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Mediterranean Diets and the Heart

Think sun, sand and wonderful food on holiday in the Mediterranean. A great prescription for health, but this is fact. Mediterranean cuisine is well known for its food and wine. The people spend long hours preparing and eating a variety of delicious dishes.   Food is an integral part of their culture, yet, they have one of the lowest rates of heart disease, and certain cancers, of any population in the world.

Interest spread world wide as to why their diet reduced the risk of heart disease and scientists investigated the facts in the Lyon Diet Heart Study, which demonstrated a strong protective effect.

There are many Mediterranean countries with wide variations in eating patterns, but essentially the cuisines are similar.   This diet is not especially low in fat, because it contains olive oil, but is high in fish omega-3 fatty acids , oleic acid, fibre, antioxidants, minerals, proteins and B-group vitamins.

Cholesterol is confusing when it comes to dietary fat: saturated, polyunsaturated and monounsaturated. The saturated fats come from mainly animal products e.g. meat, cheese, eggs and poultry, they need to be balanced with the other fat intakes, ideally a diet containing 10% of each type of fat, totalling 30% overall.

Substituting saturated fats with unsaturated fats wherever possible, may significantly lower blood cholesterol levels.   Unsaturated fats are generally thought of as the "good" fats, as opposed to saturated fats.  

The fat in the Mediterranean diet is essentially monounsaturated and polyunsaturated from the vegetables and fish oils. These have been shown to be heart protective. Provided you do not exceed your daily total fat allowance, the intake of polyunsaturated fats can reduce blood cholesterol levels - they lower low density lipoprotein (LDL), which is good, but slightly lower high density lipoprotein (HDL).   There are two main types of polyunsaturated fats: omega-3 fatty acids and omega-6 fatty acids.   These fatty acids are precursors of hormone-like compounds that help regulate blood pressure, heart rate and blood clotting.

Fish oils are rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which originates from cold water fish, such as salmon, herring, mackerel, sardines and trout.   Omega-3 fatty acids may have a particularly important function to play in the prevention of heart disease.   To date, most clinical trials with human subjects consistently show that fish oil cause a decrease in blood cholesterol levels.

Even though nuts are high in fat, 80% of the calories in nuts come from polyunsaturated fat. The fats in nuts like other polyunsaturated fats, actually work to lower cholesterol and thus lower the risk for heart disease.   Because nuts are high in fat, remember that one small handful is considered a generous serving.

Monounsaturated fat is found mainly in vegetable products olive oil, canola oil, avocados, nuts and peanut oil - they reduce total cholesterol and LDL-cholesterol, while not affecting the protective HDL-cholesterol (good cholesterol). Avocados are high in fat, but contain no cholesterol - no plant foods do!   Between 70-90% of the calories in avocados are from fat of which 60% is made up of "monounsaturated" fat the "good" fat.  

According to the research, people who eat five to six daily servings of vegetables (particularly cruciferous and green, leafy varieties) and fruit have less risk compared to those who eat two to three servings a day. This is because these foods contain water, fibre, vitamins and minerals and antioxidants.

Antioxidants protect our cells from free radicals. Free radicals are reactive molecules used by the immune system to fight off invading pathogens.   When produced in excess, free radicals do not confine their activity to pathogens and damage human cells and tissues.   Free radicals have been implicated in the aetiology of heart disease and atherosclerosis.   Smoking, alcohol, high-fat diets, too much sun and pollution can cause our bodies to produce more free radicals than are needed. Antioxidants are nutrients that offer us some means of protection against the hazardous effects of these reactive molecules.   They prevent some of the damage by neutralising the harmful effects of free radicals rendering them inactive.  

Commonly known antioxidants are vitamin A, beta-carotene, vitamin E, vitamin C, lycopene and selenium.   These are all found in varieties of fruits, vegetables, salads and especially garlic and onions. Therefore aim for more than 5 portions a day to optimise health.

Fibre has also been shown to reduce the absorption of fat from the diet. It comes from plant cell walls, which our bodies cannot digest and absorb. Fibre combines with bile salts in the small intestine, which slows down their reabsorption.   The liver therefore has to produce new bile salts from cholesterol, thus lowering the concentration of cholesterol in the blood.   Good sources of soluble fibre include oats, legumes and fruit, particularly citrus fruits and apples.

Sterols are scientifically proven in several studies to lower total cholesterol and LDL cholesterol and the food industry are using these products to promote cholesterol lowering, however they are found naturally in plant seeds being the richest source, whilst vegetable oils, grain products; fruit, vegetables and nuts are also important sources.  

A moderate amount of alcohol actually reduces the risk of heart disease. Alcohol is thought to increase the amount of HDL-cholesterol and thin the blood. Two drinks a day i.e. two glasses of 125mls wine preferably red per day or two tots of whisky per day is a moderate amount.   If you have a high triglyceride level or are overweight, you should avoid alcohol altogether. Furthermore, the metabolism of alcohol generates harmful free radicals.   Excessive alcohol consumption can also increase blood pressure - therefore, drink alcohol in moderation.

Caffeine may aggravate hypertension (high blood pressure) and cause irregular heartbeats in sensitive individuals.   If you have high blood pressure, avoid tea, coffee, coke and chocolate, but if your blood pressure is normal, modest caffeine won't give you hypertension.  

Therefore the Mediterranean diet offers many protective effects for the heart and therefore longevity.

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