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American Heart Association – Mediterranean Diet

There’s no one “Mediterranean” diet. At least 16 countries border the Mediterranean Sea. Diets vary between these countries and also between regions within a country. Many differences in culture, ethnic background, religion, economy and agricultural production result in different diets. But the common Mediterranean dietary pattern has these characteristics:

• high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
• olive oil is an important monounsaturated fat source
• dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
• eggs are consumed zero to four times a week
• wine is consumed in low to moderate amounts

Does a Mediterranean-style diet follow American Heart Association dietary recommendations?

Mediterranean-style diets are often close to our dietary recommendations, but they don’t follow them exactly. In general, the diets of Mediterranean peoples contain a relatively high percentage of calories from fat. This is thought to contribute to the increasing obesity in these countries, which is becoming a concern.

People who follow the average Mediterranean diet eat less saturated fat than those who eat the average American diet. In fact, saturated fat consumption is well within our dietary guidelines.

More than half the fat calories in a Mediterranean diet come from monounsaturated fats (mainly from olive oil). Monounsaturated fat doesn’t raise blood cholesterol levels the way saturated fat does.

The incidence of heart disease in Mediterranean countries is lower than in the United States. Death rates are lower, too. But this may not be entirely due to the diet. Lifestyle factors (such as more physical activity and extended social support systems) may also play a part.

Before advising people to follow a ‘Mediterranean diet’, we need more studies to find out whether the diet itself or other lifestyle factors account for the lower deaths from heart disease.

http://www.americanheart.org/presenter.jhtml?identifier=4644

Lyon Diet Heart Study

What was the diet in the Lyon Diet Heart Study?

The Mediterranean-style diet used in the Lyon Diet Heart Study was quite comparable to the common pattern but different in a significant way. It was high in alpha-linolenic (lin”o-LEN’ik) acid (a type of polyunsaturated omega-3 fatty acid). It included

• more bread, more root vegetables and green vegetables,
• more fish. less beef, lamb and pork (replaced with poultry).
• no day without fruit.
• butter and cream were replaced with margarine high in alpha-linolenic acid.
• The diet averaged 30 percent of calories from fat, 8 percent from saturated fat, 13 percent from monounsaturated fat, 5 percent from polyunsaturated fat and 203 mg/day of cholesterol. This is consistent with the American Heart Association Eating Plan for Healthy Americans. Compared to the control group, people in the experimental group consumed less linoleic acid and more oleic acid, alpha-linolenic acid and dietary fiber.

What are the conclusions?

The Lyon Diet Heart Study shows the potential importance of a dietary pattern that emphasizes fruits, vegetables, breads and cereals, and fish as well as alpha-linolenic acid within the context of an Eating Plan for Healthy Americans diet plan. The findings from this study imply risk factors beyond lipids and lipoproteins (cholesterol) that have been our primary focus in secondary prevention. The fact that omega-3 fatty acids exert cardioprotective effects in several ways suggests that they could have accounted for the results that were observed. The reduction in coronary recurrence rates, even though lipid and lipoprotein risk factors were comparable, clearly points to other important risk factor changes as major influences in the development of CVD. There’s a pressing need to identify these risk factor(s) and find effective treatment strategies.

Had this dietary pattern been prescribed with a TLC diet, as we recommend for patients with CVD, the beneficial effects could have been even more remarkable. Still, this study shows that a Mediterranean-style Eating Plan for Healthy Americans diet can be followed by free-living people. This diet plan has not yet been evaluated as a long-term strategy for primary prevention.

http://www.americanheart.org/presenter.jhtml?identifier=4655

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