 |
Sign In | Contributing Author |  |
| Diseases and Conditions | Health Topics | Medicine Drugs Vitamins Herbs | Mental Health | Alternative Medicine | Grand Rounds - Case Studies |
  Would you like to ask us a medical question?
  |
Mediterranean Diet And The American Heart
Mediterranean Diet: Impact on American Hearts April 22, 2009 - Strong evidence supports the protective effect of a Mediterranean diet on risk of coronary heart disease CHD, and overall diet pattern appears more important than individual foods [1]. A review of nearly 200 studies was published in the April 13, 2009 issue of the Archives of Internal Medicine. The "Mediterranean Diet" comes to us from Greece, southern Italy, and Sicily. Variations have developed via geophysical, climatic, demographic, economic, agricultural, animal husbandry, and palatal laws. This lecture will point out recent scientific evidence supporting benefits of the Mediterranean Diet based on Cohort Studies and Randomized Control Trials (RCTs).[1]A "prudent diet"-characterized by high intake of vegetables, fruit, legumes, whole grains, fish, and other seafood--was associated with significantly lower CHD (Coronary Heart Disease) risk. Similarly, strong evidence supports benefits from monounsaturated fatty acids and foods such as vegetables and nuts. Harm distinctly rises from regular intake of trans-fatty acids and foods with a high glycemic index. Western diets tend to have more trans-fats (manufacturer hydrogenates oil to make it solid at room temp, i.e. a shortening or stiff margarine used in baking, such as snack crackers or frying, such as french fries) These diets also contain large amounts of saturated fats and cholesterol, as in butter, eggs and marbled steak. "We found strong evidence that a 'Western' diet--which is high in processed meats, red meats, butter, eggs, refined grains (white flour), and high-fat dairy products (butter)--is associated with an increased risk of CAD coronary artery disease. So we said to patients: 'You should consume less of those types of foods and gravitate more toward a "prudent" diet or a Mediterranean diet, which are both high in fruits and vegetables, legumes, whole grains, and fish,' " senior author Dr Sonia Anand (McMaster University, Hamilton, ON) told heartwire .[1] "Although this message is not really new, what is new is the way that this review assessed the strength of the evidence," she noted.[1] The study also found strong evidence of increased CHD risk from consuming trans-fatty acids and foods with a high glycemic index such as white potatoes, sugar, white rice, and white bread. Physicians should advise patients: "Lower your trans-fats, lower your saturated fats, but also watch for some of these simple carbohydrates, because they can have adverse effects as well,'' said Anand.[1] Diet Dilemma The relationship between diet and CHD has been studied for decades, yet there is still some confusion about which foods or diets are best, since cohort studies and randomized controlled trials have often produced discrepant results, the researchers write. To examine the strength of the evidence supporting a causal link between diet and CHD, the researchers reviewed 146 prospective cohort studies and 43 randomized controlled trials (RCTs). Studies were scored on how well they met criteria of strength, consistency, temporality, and coherence. A score of 4 was considered strong evidence of a cause-and-effect relationship between dietary exposure and disease, as seen below. Dietary Pattern vs Single Food In the cohort studies, a Mediterranean diet--characterized by higher intake of vegetables, legumes, fruits, nuts, whole grains, cheese or yogurt, fish, and monounsaturated oils was strongly associated with significantly lower risk of CHD. Similarly, strong evidence supported the benefits from monounsaturated fatty acids and foods such as vegetables and nuts versus the harm from trans-fatty acids and foods with a high glycemic index. In the RCTs, only the Mediterranean diet was strongly linked to risk of CHD. "Our findings support the strategy of investigating dietary patterns in cohort studies and RCTs for common and chronic complex diseases such as CHD," the researchers write.[1] Study Reinforces Heart-Healthy Diet Commenting on the results for heartwire , Dr Robert Eckel (University of Colorado, Denver) said that the study confirms previous notions about what a heart-healthy diet is all about. It's not a matter of good foods and bad foods. It's what the overall quality of the diet is. "I think cardiologists need to increasingly make lifestyle-related issues an important part of their practice," he added. "This is another article reinforcing that a heart-healthy diet contains certain constituents and avoids certain constituents." Concurring with the study authors, he noted: "Overall, the dietary pattern is what needs to be emphasized. It's not a matter of good foods and bad foods. It's what the overall quality of the diet is. The Western pattern is high in saturated fat, trans-fat, and cholesterol, whereas a Mediterranean diet and 'prudent' diet include more monounsaturated or polyunsaturated fats, and there is more fish consumption."[1] Low fat diets have been used to treat obese diabetics, but better results are obtained with reduced carbohydrate diets, wherein significant weight loss drops insulin resistance, reduces triglyceride levels, and raises HDL (good) cholesterol. Here is a list of Mediterranean cuisine: · Bread, pasta, rice, potatoes · Vegetables: Spinach, Cauliflowers, Carrots, Eggplants, Tomatoes, broccoli, capsicum, capers, garlic and onion · Fruit: Olives, Grape, Oranges, Lemons, Apples, cherries, Strawberries, peaches, apricots · Legumes: beans, peas · Nuts: Walnuts, Almonds, Pistachio nuts · Oil of olive · Honey · Low fat milk and cheeses · White Meat (chicken, rabbit, turkey, etc...) and fish (fish sword, sardines, tuna, clears) · Eggs, red meat (veal, lamb, etc...) · Water: 6 to 8 glasses daily Eat 5 times daily--breakfast, snack, lunch, snack, dinner; choose from the foods listed above. Aerobic exercise at least 30 minutes per day; resistance exercise three times weekly if sedentary. Southern Europeans are want to consume one glass (or more) of red wine or purple grape juice daily. Next in Table 1. we will view sources of trans fatty acids and other CHD-inducing substances: Table 1. Breakdown of fats and cholesterol in common foods:
Foods which cause a rapid rise in blood glucose, due to rapid carbohydrate (CHO) digestion, are said to have a high glycemic index. These foods cause high peak glucose and insulin levels, increased deposition and triglyceride in abdominal fat, and promote weight gain and insulin resistance. Foods with high glycemic indices include white rice, white bread, white potatoes, white flour, orange juice, etc. Substitution of refined CHO is recommended with whole grains, vegetables, fruit, pasta and other non-milled CHOs. Following a heart-healthy program is a global intervention, involving grouped food selections, not isolated consumption. Make choices promoting reduced fat intake, moderation in simple CHO consumption, with increased vegetable, fruit and other fibrous macro- and micro-nutrient laden foods and legume, nut and lean meat, fish, and monounsaturated oils, including marine omega-3 oils.
Reference
The authors disclosed no relevant financial relationships.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Copyright ©2010 Healthocrates.com All Rights Reserved.
