KaiMD

Mediterranean Diet

March 21st, 2013

A recent article published in the New England Journal of Medicine, titled “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet” created many waves in the world of nutrition.  The researchers from Spain who conducted the study had assigned two groups of people to a control group that ate a traditional “low fat” diet and an experimental group that ate a “Mediterranean” diet.  Some of the main differences include:  Encouragement to consume more than 4 tablespoons of olive oil per day, more nuts and beans in the Mediterranean group, Wine (no more than 1 glass/day) was allowed in the Mediterranean group, but none in the “low fat” group.

Though there was little observed weight loss in either group, the researchers saw dramatic reductions in heart attacks and strokes in the Mediterranean diet group.  In fact, the study was halted early because the researchers believed it was unethical to allow the control group (low fat) to continue because there was overwhelming evidence to show that the Mediterranean diet could make an impact on the participants’ health.

I believe the study reinforces many aspects of nutrition that we already know.  We know that olive oil, tree nuts (such as almonds and walnuts), red wine, and fish oils can raise HDL (“good”) cholesterol and that in turn has a cardioprotective benefit.  The diet also emphasized increasing intake of foods with antioxidants, such as fruits and vegetables.  I was a little surprised that weight was not as much of a factor.  Perhaps, it is the quality of the calories in the diet that makes a bigger difference.  However, I do think it is still important to maintain a good BMI.

The study also included a spice mixture called “sofrito” which is ubiquitous in Spanish cuisine.  It contains tomato, onion, garlic and olive oil. Previous studies have speculated that garlic can be helpful for lowering LDL (“Bad”) cholesterol and lower blood pressure.  Before you go out and buy that large bottle of olive oil, be sure that you purchase extra virgin olive oil, as use of the the refined variety (low in polyphenols) was discouraged.  Overall, I believe there is no downside to following the Mediterranean diet.  Many people have already adopted it or some aspects of the diet already. I am ectstatic to see that there is more evidence that diet can change your medical conditions and hope that one day a prescription for the “Mediterranean Diet” will be more commonplace than drugs for high cholesterol and high blood pressure.

Here are the actual daily recommendations for the Mediterranean diet group in the study:

Recommended

  • More than 4 tablespoons of extra virgin olive oil
  • 1 serving of nuts per day (30 grams total with 15g walnuts, 7.5g almonds, 7.5g hazelnuts)
  • More than 3 servings of fresh fruit per day
  • More than 2 servings of vegetable per day
  • More than 3 servings of fish per week (fatty fish was recommended)
  • More than 3 servings of legumes (beans) per week
  • More than 2 servings of Sofrito (sauce made with olive oil, tomatoes, garlic, and onions)
  • White meat instead of red meat
  • 1 glass of wine with meals (optional, only for people who usually drink alcohol)

Discouraged

  • Soda
  • Commercial bakery goods, sweets, pastries
  • Spread fats (i.e. butter)
  • Red and processed meats