My stepmother, Janet Long, served as a Cardiology Nurse Practitioner and Clinical Lipid Specialist for around twenty-five years before her retirement. During her tenure, she saw a lot of patients in a lot of scenarios and learned a lot of things, particularly regarding a healthy diet. Herein she writes about the Mediterranean diet, a form of eating very close to my own heart and something I've been meaning to write about for awhile. Enjoy!
The Mediterranean Diet was first introduced in the late 1950’s when it was observed that people living in southern Europe had less coronary heart disease mortality. Since that time, there have been numerous studies that support the cardiovascular benefits of this diet including current guidelines for the primary prevention of stroke. (1)
February is “Heart Month” and a good time to look at the benefits of diet on the cardiovascular system. Numerous trials including two landmark studies, Prevención con Dieta Mediterránea (PREDIMED) trial (2) and the Lyon Diet Heart Study (3) have shown significant benefits. The PREDIMED trial was a primary prevention (those without any known history of cardiovascular disease) trial that showed a 30% reduction in vascular events in those participants following the Mediterranean style diet. The Lyon Diet Heart Study was a secondary prevention study (those with known cardiovascular disease) that showed a 72% reduction in cardiovascular events in the Mediterranean style diet group compared with the control group who followed a Western style diet.
The Mediterranean Diet consists of:
o Cheese, yogurt, olive oil, fruits, beans, legumes, nuts, vegetables, whole grain bread, pasta, rice, couscous, barley, other whole grains and potatoes. Drink large amounts of water. Wine in moderation.
o Sweets, eggs, poultry, fish
o Red meat in small portions
The Mediterranean Diet is not a homogenous nutritional model. There are varied cultures in the Mediterranean basin with different traditions and dietary habits that result in a wide variation of dietary patterns. The benefits of the Mediterranean Diet are thought to come from a high consumption of plant based foods and olive oil. Additionally the benefit of omega-3 polyunsaturated fat from fish and green leafy vegetables and legumes is important. (3) High amounts of vitamin C, vitamin E, beta carotene, glutathione, phytoestrogens, and phytochemicals from green leafy vegetables, phenolic compounds from wine and olive oil all contribute to the antioxidant and anti-inflammatory benefits and thus a reduction in the coronary vascular disease. (4)
Inflammation is an enemy to the vascular system, specifically the endothelium, the lining of the arteries throughout the body. When the endothelium becomes inflamed, it does not dilate or relax normally, and it becomes porous and fatty deposits are able to invade the endothelium. In simplistic terms, this begins the process of cardiovascular disease. So a diet that is low in saturated fat, high in omega-3 fatty acids, rich in antioxidants fiber and vitamins, has been shown over decades to decrease the inflammatory process and protect the blood vessels.
1. Meschia JF, Bushness C, Boden-Albala B, et al. on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Functional Genomics and Translational Biology and Council on Hypertention. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; 45:3754–3832
2. Estruch R, Ros E, Salas-Salvadό J, et al; on behalf of the PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013; 368: 1279-90.
3. De Lorgeril M, Salen P, Martin JL, Monjaud l, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999; 99: 779-85.
4. Simopoulos AP, Visioli F. World Review of Nutrition and Dietetics Mediterranean Diets. Vol.87. New York. Karger. 2000.
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