In life and in medicine we tend to categorize as a way of simplifying things. But every so often we learn something new about a medical technique that genuinely surprises us. Take the Mediterranean diet for instance. Doctors and patients throughout the world associate this way of eating with cardiovascular benefits. It’s the “heart healthy” diet. This view is both accurate and incomplete.

The term “Mediterranean diet” conjures up images of exquisite Greek and Italian cuisine that focuses on fresh fish, fruits, lean meats, nuts, red wine and vegetables. The cardio-protective benefits of such a menu plan is very well established in the scientific literature. Multiple studies have been published this year alone that attest to this fact. The traditional diet of the Mediterranean region is: a) rich in monounsaturated fats (fish, nuts and olive oil); b) contains large quantities of dietary fiber (40-60 grams a day) and; c) is an abundant source of food based antioxidants (from fruits, vegetables and red wine). (1,2,3,4,5,6)

What isn’t so well known is that the reach of this eating program extends far beyond the prevention of heart attacks and stroke. There are three important areas of health care with which the Mediterranean diet can specifically help. Here’s a brief overview of what the latest studies tell us:

• Blood Sugar Disorders - A 4 year trial, just published, examined the effects of a low-carbohydrate Mediterranean-style diet vs. a low fat diet in a group of 215 overweight type 2 diabetics. At the start of the experiment none of the participants required drug therapy to manage blood sugar. By the end of the study, 44% of those on the Med diet and 70% on the low fat diet were undergoing “antihyperglycemic drug therapy”. The researchers also noted that those following the Mediterranean eating plan lost more weight and demonstrated better cardiovascular health than the low fat group. Other trials indicate that adding more nuts and tea to a typical Med diet can further enhance the health of those with diabetes and “prediabetes”. (7,8,9)
• Depression - A new study presented in the Archives of General Psychiatry determined that long term adherence to “Mediterranean dietary pattern” can significantly decrease the likelihood of depression. This conclusion is based on an examination of over 10,000 men and women who were followed over a 4 year period. Food frequency questionnaires, medical records and physician diagnosis were used to evaluate the connection between diet and mood changes over time. Those who stuck to the diet the most consistently demonstrated the lowest risk for depressive symptoms. Not surprisingly, they were also less likely to be on antidepressant medication. Supportive research has found that higher levels of fish and olive oil intake may afford additional psychological benefits to those already on a Med diet. (10,11,12)

Health Parameters While on a Very Low Carb Med. Diet
Parameters	Week 0	Week 12	% of Change
Weight (kg)	108.62	94.48	13.02
Body Mass Index (kg/m2)	36.46	31.76	12.89
Total Cholesterol (mg/dl)	208.24	186.62	10.38
LDL Cholesterol (mg/dl)	114.52	105.95	7.48
HDL Cholesterol (mg/dl)	50.10	54.57	8.19
Triglycerides (mg/dl)	218.67	113.90	47.91
Blood Sugar (mg/dl)	109.81	93.33	15.01
Systolic Blood Pressure (mm Hg)	125.71	109.05	13.25
Diastolic Blood Pressure (mm Hg)	84.52	75.24	10.98
Source: Nutr J. 2008; 7: 30.(a)

• Memory Decline - The August issue of the Journal of the American Medical Association (JAMA) found a correlation between “higher adherence to a Mediterranean diet” and slower cognitive decline. A separate study in the Archives of Neurology estimates a 28% reduced risk of “mild cognitive impairment” for those classified as strict followers of this manner of eating. A dramatic 48% decline in Alzheimer’s disease incidence was also reported in this group of over 1,400 study volunteers. Other research presented in JAMA suggests that combining regular physical exercise with a Med diet may further protect against age related cognitive decline. (13,14,15)

All of these individual findings are very promising. But the big picture is even more encouraging when we look at it from afar. Elevated blood sugar (diabetes and metabolic syndrome) and depression have been linked to higher rates of dementia. These two conditions have also been associated with poor cardiovascular health. This, in turn, brings us full circle. It also provides a rationale for why the Med diet is good for the heart, both directly and indirectly. (16,17,18,19,20)

In health care and in life, good decisions tend to have far reaching consequences. It’s similar to the concept of “paying it forward” – if you show kindness to one individual, that person is likely to do the same for someone else. This process then continues forth and ultimately leads to a better community and society at large. A similar reaction occurs within the body. When we do something positive for the cardiovascular system, it’s likely to affect other, seemingly unrelated systems – such as the brain (depression) and pancreas (diabetes). This is a common result of many holistic therapies and the primary reason why I encourage their use.

Be well!

JP

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