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Mediterranean diet for a healthy heart

Shubham Pant

Updated: March 20, 2013, 6:14 PM IST
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Struggling with heart issues? Here's some good news. A recent study published in the 'New England Journal of Medicine' evaluated the possible benefits of a Mediterranean diet on outcomes of people at risk for heart-related complications.

What exactly is a Mediterranean diet?

Though many variations exist, traditionally, a Mediterranean diet emphasises intake of olive oil, fish, low fat dairy (skim milk), whole grains, legumes, nuts, fruits and vegetables and wine (in moderation); while limiting red meats, high fat dairy (whole milk) and sweets.

What was the study?

The researchers followed 7,500 people in Spain who either had type 2 diabetes mellitus or at least three of the following major risk factors for heart disease: smoking, high blood pressure, elevated LDL cholesterol levels (commonly referred to as the 'bad' cholesterol that clogs the arteries), low HDL cholesterol (a beneficial cholesterol), obesity, or a family history of heart disease. These patients were randomised to one of two Mediterranean diets (one supplemented with daily extra-virgin olive oil or supplemented with mixed nuts) and compared these diets to a low fat diet. Mediterranean diet on the study included multiple servings a day of fresh fruits, fish (especially fatty fish), legumes, white meat and wine with meals (only for habitual drinkers); while avoiding sodas, commercial bakery goods, sweets, pastries and red meat. One group assigned to the Mediterranean diet was instructed to use a minimum of 4 tablespoons a day of extra-virgin olive oil daily. For the other group, the recommended consumption was 30 grams of a mix of walnuts, almonds and hazelnuts. The recommended diet for the control (low fat group) consisted of low fat dairy products, bread, potatoes, pasta, rice, fresh fruits, vegetables, lean fish and seafood. Trained dieticians followed the patients closely to assure compliance with the diets.

What were the results?

The trial was stopped early as after five years of follow up, participants in the Mediterranean group had a significantly lower risk of stroke, heart attack or dying from heart related causes (risk reduction of 30 per cent) as compared to participants following the low fat diet. The authors concluded that extra virgin olive oil and nuts were probably responsible for most of the observed benefits.

Why is this study important?

You may ask the question: there are millions of diets out there (If you google the word 'diet', you get 429,000,000 hits in half a second!!), why is this one special? The difference lies in the fact that most diets are based on empirical evidence and not backed by hard data, whereas this study was unique in that this was a scientifically rigorous study with a long follow up of participants.

Here are a few important take home points:

It's never too late to start eating healthy: The participants in this study were between 55 and 80 years.

A low fat diet has its pitfalls (and it is harder to follow): The study drop out rate was higher for patients on the low-fat diet than the Mediterranean diet (11.3 per cent vs 4.9 per cent). Moreover, foods that are marketed as 'fat free' invariably make up most of their calories from carbohydrates and sugars, leading to worse outcomes.

All fats are not created equal: It is important to decrease intake of saturated and trans fats (butter and Ghee) and try and switch to sources of monounsaturated fats and polyunsaturated fats (olive oil and canola oil). Fatty fish (like Salmon, mackerel, herring, sardines and albacore fish) can be good sources of omega 3 fatty acids, which can contribute to heart health.

Moderation is the key: Dietary extremes are usually unsustainable and in some cases, harmful. For example, the Mediterranean diet incorporates wine, but not more than 150 ml. a day. Diet should be well balanced and should include plenty of vegetables, fruits, nuts and less red meat, sweets and high fat dairy.

Overall, it is important to be consistent and for the best results, add on some physical activity to your daily routine. And remember, even if you don't follow the diet strictly, just eating more of the foods listed on the diet and less processed foods can make a world of difference.
First Published: March 20, 2013, 6:14 PM IST

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