Category Archives: Heart Disease

Fresh Praise for the Mediterranean Diet in NYT

Dead whole fish aren’t very appealing to many folks

From Paul Greenberg’s opinion piece in the New York Times (July 19, 2018):

In 1953, not long before President Dwight Eisenhower suffered a heart attack in office, the social scientist Leland Allbaugh published “Crete: A Case Study of an Underdeveloped Area.” The landmark analysis of the eating patterns of an isolated Greek population strongly suggested that a calorie-limited diet high in fresh fruits and vegetables, whole grains, and olive oil and low in animal protein, particularly red meat, could lower the risk of heart attacks and strokes, decrease chronic disease and extend life.

Medical research over the last half-century has largely borne out this initial finding. Weight-loss fads and eating trends come and go, but the so-called Mediterranean diet has stood fast. “Among all diets,” Dr. Walter Willett of Harvard’s T.H. Chan School of Public Health concluded in an email, “the traditional Mediterranean diet is most strongly supported for delivering long term health and wellbeing.”

Click for a more complete definition of the traditional Mediterranean Diet, which includes alcohol. More from Greenberg:

***

As the clinician Artemis Simopoulos pointed out to me, two meatless days a week are the norm in Greek Orthodox communities. This religious provision encouraged traditional communities to eat fish not only on Fridays but on Wednesdays as well. Recent epidemiological evidence links two portions of seafood a week with lower blood pressure, lower LDL cholesterol and lower triglycerides. In spite of this, American seafood consumption has stayed consistently low compared with other developed countries.

***

And for decades now, even Greeks have been abandoning their traditional foods and eating much more than they previously did. “In my view, the reason the diet worked to prevent heart disease on Crete was because they weren’t overeating,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University. “By the time I got to Crete in the early 1990s, they were, and the hospitals were full of heart attacks and people with type 2 diabetes.”

***

Today, 65 years after Allbaugh returned from Crete, with modern America plagued by one of the highest obesity rates in the world and failing to meet life expectancy averages of almost every other developed nation, it’s worth circling back to the eating patterns of the ancients. For if the United States were to put itself on a Mediterranean diet, we would likely see huge improvements not only in human and environmental health, but also in rural economic stability.

RTWT for Greenberg’s roadmap to an American Mediterranean diet.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

Omega-3 Fatty Acids Linked to Lower Multiple Sclerosis Risk 

Dead whole fish aren’t very appealing to many folks

I’ve been telling you guys for years to eat cold-water fatty fish twice weekly. To protect your heart. Now we have another reason…

“Omega-3 fatty acids may play an important role in lowering the risk of developing multiple sclerosis (MS), researchers suggested.Consuming fish at least once a week — or at least once a month with regular fish oil use — was associated with a 44% reduced risk of MS or its precursor, clinically isolated syndrome (CIS), reported Annette Langer-Gould, MD, PhD, of Kaiser Permanente Southern California in Pasadena, CA, and co-authors, in an early-release abstract from the American Academy of Neurology annual meeting, to be held here in April.”

Source: Omega-3s Linked to Lower MS Risk | Medpage Today

Bob Harper of “Biggest Lose” Fame Switches to Mediterranean Diet After His Heart Attack 

Exercise is clearly health-promoting, but it’s unlikely to keep you alive forever. Immortality is over-rated anyway.

The traditional diet consumed in the countries bordering the Mediterranean Sea, has been adopted all over the world because of its health benefits. The most recent convert? Bob Harper, the fitness trainer on “The Biggest Loser.

Harper, 51, recently switched to the Mediterranean diet, per doctor’s orders, after suffering a massive heart attack late February, according to POPSUGAR. He collapsed in a New York City gym and was unconscious for two days. While Harper obviously lives a healthy lifestyle, the POPSUGAR report points out his mother died of a heart attack, and genetics can affect heart health.  It’s not a surprise Harper’s doctor’s would recommend the Mediterranean diet as a form of recovery. According to the Mayo Clinic, this traditional diet reduces the risk of heart disease, cancer, Parkinson’s and Alzheimer’s.

Source: ‘The Biggest Loser’s’ Bob Harper Switches to Mediterranean Diet Post Heart Attack | PRODAY

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

What Exactly Is a “Whole Grain”?

Now THIS is whole grain

Do you know what a whole grain food is? I thought I did. But I was wrong. Here’s the definition in a 2013 article in Scientific American:

The term “whole grain” might evoke an image of a whole, intact grain—that is, a fiber-rich coating of bran surrounding a starchy endosperm and a small reproductive kernel known as the germ. But in a definition created in 1999 by the American Association of Cereal Chemists (AACC) International, an organization of food industry professionals and scientists, and adopted by the U.S. Food and Drug Administration in 2006, “whole grain” refers to any mixture of bran, endosperm and germ in the proportions one would expect to see in an intact grain—yet the grains can be, and usually are, processed so that the three parts are separated and ground before being incorporated into foods. (Refined grains, on the other hand, are grains that have been stripped of their bran and germ.) For a food product to be considered whole grain, the FDA saysit must contain at least 51 percent of whole grains by weight. Compared with intact grains, though, processed whole grains often have lower fiber and nutrient levels.

Many of the scientific studies that support the healthfulness of whole grains, and there aren’t many, considered wheat germ and bran cereals as whole grain foods. But those are only parts of a whole grain. The studies that linked lower heart disease and type 2 diabetes with whole grain consumption were diets high in fiber or bran as a whole grain.

Read the whole article (it’s not long) to find out how modern processing of whole grains can reduce their healthfulness.

Food companies lump ground whole grains, partially processed grains and intact unprocessed grains together under the same broad category of “whole grains,” so it’s difficult for consumers to know which they’re getting.

NASEM: Current U.S. Dietary Guidelines Aren’t Trustworthy

Back to the drawing board

NASEM is the National Academies of Sciences, Engineering, and Medicine. Dr. Andy Harris writes that:

The nation’s senior scientific body recently released a new report raising serious questions about the “scientific rigor” of the Dietary Guidelines for Americans. This report confirms what many in government have suspected for years and is the reason why Congress mandated this report in the first place: our nation’s top nutrition policy is not based on sound science.

Dr. Harris notes that since 1980, when the guidelines were first published, rates of obesity have doubled and diabetes has quadrupled.

Current recommendations to reduce saturated fat consumption and to eat health whole grains do not, after all, reduce rates of cardiovascular disease. That was my conclusion in 2009.

For a mere $68 you can read the NASEM report yourself. Better yet, read Tom Naughton’s thoughts for free.

Steve Parker, M.D.

PS: The diets I’ve designed are contrary to U.S. Dietary Guidelines.

PURE Study: Higher Carb Consumption Linked to More Deaths

Here’s the abstract of a new epidemiological study that investigated the relationships between diet, cardiovascular disease, and death rates. I don’t have the entire article. My sense is that the 18 countries studied are mostly non-Western:

Background

The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear.

Methods

The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3–9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering.

Findings

During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12–1·46], ptrend=0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67–0·87], ptrend<0·0001; saturated fat, HR 0·86 [0·76–0·99], ptrend=0·0088; monounsaturated fat: HR 0·81 [0·71–0·92], ptrend<0·0001; and polyunsaturated fat: HR 0·80 [0·71–0·89], ptrend<0·0001). Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality.

Interpretation

High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.

Source: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study – The Lancet

Mediterranean Diet Lowered Blood Pressure By a Whopping 1 Point

Or more accurately, 1.1 to 1.3 mmHg over the course of six months in an Australian population. Systolic pressure, if you’re wondering. This isn’t clinically significant.

Details:

“A total of 166 men and women aged >64 y were allocated via minimization to consume either a MedDiet (n = 85) or their habitual diet (HabDiet; control: n = 81) for 6 mo. The MedDiet comprised mainly plant foods, abundant extra-virgin olive oil, and minimal red meat and processed foods. A total of 152 participants commenced the study, and 137 subjects completed the study. Home blood pressure was measured on 5 consecutive days at baseline (n = 149) and at 3 and 6 mo. Endothelial function (n = 82) was assessed by flow-meditated dilatation (FMD) at baseline and 6 mo. Dietary intake was monitored with the use of 3-d weighed food records. Data were analyzed with the use of linear mixed-effects models to determine adjusted between-group differences.Results: The MedDiet adherence score increased significantly in the MedDiet group but not in the HabDiet group (P < 0.001). The MedDiet, compared with the HabDiet, resulted in lower systolic blood pressure (P-diet × time interaction = 0.02) [mean: −1.3 mm Hg (95% CI: −2.2, −0.3 mm Hg; P = 0.008) at 3 mo and −1.1 mm Hg (95% CI: −2.0, −0.1 mm Hg; P = 0.03) at 6 mo]. At 6 mo, the percentage of FMD was higher by 1.3% (95% CI: 0.2%, 2.4%; P = 0.026) in the MedDiet group.”

Source: AJCN | Mobile