May 17, 2010 · 12:22 AM

Low-Carb Mediterranean Diet Improves Glucose Control and Heart Risk Factors in Overweight Diabetics

In overweight type 2 diabetics, a low-carbohydrate Mediterranean diet improved HDL cholesterol levels and glucose control better than either the standard Mediterranean diet or American Diabetes Association diet, according to Israeli researchers reporting earlier this year.

Background

Prior studies suggest that diets rich in monounsaturated fatty acids (olive oil, for example) elevate HDL cholesterol and reduce LDL cholestrol and triglycerides in type 2 diabetics.

Low-carb diets improve blood sugar levels and reduce excess body weight in type 2 diabetics, leading to the ADA’s allowance in 2008 of a low-carbohydrate diet as an alternative to standard diabetic diets.

Many—probably most—type 2 diabetics have insulin resistance:  the body’s cells that can remove sugar from the bloodstream are not very sensitive to the effect of insulin driving sugar into those cells.  They “resist” insulin’s effect.  Consumption of monounsaturated fatty acids  improves insulin sensitivity.  In other words, insulin is better able to push blood sugar into cells, removing it from the bloodstream.

Previous studies have shown that both low-carb diets and the Mediterranean diet reduce after-meal elevations in blood sugar, which likely lowers levels of triglycerides and LDL cholesterol.

How Was the Study Done?

The goal was to compare effects of three diets in overweight type 2 diabetics in Israel over the course of one year.  Study participants totalled 259.  Average age was 56, average weight 86 kg (189 lb), average hemoglobin A1c 8.3%, and average fasting plasma glucose (sugar) was 10.3 mmol/L (185 mg/dl).  [Many diabetics in the U.S. fit this profile.]  People taking insulin were excluded from the study, as were those with proliferative diabetic retinopathy—no reasons given. 

Participants were randomly assigned to one of three diets, so there were about 85 in each group.  [Over the course of one year, people dropped out of the study for various reasons, leaving each group with about 60 subjects.] 

Here are the diets:

  • 2003 ADA (American Diabetes Association) diet:  50-55% of total caloric intake from carbohydrate (mixed glycemic index carbs), 30%  from fat, 20% from protein
  • Traditional Mediterranean (TM):  50-55% low-glycemic-index carbs, 30% fat—high in monounsaturated fat, 15-20% protein
  • Low-carb Mediterranean (LCM) :  35% low-glycemic-index carbs, 45% fat—high in monounsaturated fat, 15-20% protein

Patients were followed-up by the same dietitian every two weeks for one year.  All were advised to do aerobic exercise for 30-45 minutes at least three days a week.

Olive oil is traditionally the predominant form of fat in the Mediterranean diet and is a particularly rich source of monounsaturated fat.  At no point in this report was olive oil mentioned, nor any other source of monounsaturated fat.  Until I hear otherwise, I will assume that olive oil was the major source of monounsaturated fat in the TM and LCM diets. 

 All diets were designed to provide 20 calories per kilogram of body weight. 

In all three diets, saturated fat provided 7% of total calories.  Monounsaturated fatty acids provided 23% of total calories in the LCM, and  10% in the other two diets.  Polyunsaturated fatty acids provided 15% of calories in the LCM, and 12% in the other two diets.  The ADA diet provided 15 grams of fiber, the TM had 30 g, and the LCM had 45 g.

Adherence to the assigned diet was assessed with a “food frequency questionnaire” administered at six months.

What Did the Researchers Find?

Average reported energy intake was similar in all three groups: 2,222 calories per day.

Monounsaturated fat intake differences were statistically significant: 14.6, 12.8, and 12.6% for the LCM, TM, and ADA diets, respectively.  Polyunsaturated fat intake differences were statistically significant: 12.9, 11.5, and 11.2% for the LCM, TM, and ADA diets, respectively.

Percentage of energy from carbs was highest for the ADA diet (45.4%), intermediate for the TM diet (45.2%), and lowest for the LCM diet (41.9%).

At the end of 12 months, all three groups lost about the same amount of weight (8-9 kg or 18-20 lb), body mass index, and waist circumference.

Hemoglobin A1c fell in all three groups, but was significantly greater for the LCM group than for the ADA diet (6.3% absolute value vs 6.7%).

Triglycerides fell in all three groups, but was significantly greater for the LCM diet compared to the ADA diet.

The LCM group achieved a significant increase (12%) in HDL cholesterol compared to the ADA diet, but not different from the TM group.

LDL cholesterol fell in all three groups, and the LCM group’s drop (25%) was clearly superior to that of the ADA diet (14%) but about the same as the TM diet (21%).

Conclusions of the Investigators

We found that an intensive community-based dietary intervention reduced cardiovascular risk factors in overweight patients with [type 2 diabetes] for all three diets.  The LCM group had improved cardiovascular risk factors compared to either the ADA or the TM groups.

Only the LCM improved HDL levels and was superior to both the ADA and TM in improving glycaemic control.

It would appear that the low carbohydrate Mediterranean diet should be recommended for overweight diabetic patients.

My Comments

There’s no way the average diabetic could replicate this low-carb Mediterranean diet without working closely with a dietitian or nutritionist.

Any superiority of this low-carb Mediterranean diet may have as much to do with the increased monounsaturated fat intake as with the reduced carb consumption.  Monounsaturated fatty acid consumption is thought to improve insulin sensitivity. 

NutritionData’s Nutrient Search Tool can give you a list of foods high in monounsaturated fat.

The Mediterranean diet and low-carb diets independently have been shown to lower after-meal glucose levels, which probably lowers LDL cholesterol and triglycerides.

I’m disappointed the dietitians were not able to achieve a lower level of carbohydrate consumption in the low-carb Mediterranean diet group.  I suspect if they had, improvements in glucose control and lipids would have been even better.  But proof awaits another day.

We saw last year an article in the Annals of Internal Medicine that showed a dramatic reduction in the need for glucose-lowering drugs in type 2 diabetics following a different low-carb Mediterranean diet over four years, compared to a low-fat American Heart Association diet.  These two studies convince me a low-carb Mediterranean diet has real life-preserving and life-enhancing potential. 

Diabetics looking for a low-carb Mediterranean diet today have several options:

If you’re aware of any other low-carb, explicitly Mediterranean-style diets, please share in the Comments section.

Steve Parker, M.D. 

References: 

Elhayany, A., Lustman, A., Abel, R., Attal-Singer, J., and Vinker, S.  A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 dabetes mellitus:  a 1-year prospective randomized intervention study.  Diabetes, Obesity and Metabolism, 12 (2010): 204-209.

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.

2 Comments

Filed under Carbohydrate, coronary heart disease, Fat in Diet, Glycemic Index and Load, Mediterranean Diet, olive oil

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

May 15, 2010 · 12:41 AM

R.I.P.: K. Dun Gifford, Mediterranean Diet Advocate

K. Dun Gifford, founder of Oldways, passed away a few days ago.  Read about his interesting life at The Boston Globe.

I have no doubt that Mr. Gifford’s promotion of the healthy Mediterranean diet helped to save lives and improve quality of life for many. 

Steve Parker, M.D.

Comments Off on R.I.P.: K. Dun Gifford, Mediterranean Diet Advocate

Filed under Mediterranean Diet

Tagged as , ,

May 11, 2010 · 2:55 PM

“Dementia Runs In My Family. Does Food Affect MY Risk?”

New York researchers reported in Archives of Neurology this month that a particular eating pattern does seem to lower the risk of Alzheimers Disease, the most common type of dementia.  Manhattanites were significantly less likely to develop dementia if they had . . .

Higher consumption of:

  • salad dressing
  • nuts
  • tomatoes
  • fish
  • poultry
  • cruciferous vegetables (e.g., cabbage, radish, broccoli, kale, collard greens, cauliflower, turnips, brussels sprouts)
  • fruits
  • dark and green leafy vegetables

Lower consumption of:

  • high-fat dairy products
  • red meat
  • organ meats
  • butter

The study involved over 2000 people over age 65 who were followed for the onset of dementia over four years.  The researchers used a sophisticated analytic technique called “reduced rank regression.”  See the original article for details.

The study authors note similarities of this dietary pattern to the Mediterranean diet, long associated with lower risk of dementia.  They also document (again) the strong association of moderate alcohol consumption with lower dementia risk, although it was not part of their predetermined anaylytic technique.

Alzheimers Dementia has a strong tendency to run in some families.  As lifespans increase, we’re going to be seeing lots more of it.  If you make it to age 85, your odds of having dementia are 50:50.

If you worry about developing Alzheimers, perhaps because of family history, you may be doing yourself and others a favor by adopting either the dietary pattern above or the Mediterranean diet.

On the other hand . . .

MedPageToday on April 28, 2010, reported the conclusions of a panel convened by the (U.S.) National Institutes of Health:

The independent panel . . . determined that the causes of Alzheimers disease are still unknown and that no reliable evidence has shown that anything can prevent the disease or stop it from progressing.

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.

References: 

Gu, Yian, et al.  Food combination and Alzheimer Disease risk.  Archives of Neurology, 67 (2010).  Epub ahead of print.  doi: 10.1001/archneurol.2010.84

Walker, Emily P.  NIH panel provides no help in unraveling Alzheimers disease.  MedPageToday, April 28, 2010.  Accessed online April 28, 2010.

2 Comments

Filed under Uncategorized

Tagged as , ,

May 1, 2010 · 1:36 AM

Mediterranean Month: Health Benefits of the Mediterranean Diet

Oldways, the preeminent promoter of the Mediterranean diet,  proclaims May to be “Mediterranean Month.”  The idea is to spread awareness of the traditional Mediterranean diet. 

In addition to “it just plain tastes good,” I’m a Mediterranean diet advocate because of the potential health benefits.

Relatively strong evidence supports the Mediterranean diet’s association with:

  • increased lifespan
  • lower rates of cardiovascular disease such as heart attacks and strokes
  • lower rates of cancer (prostate, breast, uterus, colon)
  • lower rates of dementia
  • lower incidence of type 2 diabetes

Weaker supporting evidence points to associations with:

  • slowed progression of dementia
  • lower severity of type 2 diabetes, as judged by diabetic drug usage
  • less risk of developing obesity
  • better blood pressure control in the elderly
  • improved weight loss and weight control in type 2 diabetics
  • less risk of metabolic syndrome
  • improved control of asthma
  • lower rates and severity of chronic obstructive pulmonary disease
  • lower risk of gastric (stomach) cancer
  • less risk of macular degeneration
  • less Parkinsons disease
  • increased chance of pregnancy in women undergoing fertility treatment
  • lower incidence of asthma and allergy-like symptoms in children of women who followed the Mediterranean diet while pregnant

For ideas on moving your diet in a Mediterranean direction, why not visit this page at one of my other websites, or the Oldways site?  You don’t have to go “full Mediterranean” to gain some of the health benefits.  Just taking a couple steps in that direction should help. 

Diabetics concerned about the relatively high carbohydrate content in the Mediterranean diet should consider the Low-Carb Mediterranean Diet. 

Also check out Oldways blog, The Oldways Table.

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 physican before making any dietary or exercise changes.

2 Comments

Filed under Health Benefits, Mediterranean Diet

Tagged as , , ,

April 29, 2010 · 4:21 PM

Nuts Are Not Fattening

Dietitian Melanie Thomassian at her Dietriffic blog April 27, 2010, notes that nuts are not fattening, contrary to popular belief.  This is in a guest post by Matthew Denos.  Most of his references refer to almonds, so I’m not sure other nuts would be equally non-fattening. 

We’re talking about one or two ounces (up to 60 grams) a day.  Could someone gain fat weight eating more than that?  Probably, especially if they have a high-carbohydrate eating pattern.  Do I have scientific studies to back me up?  No. 

Nuts are characteristic of the traditional Mediterranean diet, which is one reason I included them in the Ketogenic Mediterranean Diet.  The other reason is that nut consumption is associated with lower heart disease risk.

Steve Parker, M.D.

Comments Off on Nuts Are Not Fattening

Filed under nuts, Overweight and Obesity

Tagged as , , ,

April 29, 2010 · 12:10 AM

Ad-Free Zone

I was reading the Diabetic Mediterranean Diet Blog from a hospital computer last week and was surprised to see three advertisements.  They were the first I’ve seen in the life of this blog.  WordPress.com is set up to display ads only to certain viewers, not including the blog owner on his usual computer.

I have no control over the ads, and I don’t want my information adjacent to potential quackery and other scams.

I just paid the $30 (USD) yearly fee to keep the blog ad-free.

Steve Parker, M.D.

PS:  If you run ads on your blog, that’s OK with me.  I pretty much tune them all out anyway.

Comments Off on Ad-Free Zone

Filed under Uncategorized

Tagged as ,

April 28, 2010 · 9:18 PM

Individual Response to Weight-Loss Diet May Depend on Genes

Dieters with particular genetic make-up respond better or worse to specific types of weight-loss diets, suggest researchers who presented data at the 2010 Cardiovascular Disease Epidemiology and Prevention /Nutrition, Physical Activity, and Metabolism conference.  Findings are preliminary, but may explain the common phenomenon of two people going on the same diet, but only one achieving good results. 

I’ll bet you can imagine several other explanations.

Several years ago, the “A to Z” study compared the weight loss of 311 overweight women on one of four diets:  Atkins (low-carb), Ornish (very low fat, vegetarian), Learn (low-fat), and Zone (moderate carb restriction, high protein, moderate fat).  Atkins was a bit better than the other diets, in terms of long-term (one year) weight loss.  But within each diet group, some women lost 40–50 pounds (18–23 kg), whereas others gained over 10 pounds (4.5 kg).

Stanford University researchers obtained DNA from 138 of the 311 women and noted the occurence of three genes—ABP2, ADRB2, and PPAR-gamma—that had previously been shown to predict weight loss via diet-gene interactions.  For example, a particular mix of these genes predict better weight loss with a low-fat diet; a different mix predicts more loss with a low-carb diet.

Women who had been randomly assigned to one of the A to Z diets tended to lose much more weight if they happened to have the gene mix appropriate for that diet (compared to those on the same diet with the wrong gene mix).  The difference, for example, might be loss of 12 pounds versus two pounds.

The lead researcher, Dr. Mindy P. Nelson, told TheHeart.Org that the proportion in the general population genetically predisposed to the low-fat versus low-carb approach is about 50:50.

Take-Home Points

These results, again, are preliminary; additional testing is necessary for confirmation.  If they had been able to test the DNA of the other 178 women in the A to Z study, the results could have been either stronger or shown no diet-gene interaction.  The study hasn’t even been published in a peer-reviewed journal yet.

Men may or may not be subject to similar diet-gene interaction.

If a genetic test is ever clinically available to tell a dieter which type of weight-loss diet would be more successful, it will likely be cheaper to just try a particular diet first and see if it works over 4–6 weeks.  Successful long-term weight loss is like smoking cessation—most smokers try 5–7 different times or methods before hitting on one that works for them.

This potential diet-gene interaction could be a major finding that will stop the arguing about which is the single best way to lose excess fat.  Many paths may lead to the mountaintop. 

Steve Parker, M.D.

Reference:  O’Riordan, Michael.  Dieting by DNA?  Popular diets work best by genotype, reseach shows.  HeartWire by TheHeart.Org, March 8, 2010.

6 Comments

Filed under Carbohydrate, Fat in Diet, ketogenic diet, Vegetarian Diet, Weight Loss

Tagged as , , , , , , , ,

April 26, 2010 · 11:23 AM

Best Diet for Type 2 Diabetes: And the Winner Is…

“There are no high quality data on the efficacy of the dietary treatment of type 2 diabetes…,” according to a review at The Cochrane Collaboration.

Isn’t that an amazing revelation?  There is no clearly superior diet for type 2 diabetes, according to Cochrane. 

Nearly every published introductory remark on diabetes from various authorities declares that diet modification is a cornerstone of therapy for type 2 diabetes.  I’m not surprised to see the opinion of the Cochrane group; it’s consistent with the literature review I’ve been doing for the last 18 months.

Cochrane last reviewed the evidence for various diabetic diet approaches on April 15, 2010.  They looked at low-fat/high carb diets, high-fat/low-carb diets, low-calorie diets, very-low-calorie diets, and modified fat diets.

One of their conclusions is that the adoption of regular exercise seems to improve hemoglobin A1c in type 2 diabetics as measured at six and 12 months after initiation.

The Cochrane Collaboration has a history of skewering sacred cows in Medicine, based on reviews of the evidence.  A quote from Cochrane’s “About Us” page:

The Cochrane Collaboration is named after Archie Cochrane (1909-1988), a British epidemiologist, who advocated the use of randomised controlled trials as a means of reliably informing healthcare practice. We are an independent, not-for-profit organisation, funded by a variety of sources including governments, universities, hospital trusts, charities and personal donations. However, we do not accept commercial or conflicted funding – this is vital for us to generate authoritative and reliable information, produced by people who can work freely, unconstrained by commercial and financial interests.

So, what’s a diabetic to eat in 2010?

Stay tuned here, and I’ll share with you the evidence-based answers as they are published in the medical and nutrition literature.

If a diabetic is interested in trying carbohydrate restriction, the Cochrane position statement provides that latitude.  Regular readers here know my inclination: significant carb restriction.  But also note that I’ve considered and reviewed vegetarian diets—which are usually high-carb—for diabetes.   

I pledge to stay open-minded, altering my opinions on the basis of high quality scientific evidence as it becomes available. 

Steve Parker, M.D.

Reference:  Dietary advice for treatment of type 2 diabetes in adults.  Cochrane Reviews, accessed online April 26, 2010.

Comments Off on Best Diet for Type 2 Diabetes: And the Winner Is…

Filed under Uncategorized

Tagged as , , , ,

April 24, 2010 · 8:21 AM

Whole Grains Reduce Heart Attacks and Strokes

Whole grain consumption is associated with a 21% reduction in cardiovascular disease when compared to minimal whole grain intake, according to a 2008 review article in Nutrition, Metabolism, and Cardiovascular Disease.   

Coronary heart disease is the No. 1 killer in the developed world.  Stroke is No. 3.  The term “cardiovascular disease” lumps together heart attacks, strokes, high blood pressure,  and generalized atherosclerosis (hardening of the arteries). 

Investigators at Wake Forest University reviewed seven pertinent studies looking at whole grains and cardiovascular disease.  The studies looked at groups of people, determining their baseline food consumption via questionnaire, and noted disease development over time.  These are called “prospective cohort studies.” 

None of these cohorts was composed purely of diabetics.

The people eating greater amounts of whole grain (average of 2.5 servings a day) had 21% lower risk of cardiovascular disease events compared to those who ate an average of 0.2 servings a day.  Disease events included heart disease, strokes, and fatal cardiovascular disease.  The lower risk was similar in degree whether the focus was on heart disease, stroke, or cardiovascular death.

Note that refined grain consumption was not associated with cardiovascular disease events. 

Why does this matter?

The traditional Mediterranean diet is rich in whole grains, which may help explain why the diet is associated with lower rates of cardiovascular disease.  If we look simply at longevity, however, a recent study found no benefit to the cereal grain component of the Mediterranean diet.  Go figure . . . doesn’t add up. 

Readers here know that over the last four months I’ve been reviewing the nutritional science literature that supports the disease-suppression claims for consumption of fruits, vegetables, and legumes.  I’ve been disappointed.  Fruit and vegetable consumption does not lower risk of cancer overall, nor does it prevent heart disease.  I haven’t found any strong evidence that legumes prevent or treat any disease, or have an effect on longevity.  Why all the literature review?  I’ve been deciding which healthy carbohydrates diabetics and prediabetics should add back into their diets after 8–12 weeks of the Ketogenic Mediterranean Diet.

The study at hand is fairly persuasive that whole grain consumption suppresses heart attacks and strokes and cardiovascular death.  [The paleo diet advocates and anti-gluten folks must be disappointed.]  I nominate whole grains as additional healthy carbs, perhaps the healthiest.

But . . .

. . .  for diabetics, there’s a fly in the ointment: the high carbohydrate content of grains often lead to high spikes in blood sugar.  It’s a pity, since diabetics are prone to develop cardiovascular disease and whole grains could counteract that.  We need a prospective cohort study of whole grain consumption in diabetics.  It’ll be done eventually, but I’m not holding my breath.

[Update June 12, 2010: The aforementioned study has been done in white women with type 2 diabetes.  Whole grain and bran consumption do seem to protect them against overall death and cardiovascular death.  The effect is not strong.]

What’s a guy or gal to do with this information now?

Non-diabetics:  Aim to incorporate two or three servings of whole grain daily into your diet if you want to lower your risk of heart disease and stroke. 

Diabetics:  Several options come to mind:

  1. Eat whatever you want and forget about it [not recommended].
  2. Does coronary heart disease runs in your family?  If so, try to incorporate one or two servings of whole grains daily, noting and addressing effects on your blood sugar one and two hours after consumption.  Eating whole grains alone will generally spike blood sugars higher than if you eat them with fats and protein.  Review acceptable blood sugar levels here.
  3. Regardless of family history, try to eat one or two servings of whole grains a day, noting and addressing effects on your blood sugar.  Then decide if it’s worth it.  Do you have to increase your diabetic drug dosages or add a new drug?  Are you tolerating the drugs?  Can you afford them?    
  4. Assess all your risk factors for developing heart disease: smoking, sedentary lifestyle, high blood pressure, age, high LDL cholesterol, family history, etc.  If you have multiple risk factors, see Option #3.  And modify the risk factors under your control.   
  5. Get your personal physician’s advice.    

Steve Parker, M.D.

Extra Credit:  The study authors suggest a number of reasons—and cite pertinent scientific references—how whole grains might reduce heart disease:

  • improved glucose homeostasis (protection against insulin resistance, less rise in blood sugar after ingestion [compared to refined grains], improved insulin sensitivity or beta-cell function)
  • advantageous blood lipid effects (soluble fiber from whole grains [especially oats] reduces LDL cholesterol, lower amounts of the small LDL particles thought to be particularly damaging to arteries, tendency to raise HDL cholesterol and trigylcerides [seen with insulin resistance in the metabolic syndrome])
  • improved function of the endothelial cells lining the arteries (improved vascular reactivity)

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.

Reference: Mellen, P.B, Walsh, T.F., and Herrington, D.M.  Whole grain intake and cardiovascular disease: a meta-analysis.  Nutrition, Metabolism and Cardiovascular Disease, 18 (2008): 283-290.

14 Comments

Filed under Carbohydrate, coronary heart disease, Diabetes Complications, Grains, ketogenic diet, legumes, Mediterranean Diet, Stroke

Tagged as , , , , , , , ,

April 21, 2010 · 2:00 AM

Red Wine Improves Circulation

Red wine’s beneficial health effects may be related to improved circulation, according to a recent study by Israeli researchers.

Red wine is a time-honored component of the healthy Mediterranean diet.  Consumption is associated with longer lifespan and less cardiovascular disease such as heart attacks. 

Israeli investigators had 14 young healthy volunteers drink 250 cc of red wine daily for 21 days, while monitoring markers of circulatory function.  Endothelial progenitor cells may be particularly important in maintenance, repair, and formation of the arterial circulatory system.

Here’s their conclusion:

The results of the present study indicate that red wine exerts its effect through the up-regulation of CXCR4 expression and activation of the SDF1/CXCR4/Pi3K/Akt/eNOS signaling pathway, which results in increased [endothelial progenitor cell] migration and proliferation and decreased extent of apoptosis. Our findings suggest that these effects could be linked to the mechanism of cardiovascular protection that is associated with the regular consumption of red wine.

I’m not going to tell you I understand all that.  Don’t feel bad if you don’t, either.  My point is to illustrate one way that Science makes progress.  An observant person notices, “Hey, people who drink judicious amounts of red wine seem to live longer and have fewer heart attacks.  I wonder how that works.”  Perhaps a plausible mechanism is identified.  That might lead to isolation of a specific component in red wine that yields the benefit.  Then that component is produced and disseminated, leading to the health benefits, without the risks of alcohol consumption.

It’s an expensive, time-consuming enterprise with many blind alleys.

Steve Parker, M.D.

Reference:  Hamed, Saher, et al.  Red wine consumption improves the in vitro migration of endothelial progenitor cells in young, healthy individuals.  American Journal of Clinical Nutrition, April 14, 2010.    doi:10.3945/ajcn.2009.28408

1 Comment

Filed under Alcohol, coronary heart disease, Health Benefits, Mediterranean Diet

Tagged as , , , ,