Advanced Mediterranean Diet

It’s estimated that the Old Stone Age diet provided much more omega-3 fatty acids and much less omega-6s, compared to modern Western diets.  This may have important implications for development of certain chronic diseases like cancer and heart disease. 

Fatty acids, by the way, refer to the long chains of molecules that comprise the majority of fats and oils.

Some folks speculate that the Stone Age (Paloelithic) diet may be the healthiest way to eat because our genes are adapted to it.  In other words, we evolved in a certain food environment over hundreds of thousands of years, so we should have optimal health if we follow our ancestral diet (whatever that is). 

A major change in human eating habits over the last century has been the dramatic increase in consumption of industrial seed oils like corn and soybean oil.  These have dramatically increased the omega-6 fatty acids in our diets. i.e., they’v3e increased the omega-6/omega-3 ratio.  Another major change starting about 10,000 years ago is the increase in consumption of grains.

This’ll improve your omega-6/omega-3 ratio!

I haven’t studied omega-6/omega-3 ratio issue in great detail but hope to do so at some point.  Evelyn Tribole has strong opinions on it; I may get one of her books.

I saw an online video of William E.M.Lands, Ph.D., discussing the omega-6/omega-3 ratio.  He mentioned free software available from the National Insitutes of Health that would help you monitor and adjust your ratio.

You can see the video here.  Dr. Lands’ talk starts around minute 12 and lasts about 45 minutes.  He says it’s just as important (if not more so) to reduce your omega-6 consumption as to increase your omega-3.  And don’t overeat.

Steve Parker, M.D.

The Mediterranean diet slowed age-related mental decline in elderly Chicago residents, according to researchers at Rush University Medical Center.  The investigators noted that a Manhattan population following the Mediterranean diet also showed slower mental decline and lower rates of Alzheimers dementia.Over 3,000 study participants (2,280 blacks, 1,510 whites) were studied for an average of eight years.  Food consumption was determined by questionnaires, and mental function was tested every three years.  Adherence to the Mediterranean diet was judged according to a Mediterranean diet score developed by Panagiotakis, et al.

The greater the adherence to the Greek-style Mediterranean diet, the lower the rate of mental decline over the course of the study.

Mental decline to some extent is a normal part of aging.  If we can avoid it or lessen it’s impact, why not?  A couple ways to do that are regular exercise and the Mediterranean diet.

Would a low-carb Mediterranean diet work just as well or better?  Nobody knows yet.

Steve Parker, M.D.

Reference:  Tangney, Christine, et al. Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population.  American Journal of Clinical Nutrition, 2010.  doi 10.3945/ajcn.110.007369

A few of my patients have asked me if the Paleolithic diet and lifestyle would be good for their diabetes.  I’m not sure.  A few pilot studies suggest it would be.  I expect much more published scientific research over the coming decade, in addition to self-experimentation reports by patients such as Gary Rea.  I’ll be looking into the matter at Paleo Diabetic.

The paleo diet in modern times began gathering steam in 2008.  It’s still not widely known or followed, but the trend is definitely upwards.  Here’s a short video on it from CBS San Francisco.

The idea behind the paleo diet—also referred to as the Old Stone Age or caveman diet—is that optimal health depends on adherence to dietary and lifestyle factors to which we’re genetically adapted.  Our current mix of genes overwhelmingly reflects the Paleolithic era of human cultural development, starting anywhere from 750,000 to 2.5 million years ago, and ending around 10,000 years ago.  It’s also called the Stone Age.

The paleo diet pattern isn’t set in stone.  In general, it includes nuts, vegetables, fruits, fish, meat, and poultry.  It excludes or limits grains, dairy, legumes, sugars other than fruit or honey, industrial seed oils (e.g., from soybean and corn), and modern processed, highly refined foods.  Fresh, natural, and “organic” are preferred.

I’ve already got a few posts up and plan on new ones once or twice weekly.  If you’re interested, please join me at Paleo Diabetic.

Steve Parker, M.D.

Patients ask me periodically if grape seed extract provides the same health benefit as judicious red wine.  Nobody knows with certainty.  The health benefits of red wine may be due to resveratrol.  Grape seed extract contains potentially healthy antioxidants called proanthocyanidins,

Many people don’t enjoy wine or other alcohol-containing drinks, and others just shouldn’t drink any alcohol.  Should they take a grape seed extract supplement or drink grape juice as a subsitute?  Again, it’s still unclear.  In 2009 I wrote a about a review article looking at the effect of various non-wine grape products and effects on heart disease risk.

A recent meta-analysis out of the University of Connecticut found improvement in two heart disease risk factors in those who take a grape seed extract supplement:

• systolic blood pressure lower by 1.54 mmHg
• heart rate lower by 1.42 beats per minute

No effect was seen on lipids (cholesterol and triglycerides), diastolic blood pressure, and C-reactive protein (a test of systemic inflammation).

Granted, these are tiny effects.  It’s unknown whether they, or other unknown effects of grape seed extract, would translate into clinical benefits such as fewer heart attacks and strokes, and longer lifespans.

Bottom Line

Grape seed extract and other non-wine grape products may be as beneficial as red wine in prolonging lifespan and preventing heart disease.  But we have much stronger evidence in favor of red wine and other alcohol-containing drinks.

Steve Parker, M.D.

 Reference:  Feringa, H.H.H, et al. The Effect of Grape Seed Extract on Cardiovascular Risk Markers: A Meta-Analysis of Randomized Controlled Trials.  Journal of the American Dietetic Association, 111 (2011): 1,173-1,181.

Compared to a low-fat diet, a very-low-carb diet yielded better fat loss and improved adiponectin levels, according to researchers at the University of Cincinnati.  So what?

Adiponectin is a hormone-like protein secreted by fat cells. But the fatter you are, the less adiponectin you have in your bloodstream.  This hormone has several effects: 

• it’s anti-inflammatory
• high levels of one form of it (a high molecular weight oligomer) are linked to lower rates of diabetes
• low circulating levels are associatedwith athersclerosis (hardening of the arteries), high blood pressure, and impaired function of cells lining our arteries
• it sensitizes the liver and muscles to insulin, which helps keep blood sugars under control

In summary, it’s a good thing to have around.  Low levels are linked to illnesses.  Overweight and obesity tend to lower your levels of adiponectin.  If you’re overweight and have low levels of adiponectin, you should be healthier if you can raise your levels.  How do you do that?  Lose weight.

U. of Cincinnati investigators wanted to know if a very-low-carb diet would increase adiponectin levels better than a common low-fat weight loss diet.  They randomized 81 obese women to follow either a low-fat diet (American Heart Association Step 1) or a very-low-carbohydrate diet based on the Atkins diet.  Women followed the diets for either four or six months.

Findings

Both groups lost weight, but the very-low-carb group lost more: 9.1 kg loss for very-low-carb vs 4.97  for the low-fat group.

The very-low-carb group lost more body fat: 5.45 kg vs 2.62 kg.  (Fat loss was determined by DEXA scan.)

Adiponectin increased in the VLC group but not the LF group.

Discussion

We can’t tell from this article if adiponectin results would be the same in men.  The authors didn’t mention.

In fairness, the authors cite another similar study that found equal degrees of weight loss and adiponectin increase in both low-fat and low-carb groups.  It was a year-long intervention and average weight loss was 13.5% for both groups, a greater degree of weight loss than in the study at hand, in which the very-low-carb group lost 10% of body weight and the low-fat group lost 5.4%.  So you can probably increase your leptin with a low-fat diet if you lose enough excess weight.

Would the Ketogenic Mediterranean Diet work just as well as the very-low carb diet used in this study?  I suspect so, but don’t have the $500,000 it would take to do the research.  Care to donate?

Steve Parker, M.D.

Reference:  Summer, Suzanne, et al.  Adiponectin changes in relation to the macronutrient composition of a weight-loss diet.  Obesity, 2011. doi: 10.1038/oby.2011.60

The disillusion with socialism and other forms of collectivism, which became the dominant spirit of the 1980s, was only one aspect of a much wider loss of faith in the state as an agency of benevolence.  The state was, up to to the 1980s, the great gainer of the twentieth century; and the central failure.

                       -Paul Johnson in his book,  Modern Times

Men eating low-carb diets featuring protein and fats from sources other than red and processed meats may reduce risk of developing type 2 diabetes later, compared to other types of low-carb diets.  The same Boston-based researchers previously looked for a similar association in women and found none.

The article in American Journal of Clinical Nutrition seems to me unusually complicated.  It was frustrating to read, searching for but not finding much useful for clinical practice.  How low-carb were these diets?  Thirty-seven to 43% of energy from carbs in the most dedicated dieters, compared to 50-60% in the standard American diet.

After wading through most of this article, I came away with the impression the authors were just data-mining a huge database, to add one more item to their CVs (curriculum vitae).  This article is a confusing mess, or maybe I’m just stupid. I regret wasting an hour on it.

Steve Parker, M.D.

Reference: De Konig, Lawrence, et al.  Low-carbohydrate diet scores and risk of type 2 diabetes in men.  Amercan Journal of Clinical Nutrition, 2011. doi: 10.3945/ajcn.110.004333