Exploring the sense and nonsense of food and health

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The Mediterranean Diet is Dead?

The healthiest diets in the world refer to the traditional diets of the past before the cultural invasion of the Standard American Diet (SAD). This fact actually strengthens the association that poor diet choices do contribute to higher obesity and concurrent diabetes rates.  The Mediterranean countries that for so long enjoyed low obesity and diabetes rates are now also experiencing higher rates of obesity which in time may increase higher rates of associated chronic diseases.

From all indications, the most researched diet in modern times does not really exist in its original form anymore. Any heath benefits it promoted have been lost over time and replaced with foods full of fat, sugar, salt which has led to alarming obesity rates especially in children. Can it ever make a comeback?



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What are the Secrets of the Mediterranean Diet?


There are hardly any more debates about the merits and health benefits of the Mediterranean Diet. It has not only stood the scrutiny of many research studies, but has also stood the test of time in many of the countries that make up the Mediterranean region.

The secret may lie in that there may be a common component contained within most of these foods in the Med diet and it has been suggested that the component could be polyphenols,  phytonutrients found in many of these typical foods of the Mediterranean. Polyphenols are the most abundant and potent antioxidants in the diet and found only in plants.  They are thought to protect against low density lipoprotein (LDL) oxidation, and high levels in the blood are considered risk factors for heart disease.

Their health benefits have been studied only recently, specifically since 1995.  Current research strongly supports a preventive role of polyphenols in heart disease, cancers, osteoporosis, brain function, and diabetes mellitus.  However, most of the effects have only occurred in animals.  Animal studies often use doses much higher than would be found in the typical American diet even when the diet is considered healthy.  There has been more progress and stronger evidence in the prevention of heart disease in humans with polyphenols, either from supplements or foods. Until further research is done, it won’t hurt to increase our intake of them in our diets.

How To Boost Your Intake

The levels in the blood of these compounds will peak soon after they are eaten, so it is best to consume them in small amounts throughout the day.

Eat fresh whole foods (fruits, vegetables, whole grains).  Processing and refining removes these valuable compounds, which could confound many research results.  Moderate ooking does not necessarily destroy them and actually cooking may make them more available to the body.

Where are They Found?

  • Dark colored berries and fruits – blueberries, cranberries, red grapes, pomegranates and their juices – watch the sugar content
  • Turmeric (curcumin) spice – used in curry
  • Caffeinated tea and coffee – decaffeination may remove polyphenols.  Green tea is especially high.
  • Red wine – Pinot Noir is especially rich in resveratrol (another polyphenol) – moderation please
  • Beer- from the barley and hops – dark beer is best – moderation please
  • Dark chocolate and cocoa powder – dark bitter is best – moderation due to calories and saturated fat content
  • Yellow onions
  • Extra virgin olive oil – first press preferred
  • Organic peaches and pears
  • Apples
  • Prunes

The presence of polyphenols may only be one part of the complexities of diet and health. But until we know more, it may be prudent to eat more like a Greek.

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The Mediterranean Diet – A Closer Look

The Mediterranean Diet (MeDiet) has been studied in more detail than any other eating plan in the world. Does it deliver its claims that it may be so far the best diet for heart disease prevention?

Thanks to Authority Nutrition, the article looks at the research from subgroups of participants from the PREMIDED Study that studies two types of Mediterranean Diets compared to a healthy low-fat diet.

This article is a long read but an excellent summary and is simply stated.  If you don’t care for details, please read the Results and Conclusions. There is interesting information about consuming a Mediterranean type diet and its proposed benefits for heart disease prevention.

Here is a description of the entire study.

“The PREDIMED study was designed to assess the long-term effects of the MeDiet on incident CVD in men and women at high cardiovascular risk. PREDIMED is a multicenter, randomized, nutritional intervention trial for the primary prevention of CVD performed in Spain from 2003 to 2011. The study was funded by the official Spanish agency for scientific research, Instituto de Salud Carlos III, and food industries donated the key foods used in the study. Full details of the study protocol have been described previously (19). Candidates were selected from primary care facilities affiliated with 11 recruiting sites and were at high risk of CVD but had no clinical disease at enrollment. Criteria for recruitment were age of 55–80 y and the presence of diabetes or ≥3 risk factors (smoking, overweight or obesity, hypertension, dyslipidemia, and family history of early-onset CVD )(Fig. 1). Participants were randomly assigned into 1 of 3 interventions: 1) MeDiet supplemented with extra-virgin olive oil (EVOO); 2) MeDiet supplemented with nuts; and 3) control diet (advice on a low-fat diet). Thus, the 2 MeDiet interventions were high vegetable–fat dietary patterns.”

Emilio Ros, Miguel A. Martínez-González, Ramon Estruch, Jordi Salas-Salvadó, Montserrat Fitó, José A. Martínez, Dolores Corella; Mediterranean Diet and Cardiovascular Health: Teachings of the PREDIMED Study, Advances in Nutrition, Volume 5, Issue 3, 1 May 2014, Pages 330S–336S,



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Olive Oil and Alzheimer’s Disease?

A few days ago, I posted an article that  described a study that showed that the Mediterranean diet enhanced brain health. Now another study associated extra virgin olive oil with the prevention of Alzheimer’s disease (at least in mice). Read about it HERE.


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Does the Mediterranean Diet Work? An Update

A previous post described the general results from the PREDIMED Study, a study that reported on the healthy benefits of a Mediterranean-type diet. See the previous post HERE. Now new results from a subset of volunteers from the same study gives us further insight into the way the Mediterranean diet may be heart healthy.

Researchers randomly chose 296 volunteers with a high risk of heart disease who had previously participated the PREDIMED STUDY. Each was assigned to one of the following three diets for one year:

  • A traditional Mediterranean diet with added 4 tablespoons of virgin olive oil per day
  • A traditional Mediterranean diet with an added handful of nuts per day
  • A healthy control that basically was a low fat diet (decreased red meat, sweets, processed food and high-fat dairy products)

Blood tests to measure high density lipoproteins (HDL) and low density lipoprotein (LDL) were conducted at the beginning and end of the study. For a more detailed discussion of the role of HDL and LDL as heart disease risks, see the information at the end of this post.

High levels of LDL or “bad” are linked to an increased risk of plaque formation in coronary arteries while high levels of HDL are linked to a decreased risk. LDL promotes atherosclerosis in arteries and HDL absorbs cholesterol and returns it to the liver for removal from the body. Therefore, its role helps to keep the blood vessels open.

Researchers think that it is not just the number of HDL particles that allegedly reduces the risk of heart disease, but its functional ability to do so, i e., how well does HDL work?

The results of this study showed only the control diet lowered total and LDL cholesterol as found in other studies. None of the diets improved HDL levels significantly; however, the Mediterranean diets both improved the functionality of the HDL significantly. Additionally, this benefit was much larger among those who given the diet with the extra amount of olive oil.

The Med Diets enhanced the functional ability of HDL by:

  • HDL removal of cholesterol from plaque in the arteries
  • Protected the process from LDL action on plaque development
  • Increased blood vessel relaxation to open blood flow.

One author concluded: “Following a Mediterranean diet rich in virgin olive oil could protect our cardiovascular health in several ways, including making our “good” cholesterol work in a more complete way.” The study was published in Circulation 135:633-643, 2017, a journal of the American Heart Association

Risk Factors for Heart Disease include:  High blood pressure, diabetes, obesity, and abnormal blood lipid levels as well as genetics, smoking activity, gender and age.  Some of these risk factors are modifiable by diet.

How are Lipids Transported in the Body?

The liver is the major lipid-producing organ. The liver uses excess protein and carbohydrate to make triglycerides or cholesterol. Triglycerides and cholesterol are carried to the cells by low-density lipoproteins (LDLs), the primary cholesterol delivery system for cells.

LDL’a must be taken up by cells by binding to an LDL receptor on the cell membrane surface or membrane. This binding allows LDLs to be removed from the blood and enter cells where they are broken apart to releases fats and cholesterol for the cell to use. If the amount of LDL cholesterol in the blood exceeds the amount that can be taken up by cells due to either too much LDL or too few receptors, the result is a high level of LDL cholesterol and high levels  are associated with an increased risk of heart disease

How is Cholesterol Eliminated?

Cholesterol cannot be broken down by the body so it must be returned to the liver to be eliminated.  This is accomplished by lipoproteins called high-density lipoproteins (HDLs.) HDLs are particles that originate in the intestinal tract and liver and pick up cholesterol and takes it to the liver for disposal if not needed. A high level of HDL decreases the risk of cardiovascular disease.

So the bottom line:

When you have blood work, the doctor may order blood tests that measures your total cholesterol, your LDL and HDL cholesterol to determine your individual risks of having heart disease in the future.

  • Total Cholesterol: Low risk <200; High risk >240
  • LDL Cholesterol: Low risk <100; High risk   >160
  • HDL Cholesterol: Low risk: > 60; High risk <40
  • Triglycerides: Low risk; <150; High risk >200

So you ideally want your LDL-C to be low and your HDL-C values to be as high as possible (more than likely dependent on diet and genetics. So think L means “lousy” and H means “healthy.”