Advanced Mediterranean Diet

The journal Circulation earlier this year reported that the Mediterranean diet reduces risk of stroke in women by 13% in a report published earlier this year.  This supplements our prior knowledge that the healthy diet is associated with lower risk of coronary heart disease in both men and women.

Researchers in Boston analyzed the records of 74,886 middle-aged women in the Nurses’ Health Study to deteremine how closely they followed a Mediterranean diet pattern.  They followed participants’ health status for 20 years, noting how many women developed stroke, coronary heart disease, and “cardiovascular death” (fatalities from strokes and coronary heart disease combined). 

Compared with the women who adhered minimally to the Mediterranean diet pattern, the women with highest compliance had 13% fewer strokes.  Consistent with earlier studies, the Mediterranean dieters had 39% lower risk of cardiovascular death and 29% lower risk for coronary heart disease (again, comparing the women with highest and lowest compliance). 

Take-Home Points 

To gain the health benefits of the Mediterranean diet, consider making changes to the way you eat.

Here are the characteristics of the traditional Mediterranean diet:

• It maximizes natural whole foods and minimizes highly processed ones
• Small amounts of red meat
• Less than four eggs per week
• Low to moderate amounts of poultry and fish
• Daily fresh fruit
• Seasonal locally grown foods with minimal processing
• Concentrated sugars only a few times per week
• Wine in low to moderate amounts, and usually taken at mealtimes
• Milk products (mainly cheese and yogurt) in low to moderate amounts
• Olive oil as the predominant fat
• Abundance of foods from plants: vegetables, fruits, beans, potatoes, nuts, seeds, breads and other whole grain products

Steve Parker, M.D.

Reference:  Fung, Teresa, et al.  Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women.  Circulation, 119 (2009): 1,093-1,100.

Bryan Nugent, librarian at Banner Baywood Medical Center (Mesa, Arizona), makes my job much easier and affordable.  Bryan acquires medical journal articles for me, which I use in direct patient care as well as fodder for blog posts.

Individual journal articles would cost me $15-35 (US).  Regular visitors here know I read lots of journal articles; I could easily spend $4000 a year in subscriptions to medical and nutrition journals pertinent to my medical practice.

Thanks, also, to Banner Health System for providing this service at their expense.  Banner supports its medical staff by providing up-to-date journal articles, which helps us provide better medical care.

Steve Parker, M.D.

Several of the websites below include comments from people who have tried the recipes, as well as nutritional analysis.

http://www.allrecipes.com            Enter search term “Mediterranean”
http://www.arabicnews.com         See Food and Recipes under “Resources”
http://www.cliffordawright.com
http://www.gourmed.gr                For English, click on the British flag in the upper right corner
http://www.mediterrasian.com
http://www.recipezaar.com           Not a sure thing.  Try searching “Mediterranean”
http://www.videojug.com              Check the Mediterranean subsection under “Food & Drink”

Happy hunting!

Steve Parker, M.D.

I do not like broccoli.  And I haven’t liked it since I was a little kid and my mother made me eat it.  And I’m President of the United States and I’m not going to eat any more broccoli.

-George H.W. Bush, 1990, 41st President

This is for my readers of child-bearing age, and those who care about them.

The U.S. Preventive Services Task Force recently reviewed the evidence on folic acid and prevention of neural tube defects in babies.  They recommend all women planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg of folic acid.

Just in case you hadn’t heard about it already.

Steve Parker, M.D.

Reference:  USPSTF announcement in the Annals of Internal Medicine.

I ran across a thought-provoking article published a few months ago at DiabetesHealth online.  It’s a non-scientific exploration of the potential causes of “diabesity,” the combination of obesity and type 2 diabetes.

You’ll get a kick out of this especially if you’re over 40.  It probably explains much the Western world’s current obesity epidemic, separate from diabetes.

Click here to read “50 Reasons Why Diabesity Wasn’t Prevalent 50 Years Ago.”

Steve Parker, M.D.

I love Amazon.com.

I’ve had nothing but great interactions with Amazon.com, both as a business partner and as a customer buying books and music CDs.

Amazon.com is a major seller of my book, The Advanced Mediterranean Diet: Lose Weight, Feel Better, Live Longer.

When Amazon sells all their copies of the book, future sales always drop off significantly until a new shipment of books gets to the warehouse.  Who wants to order a book on back-order that may take three to five weeks to arrive?

Just be aware that you can also get the book from the publisher’s website when Amazon is out of stock.

Steve Parker, M.D.

Oldways  and the Mediterranean Foods Alliance announce that May is Mediterranean Month.  It’s a way to promote healthy Mediterranean-style eating.

I can’t think of any other organization that’s done more than Oldways to spread the gospel about the Mediterranean diet.

In this context, “diet” refers to a habitual way of eating rather than a weight-loss program.

But who is Mediterranean Foods Alliance?  From their website, MFA . . .

. . . is a group of devoted partners (health professionals, scientists, food companies, retailers, culinary experts, and media) working together to help people eat better with the Mediterranean Diet.

Mediterranean Month features include:

• Mediterranean diet recipe contest (with prizes!)
• 7-day Mediterranean diet meal plan
• budget-friendly recipes
• Mediterranean Month Calendar Tips for incorporating the Mediterranean diet into your life

Click on the links in the first paragraph for details.

Steve Parker, M.D.

Medical News Today on May 6, 2009, published a comprehensive review of the health benefits of the Mediterranean diet.  Click here to read.

My only point of disagreement is regarding whether the Mediterranean diet lowers your risk of obesity.  MNT says “yes.”  The studies I’ve read are inconclusive.

Steve Parker, M.D.

I’m not going to lie.  I admit I drop into McDonald’s now and then for a meal.  Drive-through is more like it.

The “Apple Dippers” seem like a good healthy option, often marketed as an alternative to french fries.  They are pre-packaged peeled apple slices.  About $1 (US).  Apples are healthy, right?

Nutrition facts are right there on the package:

• 35 calories
• no saturated fat
• no fat
• no trans fat
• no cholesterol
• no sodium
• no fiber [no fiber?!]
• no protein
• 6 gm sugar
• 310% Daily Value of vitamin C
• 4% Daily Value of calcium (much of the calcium and vitamin C come from the added calcium ascorbate)
• myriad unlisted phytonutrients and trace minerals

However . . .

They come with a packet of caramel dipping sauce, making for a delicious combination if you have a sweet tooth.

The sauce contains (in order listed) corn syrup, sweetened condensed whole milk, high fructose corn syrup, water, butter, sugar, salt, disodium phosphate, artificial flavors, caramel color, pectin, and potassium sorbate as a preservative.

Not exactly an integral component of the Mediterranean diet.  But it’s not going to kill you.

Here are the only major changes in the listed nutrition facts when eating the apples with the sauce:

• calories go from 35 to 100
• sugars go from 6 to 15 gm

It doesn’t seem quite so healthy now, even in comparison to french fries.  A small order of fries has 230 calories - not so good if you’re watching your weight.

A fresh whole apple with peel is healthier.  And it’s not safe to drive and dip at the same time.

You can see complete McDonald’s nutrition facts here if you want to finish the comparison.  You can see amounts of about 75 components of an apple, with and without peel, at the USDA National Nutrient Database for Standard Reference. For instance, a medium apple with peel has 4.4 gm of fiber.

You can find similar nutritional information at NutritionData, with an analysis including estimated glycemic load and Inflammation Factor.

McDonald’s has provided a huge amount of inexpensive convenient nutrition for years.  I give them credit for making an effort to be more health-conscious.

What do you think?

Steve Parker, M.D.