Mediterranean diet improves cardiovascular health – 01/30/2023 – Balance

In the 1950s, researchers around the world embarked on a comprehensive and ambitious study. For decades, they analyzed the diets and lifestyles of thousands of middle-aged men living in the United States, Europe and Japan, and then examined how these traits affected their risk of developing cardiovascular disease.

The Seven Countries Study, as it later became known, became famous for discovering associations between saturated fats, cholesterol levels and coronary artery disease. But the researchers also reported another notable result: people who lived in the Mediterranean region — countries like Italy, Greece and Croatia — had lower rates of cardiovascular disease than participants who lived elsewhere. Her diet, rich in fruits, vegetables, legumes, whole grains, nuts, seeds, lean proteins, and healthy fats, seemed to have some protective effect.

Since then, the Mediterranean diet has become the mainstay of heart-healthy eating, with well-studied health benefits including lower blood pressure and cholesterol and reduced risk of type 2 diabetes.

“It’s one of the few diets that has the research to back it up,” says Sean Heffron, a preventive cardiologist at New York University’s Langone Health Hospital. “It’s not a diet that was invented by someone to make money. It’s something that’s been developed over time by millions of people because it’s really tasty. And it turns out to be healthy.”

Here are some of the most studied questions about the Mediterranean diet, and answered by experts.

What is the Mediterranean Diet?

The Mediterranean diet isn’t exactly a strict eating plan but a lifestyle, says Julia Zumpano, a registered dietitian specializing in preventive cardiology at the Cleveland Clinic in Ohio. People who follow the Mediterranean diet tend to “eat foods that your grandparents would recognize,” adds Heffron. Whole, unprocessed foods with few or no additives.

The diet prioritizes whole grains, fruits, vegetables, legumes, nuts, herbs, spices and olive oil. Fish rich in omega-3 fatty acids, such as salmon, sardines and tuna, are the preferred source of animal protein. Other lean animal proteins, such as chicken or turkey, are consumed to a lesser extent. And foods high in saturated fat, such as red meat and butter, are rarely eaten. Eggs and dairy products like yogurt and cheese can also be part of the Mediterranean diet, but in moderation. And moderate consumption of alcohol, such as a glass of wine with dinner, is allowed.

Breakfast might be mashed avocado with whole-grain toast, fresh fruit, and a low-fat Greek yogurt, points out Heffron. For lunch or dinner, a plate of vegetables and grains cooked in olive oil and seasoned with herbs—roasted root vegetables, leafy greens, a little hummus, and small portions of pasta or whole-wheat bread, with a lean protein like grilled fish.

“It’s very easy to follow, very sustainable, very realistic,” says Zumpano.

What are the health benefits?

Several rigorous studies have found that the Mediterranean diet contributes to improved health in many ways, especially heart health. In a study published in 2018, researchers evaluated nearly 26,000 women over 12 years and found that those adhering to the Mediterranean diet consistently had about a 25% lower risk of developing cardiovascular disease.

This was primarily due to changes in blood sugar, inflammation and body mass index, the researchers reported. Other studies, in men and women, reached similar conclusions.

Research has also found that the diet is able to protect against oxidative stress, which can cause DNA damage, contributing to chronic conditions like neurological disease and cancer. And some studies suggest it may help reduce your risk of developing type 2 diabetes.

Diet can also have profound health benefits during pregnancy, says Anum Sohail Minhas, assistant professor of medicine at Johns Hopkins Medicine. In a recent study of nearly 7,800 women published in December, researchers found that those who followed the Mediterranean diet most strictly around the time they conceived and during early pregnancy had about a 21% lower risk of pregnancy complications, such as pre- eclampsia, gestational diabetes or premature birth.

“There definitely seems to be a protective effect,” says Minhas.

But the Mediterranean diet alone is not a cure-all, points out Heffron. It does not eliminate the chances of developing cardiovascular disease and it does not cure a disease either. It is important that people also pay attention to other principles of good heart health, such as exercising regularly, getting adequate sleep, and not smoking.

Does the Mediterranean diet help you lose weight?

The diet can lead to weight loss, says Zumpano, but you still need to watch your calories.

“Nutrient-rich foods aren’t necessarily low in calories,” says Heffron, who notes that the diet includes foods like olive oil and nuts, which are heart-healthy but high in calories and can lead to weight gain if eaten in large portions. But if you’re changing your diet, for example, from one high in calories, saturated fats and added sugars to one that prioritizes vegetables, fruits and leaner proteins, that could result in some weight loss, he says.

The Mediterranean diet is not intended to be a quick weight loss gimmick. Instead, it should inspire a long-term change in eating behavior. In a study of more than 30,000 people living in Italy, for example, researchers found that those who strictly followed the Mediterranean diet for about 12 years were less likely to be overweight or obese than those who followed the Mediterranean diet. with less constancy.

A smaller study, published in 2020, enrolled 565 adults who had intentionally lost 10% or more of their body weight in the previous year. It was found that those who reported following the Mediterranean diet strictly were twice as likely to maintain their weight loss as those who did not follow the diet strictly.

How long does it take to get benefits?

If you’re just starting out on the Mediterranean diet, limited evidence suggests there may be some cognitive improvements — including attention, alertness and contentment, according to a review of studies published in 2021 — within the first 10 days or so. But for there to be sustained, long-term rewards in terms of heart health, people need to practice it optimally throughout their lives, says Zumpano.

That said, she adds, the diet allows for some flexibility: an occasional cake or steak won’t negate its overall benefits.

Are there any downsides?

The diet generally offers a balanced mix of nutrients and adequate protein, so there are typically no significant risks associated with following it, says Heffron.

However, as the diet recommends minimizing or avoiding red meat, you may want to make sure you are getting enough iron. Good sources of iron include nuts, tofu, legumes and dark green leafy vegetables such as spinach and broccoli.

Foods rich in vitamin C, such as citrus fruits, bell peppers, strawberries and tomatoes, can also help the body absorb iron. And since the diet minimizes dairy, you may want to talk to your doctor about whether you need to take a calcium supplement.

However, for the average person, the benefits of the Mediterranean diet likely outweigh any potential negatives, Minhas says. “These are things we can all try to include in our lives.”

Translated by Luiz Roberto M. Gonçalves