Advanced Mediterranean Diet

My local newspaper, The East Valley Tribune, had an article yesterday headlined, “Study says gastric bypass surgery reduces cancer rates.”  Google found me an online version of the story from another source.  I assume the Canadian researchers issued a news release.

Researchers at McGill University followed 1,035 gastric bypass patients over five years or more, with 5,746 obese people serving as controls.  “Controls” means they did not have the surgery but were otherwise similar to the surgical group.  The bypass patients lost 67% of their excess weight, which is considered successful surgery.

Breast and colon cancers were reduced by 85% and 70%, respectively.  Obesity is associated with increased risk of breast and colon cancer, so some reduction would make sense intuitively.  You might guess that loss of excess weight by any method would reduce risk of developing breast or colon cancer.  You may or may not be right.  But cancer death reduction has been ”proven” for weight loss only via bariatric surgery, not other weight-loss methods.  Utah surgeons reported 60% lower risk of death from cancer after bariartric surgery (see reference below).

The Canadian researchers reported that skin cancer was reduced by 60%, which is surprising.  Obesity is not associated with skin cancer.  They also report a 50% reduction in non-Hodgkins lymphoma and 70% reduction in pancreatic cancer.  Those cancers have not consistently been associated with obesity in the past.  Furthermore, pancreatic cancer and non-Hodgkins lympoma are not common, and you wouldn’t expect many cases, if any, to occur in such a small sample size (6781 people).  I suspect the observed reductions in skin cancer, pancreatic cancer, and lymphoma are not valid and reproducible.  But who knows?  We need more details of the study, including the statistical analysis.

My point in bringing up this subject is to caution you that these results are preliminary.  I hope they are real, meaning reproducible and reliable.  Prior research from Utah tends to confirm the essential finding: bariatric surgery significantly reduces cancer rates.  The Canadians undoubtedly have submitted their report to one or more medical scientific journals for publication at a future date.  A major part of the publication process involves “peer review.”  The manuscript for publication will be reviewed by independent experts in the field who are in a position to judge whether the study was well-designed, valid, and reliable.  If not, the findings will not gain credibility among the medical/scientific community and will be ignored.  We may not see publication of the study details in a peer-reviewed journal for over a year.

Much hangs in the balance here: increased insurance coverage for the surgery, the volume of future gastric bypass operations, and people’s lives.  The odds of dying from a surgical complication are about one in 200.

Steve Parker, M.D., author of The Advanced Mediterranean Diet

Reference:  Adams, Ted, et al.  Long-Term Mortality after Gastric Bypass Surgery.  New England Journal of Medicine, 357 (2007): 753-761. 

The U.S. Centers for Disease Control and Prevention, along with the National Vital Statistics System, reported this month on death rates and life expectancy for the year 2006, the latest year for which numbers are available.

• From 2005 to 2006, death rates decreased significantly for 11 of the 15 top causes of death in the U.S.
• There were fewer age-adjusted deaths from heart disease, cancer, strokes, high blood pressure, and diabetes mellitus.
• Life expectancy in the U.S. rose to an unprecedented 78.1 years.  [Japan holds the record at 83 years.]

Please keep these optimistic statistics in mind as you fret about the risks of overweight and obesity, shoddy medical care, high fructose corn syrup, chemical additives in plastic water and baby bottles, fish contaminated with mercury and PCBs, lead paint on toys, overpopulation, medical errors in hospitals, high-carbohydrate diets, saturated fats, trans fats, food coloring and other chemical food additives, municipal water supply contamination by medications, global warming, childhood vaccinations, killer tomatoes (Salmonella contamination), cancer from cellphones, and staph gone wild (MRSA: methicillin-resistant staph aureus).

- Steve Parker, M.D., author of the award-winning Advanced Mediterranean Diet

Additional information:  CDC’s graphical presentation of declining death rates for heart disease, cancer, and cerebrovascular disease from 2001 to 2006.

Have you heard of the Geek Diet, “How to Eat Like a Hot Chick” Diet, the Tapeworm Diet, or Dr. Siegal’s Cookie Diet?  At DietsInReview, you will find reasonable reviews of these, plus just about every other diet or weight-loss method.

Brandi Koskie, senior editor at DietsInReview, graciously interviewed me a few days ago.  Please listen to the 15 to 20-minute audio-interview to satisfy your curiosity about my voice as I wax poetic about The Advanced Mediterranean Diet.

Steve Parker, M.D., author of the The Advanced Mediterranean Diet

The traditional Mediterranean diet has long been associated with lower risk of developing cardiovascular disease, cancer, and dementia.  The diet is rich in olive oil, fruits, nuts, cereals, vegetables, and fish but relatively low in dairy products and meat.  Several recent studies suggest the Mediterranean diet may also help prevent type 2 diabetes.

Researchers at the University of Navarra in Spain followed 13,380 non-diabetic university graduates, many of them health professionals, over the course of 4.4 years.  Average age was 38.  I assume most of the study participants lived in Spain, if not elsewhere in Europe (the article doesn’t say).  Dietary habits were assessed at the start of the study with a food frequency questionnaire.  Food intake for each participant was scored by adherence to the traditional Mediterranean diet.  Participants were labelled as either low, moderate, or high in adherence.  Over an average follow-up of 4.4 years, 33 of the study participants developed type 2 diabetes.  Compared to the participants who scored low on adherence to the Mediterranean diet, those in the high adherence category had an 83% lower risk of developing diabetes.  The moderate adherence group also had diminished risk, 59% less.

How could the Mediterranean diet protect against diabetes?  The authors note several potential mechanisms: high intake of fiber, low amounts of trans fats, moderate alcohol intake, high vegetable fat  intake, and high intake of monounsaturated fats relative to saturated fats.  Olive oil, loaded with monounsaturated fats, is the predominant fat in the Mediterranean diet.  In summary from the authors:

Diets rich in monounsaturated fatty acids improve lipid profiles and glycaemic control in people with diabetes, suggesting that a high intake improves insulin sensitivity.  Together these associations suggest the hypothesis that following an overall pattern of Mediterranean diet can protect against diabetes.  In addition to having a long tradition of use without evidence of harm, a Mediterranean diet is highly palatable, and people are likely to comply with it.

Please give serious consideration to the Mediterranean diet, especially if you are at risk for developing type 2 diabetes.  Major risk factors include sedentary lifestyle, overweight, and family history of diabetes.

Steve Parker, M.D., author of the award-winning Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterraneanDiet.com

Reference: Martinez-Gonzalez, M.A., et al.  Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study.  British Medical Journal, BMJ,doi:10.1136/bmj.39561.501007.BE (published online May 29, 2008).

Here’s my logic:

1. Your income is being squeezed by the higher prices you pay for gasoline.

2. Inflation is raising the cost of food, another drain on your income.

3. The recent floods in the U.S. Midwest have destroyed many crops, which will soon lead to even higher prices for basic food commodities such as corn and soybeans.

4. You still have time to lose at least 10 pounds before your vacation to the beach in August.

5. There’s a global food shortage and other people need food more than you if you are carrying lots of extra fat weight.

6. Most effective diets involve eating fewer calories than you normally eat, which means less food for you to buy and more food available to others who may need it more

7. Your body stores energy (calories) in the form of fat in order to tide you over periods of food shortage.  As your body converts fat into usable energy, you lose weight.

So now is the time to lose excess weight, saving money on groceries and helping your less fortunate neighbors.  Why not start today?

Steve Parker, M.D., author of the award-winning Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer    www.AdvancedMediterraneanDiet.com

I found another good website that could help improve your nutritional status and weight management efforts.  It’s “Calorie Count Plus,” a free service of About.com.  One of the things I like about About.com is their medical advisory board that oversees much (all?) of the health and nutrition information the site dispenses.

Calorie Count Plus provides:

• Food Log, allowing you to keep track easily of all your food intake, for those so inclined.  With a click, you can analyze your consumption for percentage intake of fat/carbs/protein,  and amounts of sodium, sugar, saturated fat, fiber, and calories.
• Activity Log, which estimates how many calories you burn during exercise.
• Weight Log.  Watch your weight trend on a graph over time.
• Body Mass Index calculator.
• My Journal.  Record your thoughts or other notes as often as you wish, allowing others to view or not.
• “Calories Needed for Weight Loss” analyzer.  The recommended caloric intake for you accounts for weight, sex, age, and activity level.
• “Daily Caloric Expenditure” analyzer.  Tells you how many calories you are probably eating currently to maintain a steady weight.  The calculation accounts for weight, sex, age, and activity level.
• Forums for discussion of weight loss, fitness, motivation, recipes, health issues, etc.
• Recipes.

The Internet is rife with harmful and misleading weight-loss, fitness, and nutrition “information.”  Check in at Calorie Count Plus before wasting time elsewhere.

Steve Parker, M.D., author of the award-winning Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterraneanDiet.com

Joel Gates, in his mid-30’s, resolved to lose weight in 2008.  Struggling with excess weight since high school, he had tried numerous “fad diets” in the past.  He looked at all the available options and couldn’t decide which diet to go with, so he decided to “try ‘em all.”

Joel is going on a new diet at the start of every month during 2008.  So far he has done a self-styled calorie-restricted diet (1872 cals/day), South Beach, Slim Fast, The Abs Diet, and Weight Watchers.  Having started at 234 pounds January 1, he was down to 196 pounds by the end of May.  So much for the adage that “diets don’t work.”  Joel shares his evaluation of various diets with us through his blog, DozenDiets.com.

Here are Joel’s criteria for judging a diet:

1. Does it work, and how well?
2. Does it allow you to “cheat” and yet still work?
3. Is it easy to stick with?
4. How do you feel while you’re on it?

You can get a sense for who Joel is by knowing his “Dozen Diets Canon”:

1) You are not as fat as you think you are.  2) It is noble and fine to work to improve yourself, but you also gotta be happy in your own skin.  3) You are a beautiful human being.  4) No expert can tell you for certain what will work for you. Different diets and exercise programs work differently for different people.  5) Don’t let anyone else make you feel bad because of the way you look.  6) Don’t let food control you. Not your mood and not your choices.  7) If you fall down, get up and get moving again.

For the month of June, Joel chose The Advanced Mediterranean Diet.  At his blog, DozenDiets.com, Joel will be writing about his experience with the AMD.  He is an interesting writer, clear-headed and concise, posting roughly every other day.  Why not follow along?

Steve Parker, M.D., author of The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer   www.AdvancedMediterraneanDiet.com

Full Disclosure: I don’t know Joel Gates.  I’ve read some of his blog, posted a few messages there, and we exchanged a couple emails earlier this year.  I gave him a copy of The Advanced Mediterranean Diet a few months ago.  We do not have a financial relationship.  He is trying the AMD of his own volition.  Nevertheless, I bet I’d like him if I knew him.