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"Eating your way to long life"

For years there has been debate about the “Mediterranean diet” and what it is exactly, whether it really prevents heart attacks, and what accounts for the benefits.

Is it the red wine? Olive oil? High intake of fruits and vegetables? Or perhaps something else about the life-style, such as vigorous daily activities? A recent study from Greece, the country that originally provided the strongest evidence for the benefits of the Mediterranean diet, has now given us some answers.

Researchers followed more than 22,000 healthy Greeks for an average of four years and found that those eating the traditional Mediterranean diet were not only 33% less likely to die from coronary artery disease than Greeks eating other foods, but also 24% less likely to die from cancer. Overall they had a 25% lower death rate. The more closely they followed the diet, the greater the benefit.

The main elements: an abundance of plant foods, such as fruits, vegetables, whole grains, nuts, and beans; olive oil as the main fat (instead of butter or lard); small to moderate amounts of fish and poultry but little red meat; and moderate consumption of wine.

In recent years studies have found that people who had already had a heart attack could greatly reduce their risk of suffering a second one by following such a diet, as we’ve reported. But this is the strongest evidence yet for the benefits in healthy people.

Most interesting, after further analysis, the researchers found that no single part of the Mediterranean diet played an appreciable role in reducing mortality. But the cumulative effect of all these foods, which may act synergistically, was substantial. Even olive oil (the most famous part of the Mediterranean diet), by itself, was not found to reduce mortality. However, healthy fats are still important. A high consumption of monounsaturated fat, together with a lower intake of saturated fat, did seem to play a significant role in reducing mortality rates. Olive oil, of course, is a major source of monounsaturated fat, and so are nuts and canola oil.

Sad to say, Greeks, like other Mediterranean people, have been moving away from their traditional habits. They are more sedentary, drink less wine, consume more calories, and eat more saturated fat (from meat and cheese) and less monounsaturated fat. Thus, cholesterol levels, blood pressure, and body weight have been increasing substantially. Researchers attribute these unhealthy changes to growing prosperity over the past 30 years. It’s ironic that as the Greeks abandon their traditional diet and try to live more like American and Australian cultures, some Americans and Australians are (for good reason) trying to eat more like Mediterranean's of old.

 

The Mediterranean diet significantly reduces the risk of heart disease. Remarkably, this benefit was not related to any significant difference in cholesterol levels, rather the components of the diet seem to work together to protect the body.

The Mediterranean diet include:

  • Eating a generous amount of fruits and vegetables

  • Consuming healthy fats such as olive oil and canola oil

  • Eating small portions of nuts

  • Drinking red wine, in moderation, for some

  • Consuming very little red meat

  • Eating fish on a regular basis

  • Fruits, vegetables and grains

The traditional diet among some Mediterranean countries includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables. This eating pattern has been associated with a lower level of low-density lipoprotein (LDL) oxidation — a change in LDL cholesterol (the "bad" cholesterol) that makes it more likely to build up deposits in your arteries.

Grains in the Mediterranean region typically contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten without butter or margarines, which contain saturated fat or trans fats.

The Mediterranean diet doesn't view all fat as bad. The focus of the diet isn't to limit total fat consumption, but to make wise choices about the types of fat you eat. Sources of fat include olive oil, canola oil and nuts, particularly walnuts. Fish another source of omega-3 fatty acids is eaten on a regular basis in the Mediterranean diet. Studies have shown that omega-3 fatty acids lower triglycerides and may provide an anti-inflammatory effect helping to stabilize the blood vessel lining. The Mediterranean diet discourages saturated fats and hydrogenated oils such as trans-fatty acids, both of which contribute to heart disease.

All types of olive oil provide monounsaturated fat, but "extra-virgin" or "virgin" oil are the least processed forms, and so contain the highest levels of the protective plant compounds that provide antioxidant effects. Generally speaking, nuts are high in fat with some nuts having a content of up to 80 percent of their calories. Tree nuts on the other hand, including walnuts, pecans, almonds and hazel nuts, are low in saturated fat. Walnuts also contain omega-3 fatty acids as an added benefit to your health. But be cautious as nuts are high in calories, so they should not be eaten in large amounts. A good guide is no more than a handful a day.

The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, light intake of alcohol is associated with a reduced risk of heart disease. Red wine has an aspirin-like effect for example, reducing the blood's ability to clot, as well as containing antioxidants. The Mediterranean diet typically includes some red wine, but this should be consumed only in moderation. This means no more than one glass of wine daily for women (or men over age 65), and no more than two glasses of wine daily for men under age 65. Any more than this increases the risk of health problems, including increased risk of certain types of cancer.

A general guideline for the Mediterranean diet  is to choose plenty of fresh fruits and vegetables, limit intake of red meat, eat fish (not fried or laden with butter or heavy sauces) at least once a week. Don't be afraid of healthy fats such as olive oil, nuts and canola oil (but use these in moderation because of their high calorie content), and reduce or eliminate saturated fat and trans fats (also known as hydrogenated or partially hydrogenated oils) from your diet. Read food labels to see what you're really buying.

 

Here are some guidelines to help you on your way:

  • Eat natural peanut butter, rather than the kind with hydrogenated fat added.

  • Use butter sparingly, and don't think that "low fat" or "cholesterol-free" on the label means a product is necessarily good for you. Many of these items are made with trans fats.

  • Eat a variety of whole fruits and vegetables every day. Ultimately, strive for seven to 10 servings a day.

  • Keep baby carrots, apples and bananas on hand for quick, satisfying snacks. Fruit salads are a wonderful way to eat a variety of healthy tasty fruit.

  • Use canola or olive oil in cooking. Try olive oil for salad dressing and as a healthy replacement for butter or margarine. After cooking pasta, add a touch of olive oil, some garlic and green onions for flavoring. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter.

  • Substitute fish and poultry for red meat. Avoid sausage, bacon and other high-fat meats.

  • Limit higher fat dairy products such as whole or 2% milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.

  • Eat fish once or twice a week. Water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it's sauteed in a small amount of olive oil.

  • Keep walnuts, almonds, pecans and Brazil nuts on hand for a quick snack.

  • If it's OK with your doctor, go ahead and have a glass of red wine at dinner with your pasta or fish. If you don't drink alcohol, you don't need to start.

  • Once you experience the delicious and healthy choices the Mediterranean diet has to offer, it just might become your favorite diet.

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