To Your Health: Benefits Of The Mediterranean Diet

Editor’s Note: It all started with a Wellness Conference that took place in March at The Peaks Resort & Spa. The talks featured part-time Telluride local Dr. Alan Safdi, who offered evidence-based medical findings for healthy living in easily digestible sound bytes. The series was so popular, Dr. Safdi and Peaks’ General Manager, Dave Ciani, plan to continue talks this summer. In the meantime, in between times, Telluride Inside… and Out continues to offer nuggets from Dr. Safdi through a bi-monthy column, “To Your Health.”

Dr. Alan Safdi

Dr. Alan Safdi

The medical community has suggested a variety of diets over the years without often considering if these could be part of a way of life one could continue, and so very few diets are ever successful in thel long term. Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain. Even worse, recommendations to follow a low-fat diet generally did not differentiate between good and bad fats. We now have some very good scientific evidence of the benefits of the Mediterranean diet. Studies looked at heart attacks and strokes and death, variables that really count.

Until now, evidence that the Mediterranean diet reduced the risk of heart disease was weak, based mostly on studies showing that people from Mediterranean countries seemed to have lower rates of heart disease — a pattern that could easily have been explained by factors other than diet.

A large and rigorous new study published in the New England Journal of Medicine found that 30 percent of heart attacks, strokes and deaths from heart disease could have been prevented in high-risk people if they had switched to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables – and that includes drinking wine. It is the first major clinical trial to measure the diet’s effect on heart risks and the magnitude of the diet’s benefits was startling. The study ended early, after almost five years, because the results were so clear it was considered unethical (and unnecessary)  to continue.

The study was a triumph because it showed that a diet could be a powerful factor in redu cing heart disease risk, and it did so using disciplined scientific methods. Scientists randomly assigned 7,447 overweight people in Spain who were were smokers, had diabetes or other risk factors for heart disease to follow the Mediterranean diet or another low-fat regime.

When strictly followed the diet helped, although participants did not lose weight and most of them were already taking statins, blood pressure or diabetes drugs to lower their heart disease risk.

I will discuss the details of the study, but remember a low fat diet is very hard to follow, so the study really compares the usual modern diet of red meats, sodas and commercial baked goods with a Mediterranean diet that shuns such things. Those assigned to an alternative low-fat diet did not lower their fat intake very much.

Researchers were careful to say in their paper that while the diet clearly reduced heart disease for those at risk, more research was needed to establish its benefits for people at low risk.

Experts hesitated to recommend the diet to people who already had weight problems, since oils and nuts have lots of calories. We have learned, however, that not all the calories from nuts are absorbed and remember that fats delay our gastric emptying so we feel full quicker and for a longer period of time. A diet that removes fats and replaces them with simple sugars does not make us feel full for very long and so we hungry again in short order.

This study has confirmed my convictions that a diet rich in olive oil, nuts, beans, fish, fruits and vegetables, even including moderate amounts of wine with meals, can have numerous benefits. The Mediterranean diet includes significant amounts of extra-virgin olive oil each week and a combination of walnuts, almonds and hazelnuts. People in the study were instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red. Most important, this type of diet can easily be followed for a lifetime.

Food for thought?

About Dr. Alan Safdi:

Dr. Alan Safdi is board certified in Internal Medicine and in Gastroenterology and is a Fellow of the American College of Gastroenterology. He is the past Chairman of the Department of Gastroenterology at the Deaconess Hospital and current Chairman of the Ohio GI and Liver Institute. A proven leader in the healthcare arena, he has been featured on the national program, “Medical Crossfire” and authored or co-authored numerous medical articles and abstracts. Safdi has been involved in grant-based and clinical research for over 33 years and is passionate about disease prevention and wellness, not just fixing what has gone wrong. He is an international lecturer on the subjects of wellness, nutrition and gastroenterology.

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