Advanced Mediterranean Diet

Americans are fat largely because of sugar, starches, and other high-carbohydrate foods.

       - Richard K. Bernstein, M.D., in his book, Diabetes Solution

Chocolate seems to protect against stroke, according to Canadian researchers as reported by TheHeart.Org. 

Investigators reviewed the best available studies and found:

1. 22% lower risk of stroke in those who ate about one serving of chocolate per week, and
2. 46% reduction in death from stroke in those who ate 50 g of chocolate per week

[These figures are comparisons to those who never ate chocolate.] 

At least one study found no association between chocolate consumption and stroke and death rates.

Researchers cite the flavonoids and procyanidins in chocolate as the potentially healthy components, along with other antioxidants.  Dark chocolate has much more than milk or white chocolate.  The underlying studies typically do not inquire as to the type of chocolate eaten.

It’s possible that chocolate consumption is simply a marker for healthy or health-conscious people who have other characteristics that would reduce stroke risk, such as keeping blood pressure under control, exercising, and not smoking.

The evidence for chocolate’s health benefits is not super-strong.  People who love chocolate don’t need science to support their habits.  The “healthy dose” of dark chocolate—if there is one—is probably no more than 20 g every three days.  That’s not much.

Interested in dark chocolate and don’t know how to get started?  I reviewed seven brands of dark chocolate here.

Steve Parker, M.D.

Reference:  Jeffery, Susan.  Chocolate linked to lower stroke and stroke mortality risk.  HeartWire by TheHeart.Org, February 12, 2010.

Dieters with particular genetic make-up respond better or worse to specific types of weight-loss diets, suggest researchers who presented data at the 2010 Cardiovascular Disease Epidemiology and Prevention /Nutrition, Physical Activity, and Metabolism conference.  Findings are preliminary, but may explain the common phenomenon of two people going on the same diet, but only one achieving good results. 

I’ll bet you can imagine several other explanations.

Several years ago, the “A to Z” study compared the weight loss of 311 overweight women on one of four diets:  Atkins (low-carb), Ornish (very low fat, vegetarian), Learn (low-fat), and Zone (moderate carb restriction, high protein, moderate fat).  Atkins was a bit better than the other diets, in terms of long-term (one year) weight loss.  But within each diet group, some women lost 40–50 pounds (18–23 kg), whereas others gained over 10 pounds (4.5 kg).

Stanford University researchers obtained DNA from 138 of the 311 women and noted the occurence of three genes—ABP2, ADRB2, and PPAR-gamma—that had previously been shown to predict weight loss via diet-gene interactions.  For example, a particular mix of these genes predict better weight loss with a low-fat diet; a different mix predicts more loss with a low-carb diet.

Women who had been randomly assigned to one of the A to Z diets tended to lose much more weight if they happened to have the gene mix appropriate for that diet (compared to those on the same diet with the wrong gene mix).  The difference, for example, might be loss of 12 pounds versus two pounds.

The lead researcher, Dr. Mindy P. Nelson, told TheHeart.Org that the proportion in the general population genetically predisposed to the low-fat versus low-carb approach is about 50:50.

Take-Home Points

These results, again, are preliminary; additional testing is necessary for confirmation.  If they had been able to test the DNA of the other 178 women in the A to Z study, the results could have been either stronger or shown no diet-gene interaction.  The study hasn’t even been published in a peer-reviewed journal yet.

Men may or may not be subject to similar diet-gene interaction.

With a little effort, you’ll be able to find the aforementioned genetic test available via the Internet.  It’s under $100 (U.S.).  The company sends you a kit to swab the inside of your cheek, then you mail your DNA to them. 

Other peope just try a particular diet first and see if it works over 4–6 weeks.  Successful long-term weight loss is like smoking cessation—most smokers try 5–7 different times or methods before hitting on one that works for them.

Regular readers here know that I advocate, for weight loss, both a reduced-calorie, balanced Mediterranean diet (Advanced Mediterranean Diet) and a very low-carb diet (Ketogenic Mediterranean Diet).  Regardless of genetics, experience has taught me that there’s no single weight-loss program that works for everyone across-the-board.

This potential diet-gene interaction could be a major finding that will stop the arguing about which is the single best way to lose excess fat.  Many paths may lead to the mountaintop. 

Steve Parker, M.D.

Reference:  O’Riordan, Michael.  Dieting by DNA?  Popular diets work best by genotype, reseach shows.  HeartWire by TheHeart.Org, March 8, 2010.

Red wine’s beneficial health effects may be related to improved circulation, according to a recent study by Israeli researchers.

Red wine is a time-honored component of the healthy Mediterranean diet.  Consumption is associated with longer lifespan and less cardiovascular disease such as heart attacks. 

Israeli investigators had 14 young healthy volunteers drink 250 cc of red wine daily for 21 days, while monitoring markers of circulatory function.  Endothelial progenitor cells may be particularly important in maintenance, repair, and formation of the arterial circulatory system.

Here’s their conclusion:

The results of the present study indicate that red wine exerts its effect through the up-regulation of CXCR4 expression and activation of the SDF1/CXCR4/Pi3K/Akt/eNOS signaling pathway, which results in increased [endothelial progenitor cell] migration and proliferation and decreased extent of apoptosis. Our findings suggest that these effects could be linked to the mechanism of cardiovascular protection that is associated with the regular consumption of red wine.

I’m not going to tell you I understand all that.  Don’t feel bad if you don’t, either. 

My point is to illustrate one way that Science makes progress.  An observant person notices, “Hey, people who drink judicious amounts of red wine seem to live longer and have fewer heart attacks.  I wonder how that works.”  Perhaps a plausible mechanism is identified.  That might lead to isolation of a specific component in red wine that yields the benefit.  Then that component is produced and disseminated, leading to the health benefits, without the risks of alcohol consumption.

It’s an expensive, time-consuming enterprise with many blind alleys.

Steve Parker, M.D.

Reference:  Hamed, Saher, et al.  Red wine consumption improves the in vitro migration of endothelial progenitor cells in young, healthy individuals.  American Journal of Clinical Nutrition, April 14, 2010.    doi:10.3945/ajcn.2009.28408

K. Dun Gifford, founder of Oldways, passed away a few days ago.  Read about his interesting life at The Boston Globe.

I have no doubt that Mr. Gifford’s promotion of the healthy Mediterranean diet helped to save lives and improve quality of life for many. 

Steve Parker, M.D.

The mainstream media has been a gushing firehose of misinformation regarding the recent Arizona laws to protect us from “undocumented immigrants” and other foreign visitors here unlawfully.

From the media coverage I’ve seen, it’s clear that most of the polititians and talking heads (news readers and pundits) haven’t bothered to read the law.  Don’t let them filter it for you; read the laws yourself if interested in the truth:

SB 1070

HB 2126

Governor’s April 30, 2010, statement regarding the two laws (HB 2126 is a revision or clarification of SB 1070)

I’m particularly interested in this issue since I’ve lived in Arizona since 2001. 

Steve Parker, M.D.

I blogged here about mesotherapy (also known as lipodissolve) in April, 2008.� It’s a technique designed to “dissolve” localized fat deposits under the skin.

The U.S. Food and Drug Administration�in April, 2010, warned�consumers that

• it has not evaluated or approved products for use in lipodissolve
• it is not aware of evidence supporting the effectiveness of the substances used in lipodissolve for fat elimination
• the safety of these substances, when used alone or in combination, is unknown
• it is not aware of clinical studies to support medical uses of lipodissolve

In addition, FDA has reports of unexpected side effects in people who�ve undergone the lipodissolve procedure. These side effects include

• permanent scarring
• skin deformation
• deep, painful knots under the skin in areas where the lipodissolve treatments were injected

This is good to know before you invest time and money in the procedure.�

Steve Parker, M.D.

Oldways, the preeminent promoter of the Mediterranean diet,  proclaims May to be “Mediterranean Month.”  The idea is to spread awareness of the traditional Mediterranean diet. 

In addition to “it just plain tastes good,” I’m a Mediterranean diet advocate because of the potential health benefits.

Relatively strong evidence supports the Mediterranean diet’s association with:

• increased lifespan
• lower rates of cardiovascular disease such as heart attacks and strokes
• lower rates of cancer (prostate, breast, uterus, colon)
• lower rates of dementia
• lower incidence of type 2 diabetes

Weaker supporting evidence points to associations with:

• slowed progression of dementia
• lower severity of type 2 diabetes, as judged by diabetic drug usage
• less risk of developing obesity
• better blood pressure control in the elderly
• improved weight loss and weight control in type 2 diabetics
• less risk of metabolic syndrome
• improved control of asthma
• lower rates and severity of chronic obstructive pulmonary disease
• lower risk of gastric (stomach) cancer
• less risk of macular degeneration
• less Parkinsons disease
• increased chance of pregnancy in women undergoing fertility treatment
• lower incidence of asthma and allergy-like symptoms in children of women who followed the Mediterranean diet while pregnant

For ideas on moving your diet in a Mediterranean direction, why not visit this page at one of my other websites, or the Oldways site?  You don’t have to go “full Mediterranean” to gain some of the health benefits.  Just taking a couple steps in that direction should help.

Steve Parker, M.D.

Disclaimer:  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physican before making any dietary or exercise changes.