"Why Was Heart Disease Rare in the Mediterranean?" The Mediterranean Diet is an "in" topicnowadays, in both the medical literature and the lay media.
450 papers published in the medicalliterature over just the last year alone, more than one a day.
Uncritical laudatory coverage is common,but specifics are hard to come by.
What is it?Where did it come from? Why is it good? Merits are rarely detailed,possible downsides are never mentioned, so let's dig in.
After World War II,the government of Greece asked the Rockefeller Foundationto come in and assess the situation.
Impressed by the low ratesof heart disease in the region, nutrition scientist, Ancel Keys(after which K rations were named) initiated his famousseven countries study, in which he found the rate of fatalheart disease on the Greek isle of Crete was 20 times lower thanthat in the United States.
They also had the lowest cancerrates and fewest deaths overall.
What were they eating? Their diets were more than90% plant based, which may explain why coronaryheart disease was such a rarity.
A rarity, that is, exceptfor small class of rich people whose diet differed from thatof the general population: they ate meat every dayinstead of every week or two.
So the heart of the Mediterraneandiet is mainly vegetarian, much lower in meat and dairy, which Keys consideredthe major villains in the diet because oftheir saturated fat content.
Unfortunately, no one is really eatingthe traditional Mediterranean diet anymore, even in the Mediterranean.
The prevalence of coronary heart diseaseskyrocketed by an order of magnitude within a few decades in Crete, blamed on the increased consumption of meatand cheese at the expense of plant foods.
Everyone is talkingabout the Mediterranean diet, but few are those who do it properly.
People think pizza orspaghetti with meat sauce, but while Italian restaurants bragabout the healthy Mediterranean diet, they serve a travesty of it.
So if no one's really eating thisway anymore, how do you study it? Researchers came up witha variety of Mediterranean diet adherence scoring systems to see if people who are eatingmore Mediterranean-ish do better.
You get maximum pointsthe more plant foods you eat, but effectively get pointsdeducted eating just a single serving of meat or dairy a day.
So, no surprise, thosethat eat relatively higher on the scale have alower risk of heart disease, lower risk of cancer, and a lower risk of death overall.
After all, the Mediterranean diet can beconsidered to be a near vegetarian diet.
As such, it should be expectedto produce the well-established health benefits of vegetarian diets.
So less heart disease, cancer, anddeath, and less inflammation, and improved arterial function, alower risk of developing type 2 diabetes, and a reduced risk for stroke,depression, and cognitive impairment.
How might it work? I've talked about the elegant studiesshowing that those who eat plant-based dietshave more plant-based compounds, like aspirin,circulating within their systems.
Polyphenol phytonutrientsin plant foods are associated with a significantly lower riskof dying in and of themselves.
Magnesium consumption also associatedwith a significantly lower risk of dying; magnesium found indark green leafy vegetables, as well as fruits, beans,nuts, soy and whole grains.
Heme iron, on the other hand,the iron found in blood and muscle, acts as a pro-oxidant and appearsto increase the risk of diabetes, whereas plant-based,non-heme iron appeared safe.
Same thing with heart disease:animal-based iron found to significantly increase the risk ofcoronary heart disease, our #1 killer, but not plant-based iron.
The Mediterranean dietis protective, compared to the Standard AmericanDiet, no question.
But any diet rich in whole plant foodsand low in animal-fat consumption could be expected to confer protectionagainst many of our leading killers.