The Health Benefits of the Mediterranean Prescription

Excerpted from
The Mediterranean Prescription: Meal Plans and Recipes to Help You Stay Slim and Healthy for the Rest of Your Life
By Angelo Acquista, M.D., Laurie Anne Vandermolen

Living Healthier and Longer

In the United States, as well as most other industrialized countries, cardiovascular disease and cancer are ranked as the top two leading causes of death, and together account for nearly half of all deaths. Indeed, it'd be hard to find someone who didn't have a case in their family or in someone's close to them. Worldwide, the numbers are so large they're numbing: cardiovascular disease accounts for around seventeen million deaths (about percent of the total), while cancer contributes to approximately seven million deaths (about 15 percent). The amazing thing is that both are strongly linked to lifestyle choices - one of the most important of which is diet. For example, it has been estimated that around one-third of all cancer deaths in the United States could be avoided simply through dietary modification. A 2005 World Health Organization report stated that up to 2.6 million deaths worldwide and 31 percent of cardio-vascular disease may be attributed simply to inadequate consumption of fruits and vegetables.

As I have said earlier, the Mediterranean diet has been studied since the 1950s, and the region stood out in worldwide nutritional research that showed its inhabitants were the healthiest, with the least heart disease and the longest life spans. Since that time, a great deal of research has been carried out to expand on the many healthful effects of the diet, more of which we're finding out every day. Some of the numerous diseases and conditions that can be potentially prevented or improved by following the Mediterranean diet are:

• Obesity
• Cardiovascular disease
• Heart attack
• Cancer
• Arthritis
• Type 2 diabetes
• Hypertension
• Metabolic syndrome

In addition to the Mediterranean lifestyle helping people achieve a healthy weight and level of physical activity, it is believed that the Mediterranean diets mix of antioxidants, phytochemicals, monounsaturated fats, omega-J fatty acids, and fiber is the key to its health-promoting qualities. Food intake produces oxidation, which leads to a state that promotes inflammation. Inflammation on a very fundamental level-such as in your arteries-may lead to a variety of illnesses. One of the leading theories of the mechanism behind the diets protective effects is that its components prevent this inflammation, which is a common link among many of the conditions the diet improves or prevents. More research needs to be done to explain the exact workings, hut in the meantime, it's important to know that there is convincing evidence that a number of illnesses can be reduced in severity or avoided just by changing your eating habits, with no drug or surgical intervention whatsoever. If any of these conditions run in your family, this advice should be considered even more seriously, since this puts you at greater risk already.

Obesity

Many studies have confirmed the successful long-term use of the Mediterranean diet in weight Kiss. One research group even stated, "Long-term follow-up of this diet program is at least as effective as any diet or diet-and-drug therapy published." In a diet review paper, after criticizing other restrictive diets, one obesity expert affirmed that "the Mediterranean diet was ideal, better tasting, proven heart-protective, with increased longevity." The most common statements in the medical literature relate to its capacity for long-term participation and adherence, in addition to the many health benefits it bestows.

Heart Disease

The relationship between the Mediterranean diet and heart disease is likely the most studied aspect of the diet. The diet has a remarkable ability to protect your heart. Perhaps most important is its capacity to reduce the risk factors for cardiovascular disease, such as increased body weight, high blood pressure, and high LDL and low HDL cholesterol. Countless studies have shown its protective effects against cardiovascular disease, atherosclerosis, and heart attack. One example is the Lyon Diet Heart Study, in which participants on the Mediterranean diet were shown to have a nearly 70 percent reduction in risk of coronary events (such as heart attack) and cardiac deaths. In another study, Harvard researchers determined that by replacing 5 percent of daily saturated tat with unsaturated fat, a woman's risk for heart disease could be reduced by 42 percent. An important aspect the heart researchers brought up repeatedly was the terrific propensity to adhere to the diet: in one of the longest studies. and I feel I could wait that long. kept telling me. Apart from the health benefit of reducing red meat in your diet.

Type 2 Diabetes

In type 1 diabetes, for some inborn reason, the body does not produce insulin, which is necessary for the body to be able to use sugar properly. Type 2 diabetes, on the other hand, is acquired; either the body stops producing enough insulin or the cells start ignoring the insulin. It's believed that in most patients, the clinical expression of type 2 diabetes could be prevented by dietary and lifestyle changes. Nearly nine out of ten people with newly diagnosed type 2 diabetes are overweight. Studies have shown that a Mediterranean-type diet can reduce aspects of type 2 diabetes, such as insulin resistance. Since diabetes is associated with a fourfold risk of atherosclerosis, it is of significance that following a Mediterranean diet has also been shown to have a protective role against it for diabetics.

Hypertension

Hypertension has long been recognized as a major risk factor for several common cardiovascular diseases. The World Health Organization reports that three million people will die annually as a result of hypertension. There is evidence to support that the adoption of the Mediterranean diet could help reduce high blood pressure levels. For example, a recent study showed that adherence to the Mediterranean diet as a whole is associated with lower blood pressure, as is olive oil intake in particular. Another study showed that following the diet was associated with a 26 percent lower risk of being hypertensive.

Since being overweight and obesity are strongly linked to high blood pressure, losing weight and maintaining weight on the Mediterranean diet can help. I had one overweight patient who came in complaining of headaches, and it turned out he was hypertensive. I was going to start him on blood pressure medications, but he didn't want the expense or hassle, nor did he like that the medications can interfere with sexual function in men, cause allergic reactions, and produce a host of other side effects such as fatigue, abdominal pain, and diarrhea. Instead, he promised me he'd lose weight. I explained my diet and wrote out some recipes on my prescription pad. He went on it, and two months later he had lost twenty pounds. His blood pressure was now normal, and he didn't need any drugs. He was in his mid-thirties, and his father had died of a stroke at a young age, so in many ways this was an extremely successful intervention and lifestyle change.

Metabolic Syndrome

The metabolic syndrome consists of a constellation of factors that increase the risk of cardiovascular disease and type 2 diabetes. The syndrome, also called insulin resistance syndrome, consists of three or more of the following characteristics:

• Resistance to the effects of insulin
• High triglyceride levels
• Low HDL ("good") cholesterol
• High blood pressure
• High blood sugar (blood glucose)
• Accumulation of fat around the abdomen

Being overweight is also an important factor, since most of the conditions above are exacerbated it not caused by excess weight.

Many scientists believe that insulin resistance is one of the major factors that either allows or causes the other components of the metabolic syndrome to develop. Insulin resistance, which can lead to type 2 diabetes, does not have symptoms, but a blood test in your doctor's office following a food challenge can diagnose it.

All of the above problems work together to increase the risk of coronary artery disease and kidney disease. It is estimated that one-fourth of the people in the United States may have the metabolic syndrome, and many of them have no idea they have it. If it can be caught in time, the progression to diabetes and heart disease could be halted.

The metabolic syndrome is so strongly associated with diet, weight, and physical activity that lifestyle modification is usually considered front-line therapy, and drug intervention secondary. For example, in one two-year study, patients who went on a Mediterranean-style diet reduced their number of syndrome factors by half-and this finding held true even after being adjusted for weight loss, since the participants also dropped pounds following the Mediterranean program. In another study, the coronary risk associated with the metabolic syndrome fell 35 percent when they adopted a Mediterranean diet. As with the majority of health benefits gained from the Mediterranean diet, the protective effects were found when the diet was taken as a whole, not from the individual components.