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Mediterranean Diet News 2013

February 27, 2013 Written by JP    [Font too small?]

By now, most health conscious individuals are at least somewhat familiar with “The Mediterranean Diet”. This eating style, popularized in countries such as Greece, Italy and Spain, emphasizes whole foods that are rich in dietary fiber, monounsaturated and omega-3 fats and overall nutrient density. Menu items such as green leafy vegetables, nuts, olives and olive oil, red wine and wild caught fish are commonplace in this region of the world. And, while this is an ancient style of eating, modern science has been studying it quite extensively over of the past few decades.

From the very start, scientists have been most interested in the effects of a Med diet on the cardiovascular system. Heart attacks and strokes continue to top the list of 21st century health threats for most of the world, but to a lesser extent in select communities that border the Mediterranean Sea. Numerous investigations point to regional dietary patterns as a possible preventative factor. Thankfully, there is encouraging news for all of us who live elsewhere. Studies conducted throughout the world suggest that anyone can benefit from adopting a Mediterranean style diet. The latest evidence is presented in the current, online edition of the New England Journal of Medicine. The authors of the publication conclude that eating a Mediterranean diet with supplemental nuts (30 grams/day as 15 grams walnuts, 7.5 grams hazelnuts and 7.5 grams almonds) or extra-virgin olive oil (1 liter per week) reduces the incidence of major cardiovascular events by upwards of 30%!

It’s long been understood that Mediterranean food plans assist with the management of healthier blood sugar, body weight and lipids (cholesterol, triglycerides). But, lately, several new mechanisms have emerged as reasons why a Med diet plan may shield the cardiovascular system. Detailed analysis of human nutrigenomic trials reveal that Mediterranean diets positively influence gene expression so as to lower inflammation, oxidative stress and the development of atherosclerosis or hardening of the arteries. Other lesser known risk factors for heart disease like elevated uric acid and sub-optimal adiponectin also appear to be responsive to diets rich in Mediterranean foods. What’s more, the adoption of a Med diet has been shown to augment body fat distribution in a manner that tends to lower cardiovascular mortality risk. Last, but not least, is the role that Mediterranean eating has on mood and quality of life. Researchers based in Australia and the Netherlands report that adherence to a Med diet reduces the prevalence of depressive symptoms and psychological distress – both of which are strongly suspected of contributing to heart attacks and strokes.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – Primary Prevention of Cardiovascular Disease w/ a Mediterranean Diet (link)

Study 2 – Up-To Date Knowledge On the In Vivo Transcriptomic Effect of the (link)

Study 3 – Dietary Intake and Major Food Sources of Polyphenols in a Spanish(link)

Study 4 – Mediterranean Diet Intervention for Patients w/ Hyperuricemia (link)

Study 5 – Uric Acid Best Predicts Metabolically Unhealthy Obesity w/ Increased (link)

Study 6 – Relationship Between a Mediterranean Diet & Circulating Adiponectin(link)

Study 7 – Chapter Eleven – Adiponectin in the Heart and Vascular System (link)

Study 8 – Adherence to the Mediterranean Diet and Body Fat Distribution (link)

Study 9 – Mediterranean Dietary Pattern & Prevalence & Incidence of Depressive (link)

Study 10 – Patterns of Dietary Intake & Psychological Distress in Older Australians (link)

Adherence to a Mediterranean Diet May Improve Psychological Outlook

Source: Eur J Clin Nutr. 2013 Jan;67(1):75-82. (link)

Posted in Food and Drink, Heart Health, Nutrition

4 Comments & Updates to “Mediterranean Diet News 2013”

  1. JP Says:



    Stroke. 2015 Jan 27.

    Adherence to a Mediterranean Diet and Prediction of Incident Stroke.


    There are limited data on the potential association of adherence to Mediterranean diet (MeD) with incident stroke. We sought to assess the longitudinal association between greater adherence to MeD and risk of incident stroke.


    We prospectively evaluated a population-based cohort of 30 239 individuals enrolled in REasons for Geographic and Racial Differences in Stroke (REGARDS) study, after excluding participants with stroke history, missing demographic data or food frequency questionnaires, and unavailable follow-up information. Adherence to MeD was categorized using MeD score. Incident stroke was adjudicated by expert panel review of medical records during a mean follow-up period of 6.5 years.


    Incident stroke was identified in 565 participants (2.8%; 497 and 68 cases of ischemic stroke [IS] and hemorrhagic stroke, respectively) of 20 197 individuals fulfilling the inclusion criteria. High adherence to MeD (MeD score, 5-9) was associated with lower risk of incident IS in unadjusted analyses (hazard ratio, 0.83; 95% confidence interval, 0.70-1.00; P=0.046). The former association retained its significance (hazard ratio, 0.79; 95% confidence interval, 0.65-0.96; P=0.016) after adjustment for demographics, vascular risk factors, blood pressure levels, and antihypertensive medications. When MeD was evaluated as a continuous variable, a 1-point increase in MeD score was independently associated with a 5% reduction in the risk of incident IS (95% confidence interval, 0-11%). We documented no association of adherence to MeD with incident hemorrhagic stroke. There was no interaction of race (P=0.37) on the association of adherence to MeD with incident IS.


    High adherence to MeD seems to be associated with a lower risk of incident IS independent of potential confounders. Adherence to MeD is not related to the risk of incident hemorrhagic stroke.

    Be well!


  2. JP Says:

    Update 05/12/15:


    JAMA Intern Med. 2015 May 11.

    Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial.

    Importance: Oxidative stress and vascular impairment are believed to partly mediate age-related cognitive decline, a strong risk factor for development of dementia. Epidemiologic studies suggest that a Mediterranean diet, an antioxidant-rich cardioprotective dietary pattern, delays cognitive decline, but clinical trial evidence is lacking.

    Objective: To investigate whether a Mediterranean diet supplemented with antioxidant-rich foods influences cognitive function compared with a control diet.

    Design, Setting, and Participants: Parallel-group randomized clinical trial of 447 cognitively healthy volunteers from Barcelona, Spain (233 women [52.1%]; mean age, 66.9 years), at high cardiovascular risk were enrolled into the Prevención con Dieta Mediterránea nutrition intervention trial from October 1, 2003, through December 31, 2009. All patients underwent neuropsychological assessment at inclusion and were offered retesting at the end of the study.

    Interventions: Participants were randomly assigned to a Mediterranean diet supplemented with extravirgin olive oil (1 L/wk), a Mediterranean diet supplemented with mixed nuts (30 g/d), or a control diet (advice to reduce dietary fat).

    Main Outcomes and Measures: Rates of cognitive change over time based on a neuropsychological test battery: Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT), Animals Semantic Fluency, Digit Span subtest from the Wechsler Adult Intelligence Scale, Verbal Paired Associates from the Wechsler Memory Scale, and the Color Trail Test. We used mean z scores of change in each test to construct 3 cognitive composites: memory, frontal (attention and executive function), and global.

    Results: Follow-up cognitive tests were available in 334 participants after intervention (median, 4.1 years). In multivariate analyses adjusted for confounders, participants allocated to a Mediterranean diet plus olive oil scored better on the RAVLT (P = .049) and Color Trail Test part 2 (P = .04) compared with controls; no between-group differences were observed for the other cognitive tests. Similarly adjusted cognitive composites (mean z scores with 95% CIs) for changes above baseline of the memory composite were 0.04 (-0.09 to 0.18) for the Mediterranean diet plus olive oil, 0.09 (-0.05 to 0.23; P = .04 vs controls) for the Mediterranean diet plus nuts, and -0.17 (-0.32 to -0.01) for the control diet. Respective changes from baseline of the frontal cognition composite were 0.23 (0.03 to 0.43; P = .003 vs controls), 0.03 (-0.25 to 0.31), and -0.33 (-0.57 to -0.09). Changes from baseline of the global cognition composite were 0.05 (-0.11 to 0.21; P = .005 vs controls) for the Mediterranean diet plus olive oil, -0.05 (-0.27 to 0.18) for the Mediterranean diet plus nuts, and -0.38 (-0.57 to -0.18) for the control diet. All cognitive composites significantly (P < .05) decreased from baseline in controls. Conclusions and Relevance: In an older population, a Mediterranean diet supplemented with olive oil or nuts is associated with improved cognitive function. Be well! JP

  3. JP Says:

    Updated 09/19/15:


    J Nutr Biochem. 2015 Aug 20.

    The gut microbial community in metabolic syndrome patients is modified by diet.

    Intestinal microbiota changes may be involved in the development of metabolic syndrome (MetS), which is a multicomponent disorder frequently associated with obesity. The aim of this study was to test the effect of consuming two healthy diets: a Mediterranean diet and a low-fat high-carbohydrate diet, for 2years in the gut microbiota of MetS patients and those in the control group. We analyzed the differences in the bacterial community structure between the groups after 2years of dietary intervention (Mediterranean or low-fat diet) through quantitative polymerase chain reaction using primers, targeting specific bacterial taxa. We observed, at basal time, that the abundance of Bacteroides, Eubacterium and Lactobacillus genera is higher in the control group than in MetS patients, while Bacteroides fragilis group, Parabacteroides distasonis, Bacteroides thetaiotaomicron, Faecalibacterium prausnitzii, Fusobacterium nucleatum, Bifidobacterium longum, Bifidobacterium adolescentis, Ruminococcus flavefaciens subgroup and Eubacterium rectale are depleted in MetS patients (all P values <.05). Additionally, we found that long-term consumption of Mediterranean diet partially restores the population of P. distasonis, B. thetaiotaomicron, F. prausnitzii, B. adolescentis and B. longum in MetS patients (all P values <.05). Our results suggest that the Mediterranean diet could be a useful tool to restore potentially beneficial members of the gut microbiota, although the stability of these changes over time still remains to be assessed. Be well! JP

  4. JP Says:

    Updated 09/19/15:


    Atherosclerosis. 2015 Sep 3;243(1):93-98.

    A Mediterranean diet and risk of myocardial infarction, heart failure and stroke: A population-based cohort study.

    BACKGROUND AND AIMS: The Mediterranean diet, which is palatable and easily achievable, has been associated with lower all-cause and cardiovascular disease (CVD) incidence and mortality. Data on heart failure (HF) and stroke types are lacking. The aim was to examine a Mediterranean diet in relation to incidence of myocardial infarction (MI), HF and stroke types in a Swedish prospective cohort.

    METHODS: In a population-based cohort of 32,921 women, diet was assessed through a self-administered questionnaire. The modified Mediterranean diet (mMED) score was created based on high consumption of vegetables, fruits, legumes, nuts, whole grains, fermented dairy products, fish and monounsaturated fat, moderate intakes of alcohol and low consumption of red meat, on a 0-8 scale. Relative risks (RR) with 95% confidence intervals (CI), adjusted for potential confounders, were estimated by Cox proportional hazards regression models.

    RESULTS: During 10 y of follow-up (1998-2008), 1109 MIs, 1648 HFs, 1270 ischemic strokes and 262 total hemorrhagic strokes were ascertained. A high adherence to the mMED score (6-8), compared to low, was associated with a lower risk of MI (RR: 0.74, 95% CI: 0.61-0.90, p = 0.003), HF (RR: 0.79, 95% CI: 0.68-0.93, p = 0.004) and ischemic stroke (RR: 0.78, 95% CI: 0.65-0.93, p = 0.007), but not hemorrhagic stroke (RR: 0.88, 95% CI: 0.61-1.29, p = 0.53).

    CONCLUSIONS: Better adherence to a Mediterranean diet was associated with lower risk of MI, HF and ischemic stroke. The Mediterranean diet is most likely to be beneficial in primary prevention of all major types of atherosclerosis-related CVD.

    Be well!


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