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The lower rate of heart disease in Mediterranean areas has long been attributed to the local diet in that region of Europe. It may also prevent cancer, Parkinson’s Disease and Alzheimer’s. But what makes up the diet and why is it so good for health?

What’s in the Mediterranean Diet?

The Mediterranean diet commonly consumed in southern Europe, typically consists of a high proportion of fruit, vegetables, whole grains, beans, fish and seafood, nuts, seeds and olive oil but is low in meat and dairy produce.  Red wine is also a common daily ingredient. 

Note that the Mediterranean diet is not a calorie-restricted or faddy weight-loss regime, it is the normal diet of people living in countries around the Mediterranean Sea, such as Greece.

Cardiovascular benefits of the Mediterranean diet

A study of more than 7,400 Spanish people was published this year and showed clear benefits from eating a Mediterranean diet, in terms of reduced rates of heart attack, stroke and death. The participants were aged 55 to 80 years of age and were considered to have major risk factors for cardiovascular events.  They either had type 2 diabetes (which is linked with heart disease) or at least three risk factors for heart disease, such as smoking, high blood pressure, high cholesterol or family history of early death from heart disease. 

The participants were divided into three groups, two of which ate a Mediterranean diet while the other one ate a standard low-fat diet.  One of the Mediterranean diet groups was supplemented with a liter of extra-virgin olive oil (the oil which comes from the first pressing of the olives) per week and the other with a daily handful (30 grams) of mixed nutsBoth groups consumed more than seven glasses of wine per week and all participants were followed for a period of seven years.

What did the study show?

Both of the Mediterranean diet groups had a 30% reduction in the risk of a major cardiovascular event (heart attack, stroke or death) compared with the low-fat control group.  

Which parts of the diet bring about the benefit?

This way of eating is an example of current advice to make fruit and vegetables the major components of the daily diet, and to reduce saturated fat consumption by only occasionally eating red meat. But which particular aspect is having the greatest benefit is hard to isolate. 

In the case of this study, because it was conducted in Spain, it is possible that some of the participants – in both the trial and control groups – were already eating a Mediterranean diet before the study, which may have influenced the outcome.  As a result the researchers felt it was probably the supplementation with extra olive oil and nuts that produced the benefit.

But the result is not an artificial one as the region of southern Europe where this type of diet is most commonly consumed has long been associated with a lower incidence of heart disease and stroke, compared with northern European and the US. 

Also many other studies have shown an association between reduction in heart events and stroke and consumption of a Mediterranean Diet.

What Other Health Benefits Come From The Mediterranean Diet?

Reduction in cognitive decline

A large US study has claimed to find an association with consuming a diet close to that in the Mediterranean and a reduction in loss of memory, or cognitive decline.  The study was in a population of patients from an area known as the ‘stroke belt’ in the southern states of America including North and South Carolina and Alabama, named for its high incidence of strokes. This study and others, found a reduction in the incidence of stroke in those with a Mediterranean-style diet.

One of the study investigators Dr. Georgios Tsivgoulis, offers a couple of reasons for the benefits seen in the study.  One is the antioxidant effect of ingredients such as fruit, vegetables and olive oil, and the other is the beneficial effect on blood vessels – which is attributed with preventing stroke.  

A type of dementia (vascular dementia) is associated with damaged blood vessels in the brain, which a Mediterranean diet may protect.  Dr Tsivgoulis commented: 

‘What you eat affects your cardiovascular health, your looks, and your brain cells.’

To benefit most he suggests increasing the amount of fruit and oily fish (such as salmon) eaten, avoid fried food, and add olive oil to salads.

Reduction in cancer, Parkinson’s  and Alzheimer’s

Analysis of over 1.5 million people involved in other studies of the Mediterranean diet showed that it also reduced development of, or death from cancer by 6%, and development of Parkinson’s disease or Alzheimer’s by 13%.

How does the Mediterranean diet differ from other diets?

A Mediterranean diet is not low in fat (hence not low calorie)because it contains nuts and olive oil, but the key difference is that the fats in these are unsaturated, which are not harmful to blood vessels, like the saturated fats contained in meat and dairy produce.

The high proportion of fruit, vegetables and beans in the Mediterranean diet, make it high in fibre, which is good for digestive health, and also lowers harmful cholesterol (LDL) levels while raising the ‘good’ cholesterol (HDL). 

Fresh fruit and vegetables also contribute antioxidants to the body, which mop up free radicals (or ‘reactive oxygen species’) which damage blood vessels, causing cardiovascular events like heart attack and stroke.

What about alcohol and the Mediterranean diet?

Daily consumption of alcohol, particularly red wine is typical of the Mediterranean diet and a number of studies have concluded that moderate consumption of alcohol may be beneficial.

But it is a difficult area as some people find it hard to limit their consumption. 

In the study, intake of red wine was moderate – less than 5 ounces (148 milliliters) for women, and men aged over 65 years, and no more than 10 ounces (296 milliliters) for men less than 65. Exceeding these limits runs the risk of developing liver disease and certain types of cancer. Obviously if you have a history of, or are at risk of developing alcohol abuse, it would be better not to drink red wine at all.

Speak to your doctor if you are at all unsure about whether you should drink alcohol.

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