and vegetables, whole grains, and olive oil and low in animal protein, particularly red meat, could lower the risk of heart attacks and strokes, decrease chronic disease and extend life.

Medical research over the last half-century has largely borne out this initial finding. Weight-loss fads and eating trends come and go, but the so-called Mediterranean diet has stood fast. “Among all diets,” Dr. Walter Willett of Harvard’s T.H. Chan School of Public Health concluded in an email, “the traditional Mediterranean diet is most strongly supported for delivering long term health and wellbeing.”

Click for a more complete definition of the traditional Mediterranean Diet, which includes alcohol. More from Greenberg:

***

As the clinician Artemis Simopoulos pointed out to me, two meatless days a week are the norm in Greek Orthodox communities. This religious provision encouraged traditional communities to eat fish not only on Fridays but on Wednesdays as well. Recent epidemiological evidence links two portions of seafood a week with lower blood pressure, lower LDL cholesterol and lower triglycerides. In spite of this, American seafood consumption has stayed consistently low compared with other developed countries.

***

And for decades now, even Greeks have been abandoning their traditional foods and eating much more than they previously did. “In my view, the reason the diet worked to prevent heart disease on Crete was because they weren’t overeating,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University. “By the time I got to Crete in the early 1990s, they were, and the hospitals were full of heart attacks and people with type 2 diabetes.”

***

Today, 65 years after Allbaugh returned from Crete, with modern America plagued by one of the highest obesity rates in the world and failing to meet life expectancy averages of almost every other developed nation, it’s worth circling back to the eating patterns of the ancients. For if the United States were to put itself on a Mediterranean diet, we would likely see huge improvements not only in human and environmental health, but also in rural economic stability.

RTWT for Greenberg’s roadmap to an American Mediterranean diet.

Steve Parker, M.D.

low-carb mediterranean diet

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June 19, 2019 · 1:54 AM

Prevent Macular Degeneration With Mediterranean Diet

Photo of the retina at the back of the eyeball

I thought we knew this already. Yet another reason to love the Mediterranean diet. Macular degeneration is a leading cause of blindness in the developed world. Prevention is much better than treatment.

High adherence to a Mediterranean diet and regular physical activity seem to be protective factors for AMD in a Portuguese population. The effect of the diet is likely driven by the increased consumption of vegetables, fruits, and nuts.

Source: Adherence to a Mediterranean diet and its association with age-related macular degeneration. The Coimbra Eye Study–Report 4 – Nutrition

Hmmm…No mention of heart-healthy whole grains.

Steve Parker, M.D.

low-carb mediterranean diet

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