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Balance - The Mediterranean Diet

Balance.


It can be difficult for the public to follow dietary advice such as reducing salt sugars and saturated fats and increasing fibre, when food choices are often based on different factors, such as taste preferences, culture, convenience and cost [1]. The Mediterranean diet has been extensively researched and is considered to be one of the healthiest diets throughout the world [2, 3]. Europe's largest randomised trial, Prevención con Dieta Mediterránea, reports multiple health benefits of the diet and identifies the possibility that the combinations of foods and their associated nutrients and antioxidants are more important than individual nutrients of foods [4, 5, 6].



The Mediterranean Diet – What Is It?


The traditional Mediterranean food is predominantly plant based and consists of fish, fruits, vegetables, whole grains, legumes, nuts, beans, some alcohol (such as red wine) and coffee [2]. Olive oil is the most predominant fat in the Mediterranean diet [7]. It generally has a lower intake of meat and dairy foods [8].


How Can It Help?


Some important benefits include a reduced risk of mortality for cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease cancer incidence and neurodegenerative diseases [4, 5, 6, 9, 10, 11, 12, 13]. It has helped to reduce obesity, blood pressure, blood sugars, inflammation, oxidative stress, atherosclerosis and improve lipid profiles which are markers of metabolic syndrome [2, 3, 9, 14].


The diet typically has high vegetable consumption and moderate wine consumption, both of which are associated with high levels of antioxidants including polyphenols [6]. Antioxidants have the ability to counteract oxidative stress from free radicals as shown in laboratory experiments and this could explain the beneficial findings from observational studies [13]. Polyphenols, from plant based foods including fruit and vegetables, whole grains, tea, coffee and nuts have been demonstrated to influence glycaemia, insulin resistance and inflammation [15, 16].


In addition, the diet typically has less carbohydrate (in particular refined carbohydrates and sugars) and is high in whole grains which have a low glycaemic effect [16, 17]. It is naturally low in saturated fat and high in monounsaturated and omega 3 fatty acids in comparison to a western low-fat diet which can improve lipid metabolism [6, 16, 17]. Furthermore, high fibrous diets can help to support healthy gut bacteria providing further health benefits [18]. Lastly, typical dishes in this diet contain many herbs and spices which could also provide health benefits [3].


The ability of the Mediterranean diet to prevent metabolic syndrome could make it an effective dietary disease prevention technique and this could rival the use of aspirin, beta-blockers and ACE inhibitors for cardiovascular disease [2, 6, 11].


Things to Consider


It is possible that an individual component may be helping to the reduce risk of cardiovascular disease as opposed to the diet as a whole [2]. In addition, before the diet can be used in medical practice, it must be validated by concrete cardiovascular endpoints in randomised trials [2]. Lastly, there are possibilities that the proposed effects of the Mediterranean diet could be caused by other factors such as lifestyle (physical and leisure activities), social interaction and sleep quality [7, 9].


Summary


Further study of the benefits of the Mediterranean diet could contribute to the use of the Mediterranean diet as a healthy lifestyle model when tailored to specific countries and dietary needs [19]. It shows strong promise as a prevention technique for many chronic diseases and may be an easier dietary tool to use compared to complex advice currently available.


The next post will discuss how to incorporate the Mediterranean diet into your own diet and lifestyle!


Love Always,


Lottie x





[1] Green, H. (2015) ‘Should foods or nutrients be the focus of guidelines to promote healthful eating?’, Nutrition Bulletin, 40 (4), pp.296-302.


[2] Widmer, R., Flammer, A., Lerman, L. and Lerman, A. (2015) ‘The Mediterranean diet, its components, and cardiovascular disease’, American Journal of Medicine, 128 (3), pp. 229-238.


[3] Bower, A., Marquez, S. and de Mejia, E. (2016) ‘The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet’, Critical Review of Food Science Nutrition, 56 (16), pp. 2728-2746.


[4] Dinu, M., Pagliai, G., Casini, A. and Sofi, F. (2018) ‘Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials’, European Journal of Clinical Nutrition, 72 (1), pp. 30-43.


[5] Fitó, M. and Konstantinidou, V. (2016) ‘Nutritional Genomics and the Mediterranean Diet's Effects on Human Cardiovascular Health’, Nutrients, 8 (4), pp. 218.


[6] Martinez-Gonzalez, M. and Martin-Calvo, N. (2016) ‘Mediterranean diet and life expectancy; beyond olive oil, fruits, and vegetables’, Current Opinions on Clinical Nutrition and Metabolism Care, 19 (6), pp. 401-407.


[7] Yannakoulia, M., Kontogianni, M. and Scarmeas, N. (2015) ‘Cognitive health and Mediterranean diet: just diet or lifestyle pattern?’, AgeingResearch Reviews, 20, pp. 74-78.


[8] NHS (2017) What is a Mediterranean diet? Available at: https://www.nhs.uk/live-well/eat-well/what-is-a-mediterranean-diet/(Accessed: 1stFebruary 2018).


[9] Aridi, Y., Walker J. and Wright, O. (2017) ‘The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review’, Nutrients, 9 (7), pp. E674.


[10] Bloomfield, H., Koeller, E., Greer, N., MacDonald, R., Kane, R. and Wilt, T. (2016) ‘Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake: A Systematic Review and Meta-analysis’, Annals of Internal Medicine, 165 (7), pp. 491-500.


[11] Di Daniele, N., Noce, A., Vidiri, M., Moriconi, E., Marrone, G., Annicchiarico-Petruzzelli, M., D'Urso, G., Tesauro, M., Rovella, V. and De Lorenzo, A. (2017) ‘Impact of Mediterranean diet on metabolic syndrome, cancer and longevity’, Oncotarget, 8 (5), pp. 8947-8979.


[12] Sofi, F., Macchi, C., Abbate, R., Gensini, G. and Casini, A. (2014) ‘Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score’, Public Health Nutrition, 17 (12), pp. 2769-2782.


[13] National Center for Complementary and Integrative Health (NIH) (2016) Antioxidants: In Depth. Available at: https://nccih.nih.gov/health/antioxidants/introduction.htm#introduction(Accessed: 1st February 2019).


[14] Ros, E., Martínez-González, M., Estruch, R., Salas-Salvadó, J., Fitó, M., Martínez, J. and Corella, D. (2014) ‘Mediterranean diet and cardiovascular health: Teachings of the PREDIMED study’, Advanced Nutrition, 5 (3), pp. 330S-336S.


[15] Guasch-Ferré, M., Dietary Polyphenols, Mediterranean Diet, Prediabetes, and Type 2 Diabetes: A Narrative Review of the Evidence’, Oxidised Medicine Cell Longevity, Epub: 6723931.


[16] Godos, J., Federico, A., Dallio, M. and Scazzina, F. (2017) ‘Mediterranean diet and nonalcoholic fatty liver disease: molecular mechanisms of protection’, International Journal of Food and Nutrition, 68 (1), pp. 18-27.


[17] Romero-Gómez, M., Zelber-Sagi, S. and Trenell, M. (2017) ‘Treatment of NONALCOHOLIC FATTY LIVER DISEASE with diet, physical activity and exercise’, Journal of Hepatology, 67 (4), pp. 829-846.


[18] Monash University (2018) Fibre, prebiotics and the gut. Available at: https://www.futurelearn.com/courses/food-as-medicine/8/steps/407076(Accessed: 1st February 2019).


[19] Dernini, S., Berry, E., Serra-Majem, L., La Vecchia, C., Capone, R., Medina, F., Aranceta-Bartrina, J., Belahsen, R., Burlingame, B., Calabrese, G., Corella, D., Donini, L., Lairon, D., Meybeck, A., Pekcan, A., Piscopo, S., Yngve, A. and Trichopoulou, A. (2017) ‘Med Diet 4.0: the Mediterranean diet with four sustainable benefits’, Public Health Nutrition, 20 (7), pp. 1322-1330.

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