The Mediterranean Diet Health Benefits Revisited


Three red tomatoes lycopene mediterranean diet prevents cancerPhotograph courtesy of epSos.de

A recent study evaluated six different clinical trials involving 2650 overweight and obese patients around the world.  The Mediterranean Diet was found to be more effective in reducing weight, body mass index, blood pressure, fasting sugar and total cholesterol than a low fat diet.  

The Mediterranean Diet is known as a moderate fat diet, because a higher percentage of calories comes from fat than in a standard heart healthy diet where less than 30% of calories are from fat. However, the secret of the Mediterranean diet is not the percentage of fat but the type of fat consumed. Olive, canola, sunflower, safflower, soybean and peanut oil commonly eaten in the Mediterranean regions are all mono and poly unsaturated oils, which are healthier than saturated and trans (partially hydrogenated vegetable oils). Monounsaturated fatty acids (commonly abbreviated MUFA) are healthier than saturated fats, which are found in animal fat products such as butter and tropical oils.  Avocados are another source of MUFA.

Nuts, another integral food consumed in Mediterranean countries, provide heart-healthy omega 3 fatty acids.

Fish, a leaner protein than red meat, is a major component of the Mediterranean Diet.  Fatty fish like salmon, halibut, herring, black cod and sardines have high levels of omega 3 fatty acids, which support healthy memory and aging, and prevent heart disease. Interestingly, omega 3 fatty acids modestly increase LDL ( bad cholesterol), but they are beneficial in preventing heart disease and stroke because they prevent platelet stickiness and help lower blood triglyceride levels. Omega 3 fatty acids also reduce the risk of sudden death by preventing heart dangerous types of heart rhythm abnormalities.Mykonos Crete Mediterranean Diet Madelaine Bulkes Made B

Photograph Courtesy of Madelaine Bulkes

The Standard American Diet or SAD (pun intended) has large amounts of red meat, fried foods, processed grains, cured meats, and sugary sweets and beverages.  In contrast, the Mediterranean Diet is plant-based, with up to 10 servings of fruits and vegetables daily. 

Whole grains are another important feature of the Mediterranean Diet. Bread is eaten plain or dipped in olive oil.  Avoid butter, which has saturated fat, and margerine, which contains trans fat made by partially hydrogenating vegetable oils. Whole grains take longer to digest so they prevent sharp increases in blood sugar after meals. 

Americans more commonly eat processed grains, which have the outer covering of the grain removed.  Remember that whole wheat bread is not made of whole grain; instead it is made out of processed wheat flour (but still has more fiber than white bread). Whole grains have more fiber and are healthier for the colon than processed grains. A high fiber diet can reduce the risk of diverticulosis and colon cancer.  It takes more calories to digest whole grains than to digest processed grains.  A diet high in fiber can also lower blood  cholesterol levels. The Mediterranean Diet have high amounts of soluble (beans, legumes, cracked wheat)  and insoluble (fruits, vegetables, oat bran) fiber.

Substitute a whole wheat version of your favorite pasta, and remember to cook it al dente (not soft) in order to prevent increases in blood sugar after eating.

red wine mediterranean diet mark phillips Timba LimberRed wine in moderation is acceptable in the Mediterranean Diet. However, if more than 5 ounces per day in women or 10 ounces a day in men is consumed, the benefits of the red wine are lost.  Women at risk for breast cancer or breast cancer

Photograph courtesy of Mark Phillips/Timba Limber

recurrence should consider restricting alcohol intake since this factor has been associated with breast cancer occurrence.  It is believed that the benefits of red wine to the heart are through the antioxidant action of the phytonutrient resveratrol, which is found in the skins of grapes. So the same benefits of wine can be achieved by eating red grapes or drinking pure red grape juice. 

Dr. Ancel Keyes and his colleagues (including Dr. Paul Dudley White, who later served as President Eisenhower’s heart doctor) developed the Seven Countries Study after World War II to evaluate the health of almost thirteen thousand middle-aged men in the United States, Greece, Italy, the Netherlands, Finland, Yugoslavia and Japan.  They discovered that people who ate a diet high in vegetables, fruits, legumes (beans, lentils), fish and whole grains were the healthiest. The healthiest men were the residents of Crete, who lived longer and had less heart disease than Americans in the post World War II era.  Dr. Keyes and his  associates hypothesized that it was the Mediterranean diet that the Cretans ate which contributed to their longevity and good health. The residents of Crete ate up to 10 servings of fruits and vegetables daily!

Studies have shown that the Mediterranean Diet decreases the risk of heart attack, stroke, Parkinson’s disease, Alzheimer’s disease and death from all causes. Although there have not been any prospective randomized, double blind, placebo controlled trials (the gold standard for evidence based medicine) comparing the Mediterranean diet to the standard American diet or weight loss programs, a number of studies have shown that people who follow the Mediterranean diet are leaner than people who follow other diets.

Cruciferous vegetables (shaped like a cross when cut)  such as broccoli, cauliflower, kale, cabbage and Brussels sprouts have antioxidants which prevent several kinds of cancer including breast and prostate.  Tomatoes have lycopene, an  antioxidant similar to vitamin A, which  reduces the risk of cancers such as breast and prostate. Cooking tomatoes or cooking with olive oil, such as in tomato sauce, increases the lycopene content.

The low sodium Mediterranean diet combined with the high potassium content of fruits and vegetables such as various greens, legumes, potatoes and squash helps lower blood pressure.  Spinach, almonds, lentils, broccoli, pumpkin and sunflower seeds are good sources of magnesium, another element essential to maintain good blood pressure.

The high fiber content of fruits, vegetables and whole grains stabilizes blood sugar and prevents diabetes.  Another benefit of fiber in the diet is that it keeps maintains a feeling of fullness, decreasing the temptation for eating unhealthy snacks when ravished! Mono unsaturated fats from foods such as avocados, olive oil and nuts increase the body’s ability to use insulin, which also decreases the risk of diabetes. 

Although nuts have healthy omega 3 fatty acids, they are composed of fat, so no more than a handful a day is recommended. Avoid salted or honey roasted nuts. Almonds, walnuts, hazelnuts, pine nuts, cashews and pistachios can be eaten as part of the Mediterranean diet.

Lean protein in the form of chicken and other poultry and fish (healthy portion  is checkbook cover size) are important components of the Mediterranean diet, and are consumed weekly. Red meat and pork is rarely eaten, no more than a few times a month, and in small portions (about the size of a deck of cards). Food is prepared simply, using fresh ingredients, without  sauces or gravies. Rosemary, garlic, thyme, basil and parsley are herbs commonly used in Mediterranean cuisine, and have been shown to have beneficial health effects.

Studies show that garlic decreases blood pressure and reduces risk of cardiovascular disease. Remember to allow cut garlic to sit out for at least 5 minutes before cooking, in order to retain its health benefits.

In the Mediterranean region, sweets are consumed infrequently (no more than twice weekly), and are usually made of natural sugars such as honey.  Aiming for a 75 calorie dessert is ideal. Sorbets, fruit and dark chocolate are the best dessert choices.

Low fat Greek yogurt, feta cheese, sardines, beans, Brussels sprouts, broccoli, spinach and kale are good sources of calcium.

Lentils, spinach, almonds, and poultry are good sources of iron. Eating citrus fruit or peppers provides vitamin C, which helps the absorption of iron in a meal. Lentils and beans are also good sources of potassium, magnesium, folic acid and soluble fiber. Soak beans and change the soaking water several times in order to decrease the gas producing substances in beans. Remember that beans are not a complete protein, meaning they lack some essential amino acids that the body must get through the diet; adding lean poultry and eggs provides these essential amino acids.  Egg yolks should be eaten no more than once a week due to the saturated fat content, but there is no limit to the amount of egg whites that can be consumed.

At least 30 minutes daily exercise or movement is a recommended part of the Mediterranean diet.

Finally, a very important component of the Mediterranean lifestyle is sharing food with friends and family. Enjoy the Mediterranean lifestyle, have a zest for life and improve health all at the same time!

Allain J. Nordmann, Katja Suter-Zimmerman, Heiner C. Bucher, Iris Shai, Katherine R. Tuttle, Ramon Estruch, Matthias Briel. Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors. The American Journal of Medicine Volume 124, Issue 9, Pages 841-851.e2, September 2011.

Last updated on January 18, 2012 by Dr. Vee  Photograph courtesy of epSos.de

red raspberries frozen antioxidants

Antioxidants, Epigenetics and How to Decrease the Risk of Cancer


Photograph of Peapod Courtesy of Catherine Merulpie

How Antioxidant Foods Affect your Epigenetics

You are your genes. Better stated, you are your epigenetics. If you have DNA that may increase the risk of certain cancers, can you change your own risk? Epigenetics refers to the cellular environment of our genes—how the expression of the genes are affected without changing the underlying DNA sequences.

How do broccoli and other cruciferous vegetable such as Brussels sprouts or cauliflower decrease the risk of cancer? Certain nutrients, such as sulforaphanes in broccoli and diallyl in garlic affect epigenetics by activating genes involved in the development of cancer (tumor promoters, tumor suppressor genes, DNA repair genes). Selenium, vitamin A, folate and vitamin D are also believed to impact on the development of cancer by affecting epigenetics.

Could it really be that easy? Just eat a lot of broccoli? More coldwater fish? Grape Juice? Dark chocolate? Green tea? Vitamin D supplements?

Actually, at least four factors—Timing, Quantity, Combination and Organ Exposure—play a role in how phytonutrients (beneficial food substances) affect the development of certain cancers.

Timing

The actual timing of a body organ’s exposure to a cancer fighting substance makes a difference. For example, taking folic acid when there are underlying pre-cancerous colon cancer cells in the body actually increases the risk of developing colon cancer.

Regular soy intake (preferably whole soy products such as miso) by adolescent and young women decreases their risk of breast cancer by about 15 %. Isoflavones in soy attach to the estrogen receptor and block the body’s intrinsic estrogen from attaching to estrogen receptors. By blocking estrogen from attaching to receptors, isoflavones may prevent development of breast cancer.

However, in women who already have estrogen positive breast cancer or who are on tomoxifen, soy intake is generally not recommended. In these women with current or previous history of breast cancer, isoflavones are believed to attach to estrogen receptors and mimics the effect of estrogen to promote the development of breast cancer. (But even that conventional wisdom is evolving! Stay tuned for several recent studies in breast cancer survivors that suggest that soy intake is safe, even in women who are taking anti-estrogen/progesterone receptor therapy.)
In general, whole soy foods rather than soy supplements or powders are recommended. This is an active area of breast cancer research, so hopefully the true effects of soy in women at risk for breast cancer or who have had breast cancer can be more clearly understood.

Quantity of Antioxidants Ingested

The total amount of a potential cancer preventing nutrient that is ingested is also important. In general, increasing vitamin D intake decreases the risk of certain cancers, especially breast and prostate cancer. But more is not always better! Patients who have very high blood levels of vitamin D actually increase their risk of prostate cancer. Very high intake of the combination of selenium, beta carotene and vitamin E has been shown to increase the risk of death in patients with esophageal cancer. So be cautious in your intake of supplements –more is not always better, and it is possible to have toxicity from high levels of supplements.

Combination

Combining an antioxidant with other substances makes a difference. The prime example is the use of beta carotene supplements in smokers, which actually increases the risk of lung cancer more than in smokers who did not take beta carotene. Of course we all know that quitting tobacco makes the biggest difference in decreasing lung cancer risk.
Combining fruits and vegetables with unhealthy fats (such as trans fats) rather than olive and canola oils eliminate many of their beneficial antioxidant effects.

The Organ Exposed

Finally, the organ that is exposed to the antioxidants in foods is affected in different ways. For example, the calcium in milk is believed to decrease the risk of colon cancer but may increase the risk of prostate cancer. The effects of calcium in milk cannot be explained just by the fat content of milk because in general, high fat intake increases the risk of both colon and prostate cancer.

In summary, antioxidants in food can decrease the risk of cancer by affecting the epigenetics of DNA susceptible to promoting cancer, but attention must be paid to other factors that can affect these phytonutrients.

This post is not meant to diagnose, treat or recommend any course of therapy. It provides general information on cancer genetics and nutrition. Check with your physician how these factors may impact on your health.

Last updated by Dr. Vee on August 6, 2011

Super Fruits for Health (Or Why Purple is the New Green)


Photographs Courtesy of Albaflickr/J.Jorge

Super Fruits are fruits that are packed with nutrients and antioxidants.

Free radicals are toxic molecules created naturally in the body when food is digested and energy is utilized by the body. Antioxidants are ingredients in fruits that fight damage created by free radicals. Cancer, heart disease, Alzheimer’s disease and eye problems can develop if free radicals aren’t neutralized by antioxidants in the body. Super Fruits have antioxidants which scavenge free radicals and decrease inflammation in the body. Antioxidants also boost the immune system to help fight infections. Many fruits have high levels of potassium, which helps prevent high blood pressure.

1.Blackberries–Purple berries have the highest antioxidant content of any food, so when it comes to fruits and vegetables, purple is the new green! Anthocyanins are the antioxidants in blackberries (and black currants) that give berries their deep purple color and protect against heart disease and cancer. Blackberries also have high levels of vitamin C, which help boost the immune system. Blueberries, raspberries, strawberries and cranberries also have high levels of antioxidants. Cranberries may help prevent bladder infections.

2. Tomatoes–(fruit though we think of as vegetable). Red fruit such as tomatoes have an antioxidant called lycopene which helps prevent heart disease and certain types of cancer. Cooking tomatoes increases antioxidant levels. Tomatoes contain high levels of Vitamin E, vitamin C and iron.

3. Avocado–also known as an alligator pear. Contains more protein than in a steak! Avocados have essential amino acids (can only eat in the food, not made naturally in the body) to build muscle. They contain heart healthy omega 3 fatty acids. The monosaturated oil in avacodos help lower bad cholesterol levels. Contains lutein, which helps preserve eyesight. The antioxidants in avocados are great for the skin when applied as a masque.

4. Red grapes and grape juice–Contains the same heart healthy antioxidant resveratrol found in red wine. Resveratrol is felt to help prevent heart disease and blood clots. The skin of red grapes are packed with polyphenol antioxidants so eat the grapes with the peels on!

5. Pomegranates–one of the earliest cultivated fruits. High in fiber, vitamin C and potassium. Contains antioxidants called polyphenols (tannins, anthocyanins, and ellagic acid) that help prevent heart disease.

6. Kiwi–Can be mashed and spread on meat as a natural tenderizer. Good source of fiber, vitamin C, potassium and vitamin E. Has antioxidants to help vision and prevent heart disease. Mild flavor so kids will enjoy. One study showed kiwi fruit helped reduce the inflammation of asthma in children.

7. Chili Peppers–All peppers have seeds so are considered fruit (though we often cook them like vegetables). Contain antioxidant called capsaicin, which treats inflammation pain due to osteoarthritis. It is also used as a natural remedy for nasal congestion. Also increases endorphins in the brain so may help improve mood. Peppers contain more vitamin C than oranges! They also have high levels of the antioxidants beta carotene (to help prevent cancer) and lutein (to preserve vision).

8. Figs–Contain lutein that helps maintain good vision. High in iron, fiber, potassium and calcium. Contain polyphenol antioxidants.

9. Oranges–high in fiber and vitamin C, which helps boost immune system. May be helpful in reducing the inflammation associated with asthma and rheumatoid arthritis. Vitamin C helps the absorption of iron from the stomach.

10. Apples–Contains pectin, a soluble fiber that lowers cholesterol and blood sugar levels. Pectin binds heavy metals like lead and mercury to help the body get rid of these toxins. Contain high levels of vitamin K which helps with clotting function, and vitamin C which helps make healthy connective tissue. Trace mineral selenium helps body’s natural antioxidant system. Antioxidants in apples help preserve brain and memory function. Lots of nutrients in the peel of apples. Consider splurging for organic apples to avoid possible pesticide exposure.

Last updated on March 15, 2011 by Dr. Vee