Tag Archives: Stroke

Live Longer With The Mediterranean Diet Even If You Already Have Cardiovascular Disease

Conquer Diabetes and Prediabetes, Steve Parker MD

Olive oil and vinegar: prominent components of the Mediterranean diet

We’ve known for years that the Mediterranean diet helps prolong life and prevent cancer, heart attacks, type 2 diabetes, dementia, and strokes in folks who start out healthy.

What about patients with existing cardiovascular disease? I’m talking about history of heart attacks, strokes, angina, and coronary artery disease.

Yep. The Mediterranean diet helps them live longer, too.

Details of the study are at the American Journal of Clinical Nutrition. The research was done at Harvard.

Steve Parker, M.D.

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Filed under coronary heart disease, Health Benefits, Heart Disease, Longevity, Mediterranean Diet, Stroke

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

A Little Known Way to Reduce Your Stroke Risk Starting Today

Older adults with high olive oil consumption have a lower risk of stroke, according to French investigators.

Caprese salad: mozzarella cheese, basil, tomatoes, extra virgin olive oil

The Mediterranean diet, rich in olive oil, has long been linked to lower rates of stroke.  French researchers wondered if that might be related to higher olive oil consumption.  Triglyceride esters of oleic acid comprise the majority of olive oil, and oleic acid blood levels reflect olive oil consumption.

Have you heard of monounsaturated fatty acids?  Oleic acid is one.

Methodology

Over 7,000 older adults without history of stroke were surveyed with regards to olive oil consumption.  Oleic acid plasma levels were measured in over a thousand of the study participants.  Over the course of five years, 175 strokes occurred.

Compared with those who never used olive oil, those with the highest consumption had a 41% lower risk of stroke.  The researchers made adjustments for other dietary variables, age, physical activity, and body mass index.

In looking at the plasma oleic acid levels, those in the highest third of levels had 73% lower risk of stroke compared to those in the lowest third.

Comments

Results suggest that the olive oil in the Mediterranean diet  may help explain the diet’s protection against stroke.  The researchers didn’t suggest an amount of olive oil that would reduce stroke risk.  I suggest at least one or two tablespoons (15–30 ml) a day, on average.  Olive oil is a key component of the Low-Carb Mediterranean Diet and Advanced Mediterranean Diet.

Steve Parker, M.D.

Reference:  Samieri, C. et al.  Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City StudyNeurology, Published online before print June 15, 2011, doi: 10.1212/WNL.0b013e318220abeb

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Filed under Health Benefits, Mediterranean Diet, Stroke

Heart Disease Death Rates For Diabetics Falling Fast

MedPage Today on May 22, 2012, reported a dramatic drop in cardiovascular death rates for folks with diabetes:

The death rate from cardiovascular disease in U.S. adults with diabetes fell 40% from 1997 to 2004, CDC and NIH researchers said.

And that’s not all:

Additionally, all-cause mortality in diabetic participants dropped by 23% (95% CI 10% to 35%), Gregg and colleagues reported, from 20.3 to 15.1 per 1,000 person-years after adjusting for age.

The researchers identified several factors that likely account for the improved life expectancy for diabetic Americans.

Among them was the “steady improvements in quality and organization of care, self-management behaviors, and medical treatments, including pharmacological treatment of hyperlipidemia and hypertension,” Gregg and colleagues suggested.

The MedPage Today article didn’t define cardiovascular disease.  It typically includes heart attacks, heart failure, strokes, aortic aneurysms, among a few others.

Hope that cheers you up!

Steve Parker, M.D. 

PS: Here’s the original research article in the current issue of Diabetes Care.

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Filed under coronary heart disease, Diabetes Complications, Heart Disease, Stroke

Is It More Important To Be Fit, Or Healthy Weight?

Men live longer if they maintain or improve their fitness level over time, according to research out of the Cooper Clinic in Dallas, Texas.  Part of that improved longevity stems from reduced risk of death from cardiovascular disease (e.g., heart attack and stroke). 

Compared with men who lose fitness with aging, those who maintained their fitness had a 30% lower risk of death; those who improved their fitness had a 40% lower risk of death.  Fitness was judged by performance on a maximal treadmill exercise stress test.

Body mass index over time didn’t have any effect on all-cause mortality but was linked to higher risk of cardiovascular death.  The researchers, however, figured that losses in fitness were the more likely explanation for higher cardiovascular deaths.  In other words, as men age, it’s more important to maintain or improve fitness than to lose excess body fat or avoid overweight.

Steve Parker, M.D.

Reference: Lee, Duck-chul, et al.  Long-term effects of changes in cardiorespiratory fitness and bodly mass index on all-cause and cardiovascular disease mortality in menCirculation, 124 (2011): 2,483-2,490

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Filed under Exercise, Longevity, Overweight and Obesity

Does Olive Oil Protect Against Stroke?

Older adults with high olive oil consumption have a lower risk of stroke, according to French investigators.

The Mediterranean diet, rich in olive oil, has long been linked to lower rates of stroke and other health benefits.  The French researchers wondered stroke prevention might be attibutable to higher olive oil consumption.  Triglyceride esters of oleic acid comprise the majority of olive oil, and oleic acid blood levels reflect olive oil consumption. 

Have you heard of monounsaturated fatty acids?  Oleic acid is one.

Methodology

Over 7,000 older adults without history of stroke were surveyed with regards to olive oil consumption.  Oleic acid plasma levels were measured in over a thousand of the study participants.  Over the course of five years, 175 strokes occurred.

Compared with those who never used olive oil, those with the highest consumption had a 41% lower risk of stroke.  The researchers made adjustments for other dietary variables, age, physical activity, and body mass index.

In looking at the plasma oleic acid levels, those in the highest third of levels had 73% lower risk of stroke compared to those in the lowest third.

Comments

Results suggest that the olive oil in the Mediterranean diet  may help explain the diet’s protection against stroke.  They also support my inclusion of olive oil in the Low-Carb Mediterranean Diet and Advanced Mediterranean Diet.

Steve Parker, M.D.

Reference:  Samieri, C. et al.  Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City StudyNeurology, Published online before print June 15, 2011, doi: 10.1212/WNL.0b013e318220abeb

3 Comments

Filed under Health Benefits, Mediterranean Diet, olive oil, Stroke

Mediterranean Diet Linked to Fewer Strokes on MRI Scans

The Mediterranean diet reduces the risk of strokes seen on brain MRI scans, according to a study earlier this year in Annals of Neurology

Brain researchers at various U.S. institutions studied a multi-ethnic population in upper Manhattan (the WHICAP cohort).  Average age of the  707 study participants was 80.  Baseline diet was determined by a questionairre.  A Mediterranean diet score was calculated to quantify adherence—or lack thereof—to the Mediterranean diet.  Participants without dementia at baseline underwent MRI scanning initially, then again an average of six years later.

What Did They Find?

One third of participants had MRI evidence for a stroke.  Higher adherence to the Mediterranean diet was linked to significantly lower odds of stroke.  Compared to those eating least like the Mediterranean diet, those with the highest adherence had 37% lower odds of an stroke being found on MRI scan.  Those with medium adherence had 20% lower odds.

So What?

This is the first study to show such an association between strokes on an MRI scan and the Mediterranean diet.  Be aware that you can find stroke on an MRI scan in someone who thought they were perfectly healthy; in other words a clinically silent stroke.  The authors note only one previous report finding lower risk of clinically obvious stroke with the Mediterranean diet, in women—I thought there were more. 

The same group of researchers had previously demonstrated that higher compliance with the Mediterranean diet is linked to lower risk of Alzheimers disease and mild cognitive impairment

If I wanted to protect my brain from stroke, I’d be sure follow a Mediterranean-style diet, keep my blood pressure under 140/90 mmHg, stay physically active, keep my weight under control, and not smoke. 

Steve Parker, M.D.

 
Reference:  Scarmeas, Nikolaos, et al.  Mediterranean diet and magnetic resonance imaging-assessed cerebrovascular disease.  Annals of Neurology, 69 (2011): 257-268.  doi: 10.1002/ana.22317

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