Mediterranean diet to prevent cardiovascular disease

 
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PostPosted: Mon Feb 25, 2013 11:38 am    Post subject: Mediterranean diet to prevent cardiovascular disease Reply with quote

A study has been published in the New England Journal of Medicine (February 24-25, 2013)claiming that the Mediterranean diet has been shown to reduce the likelihood of cardiovascular disorders, at least in the study subjects.

The study involved 7,447 people (57% women) between the ages of 55 and 80, followed over nearly 5 years.

This part of the article tells what the diet consists of:


Quote:
The general guidelines to follow the Mediterranean diet that dietitians provided to
participants included the following positive recommendations: a) abundant use of olive oil for
cooking and dressing dishes; b) consumption of ≥ 2 daily servings of vegetables (at least
one of them as fresh vegetables in a salad), discounting side dishes; c) ≥ 2-3 daily servings
of fresh fruits (including natural juices); d) ≥ 3 weekly servings of legumes; e) ≥ 3 weekly
servings of fish or seafood (at least one serving of fatty fish); f) ≥ 1 weekly serving of nuts or
seeds; g) select white meats (poultry without skin or rabbit) instead of red meats or
processed meats (burgers, sausages); h) cook regularly (at least twice a week) with tomato,
garlic and onion adding or not other aromatic herbs, and dress vegetables, pasta, rice and
other dishes with tomato, garlic and onion adding or not aromatic herbs. This sauce is made
by slowly simmering the minced ingredients with abundant olive oil. Negative
recommendations are also given to eliminate or limit the consumption of cream, butter,
margarine, cold meat, pate, duck, carbonated and/or sugared beverages, pastries, industrial
bakery products (such as cakes, donuts, or cookies), industrial desserts (puddings, custard),
French fries or potato chips, and out-of-home pre-cooked cakes and sweets.

The dietitians insisted that two main meals per day should be eaten (seated at a table,
lasting more than 20 minutes). For usual drinkers, the dietitian’s advice was to use wine as
the main source of alcohol (maximum 300 ml, 1-3 glasses of wine per day). If wine intake
was customary, a recommendation to drink a glass of wine per day (bigger for men, 150 ml,
than for women, 100 ml) during meals was given.

Ad libitum consumption was allowed for
the following food items: nuts (raw and unsalted), eggs, fish (recommended for daily intake),
seafood, low-fat cheese, chocolate (only black chocolate, with more than 50% cocoa), and
whole-grain cereals.

Limited consumption (≤1 serving per week) was advised for cured ham,
red meat (after removing all visible fat), and cured or fatty cheeses.


The nuts used as part of the dietary protocol were almonds, hazelnuts, and walnuts.

The study article is available here.
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PostPosted: Wed Mar 20, 2013 10:58 am    Post subject: Medscape editor-in-chief's favorable opinion of this study Reply with quote

A very definite thumbs-up for this study from Medscape (March 20, 2013):

Quote:
'Evidence Is Compelling' on Mediterranean Diet

Eric J. Topol, MD

Mediterranean Diet Study

Hello. I am Dr. Eric Topol, Editor-in-Chief of Medscape. I am thrilled to be the new editor-in-chief; ...

In this brief segment today, I will talk about the Mediterranean diet study. This is a study that was published in the February 25 New England Journal of Medicine.[1] I will try to get some commentary, either from myself or other colleagues, about really important studies, and I believe that this is one of them.

We don't talk enough about diet in medicine, but this is the largest randomized trial to date. The Mediterranean diet has been studied previously in randomized trials but not in a trial as large as this. It is fascinating that this was a study of more than 7400 individuals who were randomly assigned to 3 different diets. Two were Mediterranean diets enriched with either extra-virgin olive oil or nuts and other Mediterranean foods, both including more than 7 glasses of wine per week. The control diet was a low-fat diet, which some people have argued is not an ideal control. There was very good compliance with the diets in this large number of people for many years. The primary endpoint was death, heart attack, or stroke. There was a very important significant reduction of this cluster endpoint in the Mediterranean diet groups. Particularly noteworthy, even by itself, was the reduction in stroke.

Clinical Impact of the Mediterranean Diet Study
We now have dietary evidence that is fairly compelling. The absolute size reduction was not large, but the fact that the Mediterranean diets tested in this trial had such a positive impact gives us some anchoring about a diet that does lower critical cardiovascular endpoints. For many years, there has been discussion about this low-fat diet and whether it had a meaningful clinical impact. At one point, the Mediterranean diet was very much supported by the American Heart Association and other organizations. Now we see that it appears to be superior. The trial has had criticism, particularly honing in on the low-fat control arm of the study, but nonetheless, the evidence is compelling.

Why is this trial unique? It was funded by the Spanish government. This is a country that isn't known these days for having extraordinary resources to fund research, but the government of Spain got behind an important trial, perhaps the most impressive diet-randomized trial that has been performed. We have to give a lot of credit to them, because this trial was done with that level of funding and with superb investigators throughout the country of Spain, and it makes a lasting contribution. We are always in search of more information about what we eat, and this is welcome. It is particularly nice to know that you can have 7 glasses of wine or more each week and it might have a favorable effect.
...

___________________________

References
1.Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013 February 25.
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