Professional Documents
Culture Documents
Dr Simon Poole
Publication details
This book is produced on a non-profit, non-commercial, non-sponsored basis in
conjunction with the free resources available at www.tasteofthemed.com.
It is the authors belief that this guidance should be readily available and
accessed as widely as possible, and the contents of this book are therefore also
produced as a free download from the website.
Advice contained within this book is based on current scientific evidence and
theories. It should not replace the guidance or prescribed medication of a
personal physician and in the event of allergies or special prescribed diets,
further medical direction should be sought. Reference to this book should be
made as a guide to making positive changes in diet and lifestyle. Achieving a
balance of calorie intake and exercise is important for maintenance of a state of
health and fitness. If an individual has concerns about his or her capacity to
undertake changes in physical activity or weight loss they should seek medical
advice. Most of the research findings are based on adult populations and may
not be applicable to children or pregnant women.
It is assumed that readers will understand the negative effects of smoking and
obesity. Although significant benefits may be gained from following the
recommendations contained in this volume, it assumes a capability and
willingness to address general health concerns and seek further individual help
where necessary.
Contents
INTRODUCTION
STEP 1 A MEDITERRANEAN WEEKLY SHOPPING LIST ................................7
Shop, plan and enjoy your healthy eating
STEP 2 BRINGING COLOUR TO YOUR TABLE ...............................................13
Take advantage of natures colourful gifts of strength
STEP 3 HEALTH GIVING OILS............................................................................17
Bring the ancient powers of oils to your every day
STEP 4 BOWLED OVER BY FRUIT ....................................................................25
Experience fruit at its best and achieve your 5 a day
STEP 5 FABULOUS FAST FOODS ......................................................................27
Healthy snacking in between meals
STEP 6 HEALING HERBS, GLORIOUS GARLIC
AND LUSCIOUS LEMONS......................................................................30
Fantastic flavouring and salt substitutes
STEP 7 SEEDS OF LIFE .......................................................................................34
Omega 3s without the bones
STEP 8 WONDERFUL WINE (TEA AND COFFEE).........................................37
Drink yourself healthy (within reason!)
STEP 9 A SECRET CHAPTER FOR CHOCOLATE LOVERS ...........................40
Ssshhhhhhh! its positively good for you
STEP 10 EXERCISE FOR ENERGY......................................................................43
Fitness and health for bodily wealth
APPENDIX ....................................................................................................................48
SOME EXAMPLE RECIPES .........................................................................................58
Introduction
Doctors learn much from their patients. Some years ago I had the privilege of
meeting Peter. This book is dedicated to Peter and all those who, like him, seek
to enjoy life to the full and who are committed to positive actions to maintain a
healthy body and active mind.
I first met Peter one busy Monday morning. His broad smile contrasted with my
mood. It seemed that all morning I had been lecturing...
...try to avoid eating too much fat ...
...you know your diet is probably affecting your Blood Pressure ...
...I know how hard it is to exercise after a long and tiring day, but your
sedentary lifestyle is really not helping your weight ...
I started to imagine my own blood pressure rising as I suspected the slim notes
in front of me meant that his records had been lost, but soon realised that this
was one of Peters rare visits for medical advice. I cannot recall the reason for
the consultation, but he mentioned that he was flying off to Spain later that day.
Rather enviously I enquired further into his lifestyle. It transpired he had bought
a property in Spain prior to retirement, and spent half of the year there. He
explained with unrestrained enthusiasm how he had undergone a transformation
after his brothers untimely death a few years previously. He had begun by
exercising regularly and soon sensed the reward of feeling the buzz of physical
fitness. A trip to Spain had resulted in a love affair with the Mediterranean
cuisine and way of life, culminating in his moving to set up a home in Barcelona.
Peters dedication to enjoyment of the abundance of life was complete. He
described the olive groves and lemon orchards, the vineyards and the harbour
fish markets. With a smile he recalled his first invitation to a neighbours farm,
where the elderly grandmother had prepared the onions, garlic, peppers, lemon
chicken and tomatoes with the local olive oil and herb marinade. And with a
twinkle in his eye he parted with the conclusion that he was blessed not only by
good health, but that his wife and he were probably closer than they had been
throughout their long marriage...
As time has passed, I have come to appreciate the truth in Peters words. Of
course chance decrees there may always be misfortune and unavoidable illness,
but scientific evidence is increasingly demonstrating the astonishing health
benefits of the Mediterranean diet and lifestyle. The wonderful coincidence is
that this wholesome, tasty and complete way of life can confer extraordinary
health benefits and achieve a longer and healthier experience of being.
Even smiling and laughter have been shown scientifically to have positive
physical effects. So the time has come to celebrate those gifts of nature and the
possibilities in ourselves to welcome simple changes that will be positively good
for us.
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Eating to Enjoy
Diet is thought to be a causal or contributing factor in up to half of cancers.
Lifestyle (lack of exercise and dietary habits) is thought to be a direct cause
in over fifty percent of heart attacks.
Diet patterns as recommended in this book have been shown scientifically to
reduce the risk of cardiac events by 76% and to potentially increase life
expectancy free from heart disease by an average of nine years. (ref 1)
In recent years we have become accustomed to negative messages in relation to
what we do and eat. We are constantly reminded of the harm food can do to us,
whether in relation to fat, alcohol, salt or sugar. And indeed studies show trends
of increases not only in calorie intake but also of sugar, salt and saturated fats,
especially with the ready availability of processed foods. Such dietary patterns,
along with a more sedentary lifestyle contribute significantly to the exponential
increase in levels of obesity, with associated diabetes and high blood pressure,
as well as the incidence of heart disease and cancers. There is an over simplistic
response in Government advice. The message to eat a low fat, high
carbohydrate diet has been shown to be flawed since different carbohydrates
and fats have varying effects on blood sugar and lipids, and has been seriously
undermined by fad diets such as those that promote precisely the reverse i.e.
high fat, low carbohydrate consumption.
The evidence that is becoming widely accepted confirms that certain types of fat
are positively good for you, providing protection against heart disease and
many types of cancer. These are the monounsaturated fats contained in olive oil
which may be consumed freely as part of a balanced diet where exercise and
overall calorie intake ensure that weight remains within recommended limits.
Manufacturers of spreads and margarines have made claims about the benefits
of substituting saturated fats with certain polyunsaturated fats in their products
but there is increasing evidence that high levels of these omega 6
polyunsaturated fats decreases the bodys ability to utilise the beneficial
omega 3 polyunsaturated fats found in oily fish, certain nuts and linseed
(flaxseed). Consequently most of the potential benefits of polyunsaturated fats
is dependent on us getting the right balance of fats. In western cultures we
consume a ratio of fats which is unhealthily skewed towards an excess of
saturated and omega -6 polyunsaturated fats.
Not only are we understanding better the roles of fats in the diet, but the last
decade has seen the acceptance of the importance of the glycaemic index of
carbohydrates. The processed and refined carbohydrates so common in our
foods result in quick breakdown and absorption of sugars, which, in
combination with the sugars in drinks and snacks are contributing to the rise in
incidence of both obesity and diabetes. The more natural diet for which our
bodies have evolved over millennia comprises of sugars in foods such as honey
and fruits, complemented with low GI foods such as wholegrains, brown
(unmilled) rice, unprocessed cereals and oats. These unrefined, starchy
carbohydrates release sugar loads in a more controlled way and also retain the
fibrous husks, often rich in vitamins and minerals, which contribute to bowel
health and reduce cholesterol absorption It is surely time for educated western
consumers to take charge of our diet and lifestyles.
Governments may nanny or nudge, the food industry may have conflicts of
interest, manufacturers may continue to promote supplements and pills of
dubious benefit, but we alone have the final say in the choices we make.
The environmental impact of our modern system of food production is beyond
the scope of this book, however, the ability to sustain our natural world is
dependent on a more natural approach to diet and lifestyle. The ancient
traditions of farming and husbandry, soil maintenance and patterns of consumer
demand associated with the Mediterranean Diet should enable us to better fulfil
our obligations to maintain a balance which is more healthy for us as individuals
and also for our planet.
Horrible or Healthy?
This confused picture allows retailers to claim health benefits of products where
modest changes to processed foods can permit them to be included in a healthy
eating range when it is merely somewhat reduced in calories or fat.
There are numerous examples where foods are promoted as low in fat to imply a
more healthy choice, where the fats reduced are in fact the healthy good fats, or
when the product has very high levels of sugar. Consumer groups have rightly
demanded clearer food
labelling, to empower the
customer to choose and to
inform of the nutritional
content. Whilst this is limited in
scope as it does not describe
the many positive
micronutrients in foods, if care
is taken to read the small print,
it may be possible to begin to
reverse the trends of
increasingly processed and
unhealthy foods.
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Understanding the balance of foods in a diet is far more important than having
a list of fine cuisine recipes that assumes we have the time and skills to be
celebrity chefs! The Mediterranean diet pyramid and the health benefits of
many beautifully colourful fresh fruits and vegetables may be brought to our
daily lives by simply ensuring that they are included in the weekly shopping
list. The nutritional benefits of these gifts of nature is not dependent on
whether they are prepared in a simple way or used in a sophisticated
combination when there is more time for preparation and reference to cookery
books.
There is also some evidence that certain individual foods possess health giving
qualities. These have usually been shown to contain chemicals called
antioxidants and are often common constituents of the Mediterranean diet
which protects against cancers and heart disease.
Later chapters are dedicated to these positively good for you foods, to
celebrate their wonderful properties and taste. Perhaps most importantly there
are simple suggestions to help bring them into everyday use in an
approachable way.
STEP 1
A Mediterranean weekly shopping list
Shop, plan and enjoy your healthy eating
The traditional diet of the peoples of the Mediterranean has been shown to be
the healthiest diet in the World. Scientific study after scientific study has
demonstrated that people who eat such foods in the proportion outlined in the
Mediterranean Diet Pyramid not only live longer, but have significantly lower
risk of heart disease and many cancers, including bowel, prostate and breast
cancer.
...Mediterranean diet cuts death rate by 50% ...
...The Mediterranean diet is positively associated with healthy longevity...
...The Mediterranean peoples have reduced risks of bowel, breast and prostate
cancer, as well as heart disease, stroke and diabetes...
...The Mediterranean Diet appears to significantly reduce the risk of
suffering from dementia including Alzheimers disease, depression, high blood
pressure, arthritis and asthma ...
(refs 2 -14 )
The diet is high protection/low damage, essentially meaning that there are
relatively small quantities of the undesirable saturated fats, but high amounts of
cancer beating, heart protecting fruits, vegetables, antioxidants, olive oil and
fish oils.
Much of the advice on healthy eating is negative and restrictive. Many diets are
focused exclusively on weight loss and make meal times a miserable experience.
There are even fad diets that are potentially dangerous to long term health and
expose people to increased risk of heart disease and cancer.
The beauty of the ancient diet of the Mediterranean is that it provides a
wonderfully healthy, tasty and complete diet that is centred around fresh, non
processed, readily available natural produce. It is ready made, balanced and
nutrient rich. Low in saturated fats, low in salt, and with a low glycaemic index,
there is evidence that it is a healthier and more successful weight controlling
lifestyle than the low fat, high carbohydrate much promoted in the last few
years. Furthermore, people are more likely to persevere and make long term
changes when they are delighting in a wide variety of enjoyable foods.
We feel how we eat; there is increasing evidence that our diet can affect our
mood and that the Mediterranean Diet may help to maintain a healthy mind. Not
only does the Mediterranean Diet seem to significantly reduce the risk of
Alzheimers Disease and other forms of dementia, but studies also support the
notion that a Mediterranean style diet can protect us from depression. We
intuitively know that an unhealthy lifestyle full of saturated fat and processed
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foods reduces our sense of wellbeing, and now scientific research has illustrated
very elegantly that the dietary advice contained in this book can reduce the risk of
depression by as much as thirty percent (ref 18). It is thought that the low
glycaemic index, high vitamin and antioxidant Mediterranean Diet may increase
serotonin levels in our brains. Olive oil, fruit, vegetables and nuts are all likely to
contribute to this effect.
An important analysis of the combined findings of a number of studies in 2008
published in the British Medical Journal recognised the profound impact of the
diet on rates of cardiovascular disease and cancer, presenting the sum of medical
evidence in support of the benefits for individuals and society if there was more
widespread adherence to the principles of the Mediterranean Diet. (ref 16 ).
A further large study demonstrated the advantages of the Mediterranean Diet in
the prevention of metabolic syndrome the description of obesity, high blood
pressure and adverse sugar and fat levels in the blood which can eventually lead
to diabetes (ref 17 ).
In short, the evidence for the benefits of the Mediterranean diet is compelling.
So, now lets enjoy the exquisite taste combinations and fantastic foods which
we know can add up to a healthier and longer life.
STEP 1
Plan your weekly shop and meal plans around the Mediterranean Diet Pyramid.
For example, a week may be planned around two fish dishes, two poultry, two
vegetarian based and a single meal with red meat. Clearly, it is sensible to buy
low fat red meat, and to eat modest servings eg 60g per person. Most people can
increase their intake of vegetables and fruit if portions of meat are reduced.
By applying these general principles it is easy to adopt a more balanced and
healthy proportional intake of food and construct a planned weekly menu with
simple or sophisticated recipes to achieve this.
The pattern of eating will result from the pattern of shopping. Many people find
it useful to attach a laminated pyramid illustration to their fridge as a positively
reinforcing message to encourage the right proportion of content of cupboards,
freezes and chillers.
Remembering that the ideal diet is low in saturated fat, salt and sugars, we can
increasingly use the labelling on food products to restrict our intake of often
hidden harmful or inappropriate nutrition and to maximise the benefits of the
calories we absorb.
The importance of a diet balanced in calorie intake and output is an essential
component of the traditional diet and lifestyle of the Mediterranean, where
regular physical activity has been integral to daily life. The dietary pattern is one
associated with maintenance of a healthy weight, and has become accepted as
one of the most successful and sustainable ways to keep within recommended
body mass indices, in combination with an awareness of calorie intake, portion
size, food properties including glycaemic index, and a commitment to regular
physical activity which has benefits of its own.
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Salads endless combinations at least once try the super- salad, loaded
with antioxidants and colour, the only challenge will be finding a bowl big
enough. This can be served with grilled lean meat or fish and olive oil roasted
potatoes. Include; lettuce, tomatoes, pitted olives, mixed nuts, red onion,
beetroot, radish, mixed peppers, sun dried tomatoes, finely chopped carrots,
fresh bay leaves, cucumber, red grapes, seeds and a sprinkle of grated cheese or
feta. Perhaps add a little avocado... or even beans!
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STEP 2
Bringing colour to your table
Take advantage of natures colourful gifts of strength
When shopping, think beautiful natural colour.
Many plants contain compounds that provide significant health benefits, and
many of the bright colours in fruits and vegetables represent these so called
phytochemicals which are believed to have many antioxidant effects. Such
natural chemicals protect the body by neutralising free radicals or unstable
molecules which can damage body tissue and lead to ill health, defending
against cancer, diabetes and heart disease. Colourful foods are frequently rich in
vitamins which are in themselves beneficial and have been known for many
years to prevent ill health.
There are hundreds, perhaps thousands of these substances in our diet, and
study of their effects is in its very early stages. It has long been accepted that the
bright colours in seed containing fruits are an evolutionary means by which a
plant attracts an animal to eat the fruit, and deposit the undigested seeds in a
packet of fertiliser some distance away from its parent. There is a further
suggestion that evolution might have favoured plants that have incorporated
health giving properties into the chemistry of the fruit in addition to the
antioxidant protection conferred by the chemistry to protect itself. After all, the
mutually beneficial relationship between the plant and the animal would be
further enhanced if the colours that attract the animal bestowed not only the gift
of food, but also of medicine, to ensure the healthy survival of the creatures
upon which the plant depends for its successful procreation and evolution.
And colour brings beauty and joy to any dish. Imagine if the food on our plate
was entirely grey. Suppose it tasted the same, but was completely grey. Please
do not hold that thought for long, because we are blessed with an array of
colours that bring visual and tasteful delight to our table.
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Red
Shop for red fruits and vegetables. These include;
Tomatoes
Red grapes
Red peppers
Red grapefruit
Strawberries
Cranberries
Red apples
Watermelon
Cherries
Red onions
14
Blue
Shop for blue fruits and vegetables. These include;
Plums
Blueberries
Prunes
Raisins
Purple grapes
Eggplant
Blackberries
Purple cabbage
Green
Shop for green fruits and vegetables. These include;
Lettuce
Beans
Watercress
Broccoli
Leeks
Sprouts
Cucumber
Avocados
Leafy greens
Green apples
Peas
Green grapes
Celery
Limes
Green cabbage
Pears
The specific phytochemicals in these products include lutein and indoles. Such
compounds are believed to have anti cancer effects, and their consumption is
considered to be associated with a lower risk of many types of cancers.
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Grapefruit
Yellow peppers
Oranges
Carrots
Pineapple
Butternut squash
Mangoes
Watermelon
Apples
Apricots
Yellow pears
Lemon
Papaya
Next time you prepare a Saturday lunch or take sandwiches into work, spend a
few minutes preparing an accompanying salad consisting of lettuce, tomatoes,
red pepper, yellow pepper, olives, carrot, cucumber, onion, with an olive oil
dressing (see step 3). This provides perhaps hundreds of compounds that
promote health and well being.
What a glorious feast of colour and goodness!
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STEP 3
Health giving oils
Bring the ancient powers of oils to your every day
Olive oil is the cornerstone of the most healthy diet in the world. It is ubiquitous
and abundant. The proven benefits of the diet are likely to be related to the
enjoyment of olive oil as the principal source of fat. Olive oil contains many
constituents that are considered to confer health both in terms of the type of fat
and also the compounds that have antioxidant properties. There is emerging
evidence that a proportion of the benefits of the Mediterranean diet as a whole
relate to the specific contribution of olive oil itself. A recent study of a
population of more than 8,000 over 65 year olds demonstrated that those
consuming regular amounts of olive oil had significantly reduced risks of stroke.
The risk was reduced on average by 41%, but as much as 78% if those consuming
the highest and lowest quantities of olive oil were compared.
(ref 3 and 14 )
Olive oil is consumed in large quantities in the Mediterranean region. As much
as a litre a week in many households. It is used for frying, to accompany salads
and vegetables, to moisten and soften foods and as the only source of fat in the
traditional diet. Extra virgin olive oil is the most unprocessed oil and is widely
available as the finest and most palatable form of the pressed juice of the olive.
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18
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Marinades
Olive oil can be used in cooking and also for marinades. Any vegetable, fish or
meat can be refrigerated for some hours covered in olive oil and a combination
of favourite flavours. For example spices, chilli, herbs, honey, garlic, tomato
paste, lemon juice etc.
The marinade can be poured into a large pan or wok and used to fry the meal
that will have already tenderised and absorbed the delicious tastes.
Dips
A fine oil can be sampled alone, or alternatively wholemeal bread can be dipped
into a small bowl of good quality olive oil. This can be mixed with a little walnut
oil or balsamic vinegar to enhance the flavour.
If dining out, most restaurants will provide this as an alternative to butter to
accompany a meal. In fact, many chefs will delight in sharing their most
precious olive oil with a discerning customer.
Most supermarkets also stock infused or scented oils, though a simple
alternative is to add garlic, fresh herbs, peppers or even cinnamon or citrus
fruits to oil and allow to infuse for a day or two. Olive oil is a natural
preservative and has a long shelf life if stored in a cool dark place.
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Dressings
Salads can be flavoured with simple oil or infused oils. Alternatively an
antioxidant dressing can be simply prepared.
Adding ingredients such as those described for a marinade can provide flavour
and goodness.
So, for example a dressing may contain approximately 80% olive oil with
tablespoons of balsamic vinegar and walnut oil, honey, a teaspoon of dried
herbs, some lemon juice, a squirt of chilli paste, tomato and garlic paste, and
even a sprinkle of powdered flax seed.
Such a dressing is easy to make in a few minutes and contains a powerful mix of
compounds that are known to have proven or theoretical effects on the body to
lessen the risk of ill health.
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Walnut oil
Extra virgin olive oil is the most important oil in terms of health benefits. It is
quite simply the best source of life-giving MUFAs which have such beneficial
effects on cholesterol levels and reducing the risk of heart disease. As we have
seen, there are hundreds of other compounds in olive oil which add to the
experience of fantastic taste and make it positively good for you...
However, there are other plant based oils that are believed have benefits. And
for different reasons. In Step 7 we shall explore the importance of Omega 3
PUFAs. The good fats (MUFAs) the bad fats (SFAs) and the downright ugly
(Transfats) are not the only fatty acids in our diet.
Despite the best efforts of margarine manufacturers, the claim to be high in
polyunsaturates that we have heard over the years, should cause us to be less
than impressed.
Most PUFAs are Omega 6 types and we probably have too many of these in our
diets. BUT there are some PUFAs that are positively good for us the Omega 3s!
Omega 3s are contained in walnut oil, flaxseed oil and rapeseed oil.
Walnut oil is probably the most tasty. It has a fine and subtle flavour that can
enhance olive oil when mixed together in dressings or simply as a dip. Generally
a combination of olive oil to walnut oil mixed in ratio of approximately 5:1
provides a wonderful blend of flavour and nutritional goodness. Available in
most supermarkets, try it!
Hemp oil
Hempseed oil in small quantities can be added to olive oil to provide a nutty
flavour that can enhance dressings. It is a rich source of omega 3s, omega 6s and
MUFAs so is an alternative to walnut oil in its possible health benefits.
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STEP 4
Bowled over by Fruit
Experience fruit at its best and achieve your 5 a day
We have seen in previous chapters how fruit packs so much goodness into your
diet, and concentrates nutrients, vitamins and antioxidant potential.
Yet despite an abundance of choice and tastes, we still do not maximise the
possibilities of these guardians of health.
There follow a number of ideas to place fruit at the centre of our living, to
ensure that we are surrounded by opportunities to enjoy and gain the most for
our well being and fitness. There is much simplicity in these suggestions for
which I make no apology. We know we generally do not eat enough fruit, and so
we should change our environment to ensure that it is ever present and ever
available.
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STEP 5
Fabulous fast foods
Healthy snacking in between meals
Most of us snack in between meals. Indeed there is something to be said for
grazingon healthy foods within calorie limits. Children in particular are not
designed to have three full meals a day, which is why kids in particular are
susceptible to snacking on unhealthy foods in between meals.
There are wonderful possibilities for snacking healthily, as a way to access the
wonderful nutrients that confer wellbeing. It is important to have easy access to
ready made fast foods either stored in a fridge, or in small decorative bowls in
the kitchen or living areas.
Availability, convenience and flavour are the secret.
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A Bowl of Fruit
We have already seen how a bowl of fruit readily available can provide a healthy
snack, and how a grabbed handful of delicious dried fruits can give your
morning an antioxidant boost.
A Bowl of Seeds
See step 7.
A Bowl of Dates
Dates are said by some to be quite simply the most concentrated package of
antioxidants on the planet!
Raw Vegetables
Perhaps the most tasty way to snack on raw vegetables is to have a bag of fresh
peeled carrots in the fridge. If a more substantial and filling snack is needed
then simply dip the vegetable in olive oil
Olives
Olives are best stored in a bottle of extra virgin olive oil or simply in the fridge.
The olives stored in brine tend to lose their flavour and become too salty. Most
supermarkets sell jars of olives stored in oil or from the delicatessen. These
need to be stored in the fridge and consumed within a few days (no problem!).
The olive bar generally contains a wide range of different varieties, often with
peppers, lemon, or stuffed with a garlic clove.
Become an olive buff! There are so many different types and flavours
Kalamata, gaidourolia, megaritiki, kothreiki, karydolia, throumba to name but a
few. Olives can be consumed as an aperitif, in salads, in main meals, or in
passing! Olives contain the goodness of olive oil and can be consumed as an
ideal snack.
Olive paste
Olive pastes have been consumed in the Mediterranean for thousands of years.
Crushed olives mixed with lemon, herbs, garlic, or tomato. Spread on toast or
bread they can be used as an appetizer or snack. Many are now available in
supermarkets, and usually combined with fruits or herbs that are packed with
goodness.
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STEP 6
Healing herbs, glorious garlic
and luscious lemons
Fantastic flavouring and salt substitutes
Healing Herbs
The wonderful foods that can be so positively good for you have been listed
based on current scientific evidence or theory.
Herbs and spices have played an important role as medicines over the last few
thousand years. So often science reveals the wisdom of folklore, and so it is not
surprising that many herbs are now being increasingly recognised for their
goodness.
Indeed many herbs and spices contain substances that fight against disease and
infection. Chimpanzees when ill will naturally eat certain wild plants not
dissimilar to the herbs we know. So, nature can teach us to help our health!
Basil, parsley, thyme, oregano, rosemary and other herbs and spices have been
used to flavour and preserve foods as well as for medicinal purposes. Many
bioactive compounds contained in herbs are thought to have beneficial effects,
including phenols and flavonols.
Some herbs such as rosemary contain compounds similar to aspirin which has
been shown to have a protective effect in heart disease.
Hot spices such as cinnamon, mustard and chilli are also rich in antioxidants.
In Mediterranean countries, dishes are flavoured with a variety of herbs. Even a
sprinkle of dry herbs is likely to give some benefit, though fresh herbs now
readily available in supermarkets are a delightful and subtle addition to any dish.
Dry herbs may be available as a salt substitute, producing a more sophisticated
and healthier option as a flavour enhancer. Taste develops tolerance to salt, so
food will lose its natural taste to a heavy salt user. Wean yourself off added salt
gradually (YOU DONT NEED IT!), and introduce herbs... the difference will
amaze!
Glorious Garlic
Garlic is a common component in Mediterranean diets. It has been known for a
number of years that it has health benefits, and many people buy expensive
supplements or capsules.
The report of the British Nutrition Taskforce confirms the evidence that garlic
has reported benefits in the prevention of heart disease and cancers. It was not
so certain of the evidence base for the warding of vampires!
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The sulphur containing chemicals may also play a role in prevention of infection.
As with other bioactive substances at least part of the mechanism for prevention
of heart disease lies in its action to inhibit blood clot formation, and reduce
Blood Pressure.
As for bad breath, it is well understood that it is virtually impossible to smell
garlic within a household of garlic eaters. So, the answer is to help friends and
family appreciate that the gorgeous taste and aroma of garlic, coupled with its
health benefits, means that more and more of us should be eating it regularly
and so fewer of us will be aware of the later effects!
Garlic is a member of the onion family, and other varieties of onions also contain
bioactive substances. Though remember to go for colour! Red onions are far
more generously loaded with those gloriously good flavonols!
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Luscious lemons!
Ok, so back to luscious lemons! Research has shown that citrus fruits that are
acidic delay emptying of the stomach. This reduces the Glycaemic Index or Load
of the meal, and so probably reduces risk of obesity, diabetes, heart disease and
certain cancers prevalent in the overweight...
So, not only luscious, but wonderfully tasty and healthy.
Lemons ready to slice in the fruit bowl is great, but if you want quick access,
there are long life lemon juice preparations that can be stored in the fridge and
brought out at every mealtimes for a generous squirt (along with the pinch of
mixed herbs and splash of olive oil!)
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STEP 7
Seeds of life
Omega 3s without the bones
In chapter 3, we saw that there are some healthy fats that can be positively
good for you. These included the monounsaturated fats (MUFAs) and SOME
polyunsaturated fats (PUFAs), especially the so called omega 3 essential PUFAs.
Omega 3s are substances that stabilise cells and have been shown to very
significantly reduce the risk of heart disease. Cardiac problems are very rare in
Eskimo populations, despite a fat intake of 40% in their diet. This is due to the
fact that much of the fat is derived from fish which contain a high proportion of
the marine omega3 fats. Interestingly, this high fat diet in combination with an
active lifestyle is very comparable to the diet of Crete, though here the fat intake
is primarily derived from good MUFAs (in olive oil) in combination with
relatively high oily fish consumption.
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Flaxseed, which is available from whole food shops has the highest content of
plant omega3s than any other seed or nut. It is simply way out ahead.
Two tablespoons of ground flaxseed on cereal every morning is a simple, cheap
and incredibly effective way of boosting the omega3 content of the diet. It adds
a subtle, slightly nutty flavour, and is especially complimentary to muesli and
other oat based cereal. Grinding using a blender is advised as the absorption of
the omega3s is considerably higher if the seeds are crushed and powdered.
Seeds are great snacking material. A bowl of mixed seeds available provides
protein, fibre and some essential and good fats, along with other nutrients. Try
pumpkin or sunflower seeds as a crunchy snack, or scattered onto salads or
cereal.
36
STEP 8
Wonderful wine (tea and coffee)
Drink yourself healthy (within reason!)
In previous chapters we have explored foods that are positively good for you
and can be consumed in almost unlimited quantities, notwithstanding an overall
calorie controlled diet.
This is not the case for wine and coffee. Clearly the benefits are dose
dependent with a moderate intake conferring benefits, but excessive intake
reversing the advantages and indeed risking harm.
Wonderful Wine
Wine shares a place in history with olive oil. Celebrated in ancient
Mediterranean cultures it has long enjoyed associations with leisure and good
health. St Paul was recorded as extolling the benefits of wine.
Moderate regular consumption of wine (1 - 3 glasses per day depending on
gender and build) has been shown to reduce the risk of heart disease in a
dramatic way. It is clear that responsible, enjoyable drinking of wine with fine
food and excellent company is the best way of achieving this blessing. And of
course this is the way that wine can be most pleasurable. As alcohol is a mild
diuretic, always accompany the meal with generous quantities of water to
ensure adequate hydration. With water, good food and in relaxed surroundings,
moderate drinking of wine is unlikely to cause drowsiness or headaches.
There may be some direct effect of alcohol on stress reduction, however, it is
most likely that the bioactive micronutrients are the greatest contributing
factors. If this is the case, then it is certainly true that red wine is better for you
than white. Red wine contains higher concentrations of antioxidants such as
polyphenols and flavanols that have been shown to have anticancer effects, and
also a capacity to reduce cholesterol levels and lower the risk of blood clots that
lead to heart disease, heart attacks and stroke.
www.tasteofthemed.com
37
Tea
Tea is another drink with a long history and folklore that has described
medicinal qualities. Recent research has suggested a positive effect of tea on
cholesterol levels, blood pressure and probably anti cancer effects. The
antioxidants contained in tea include polyphenols and most specifically
catechins.
The bioactive chemistry varies between black, green and white tea. Rather than
argue about the most effective tea, the best advice is to enjoy the cup most
preferred. A cupboard with a selection of varieties is likely to create the
opportunity to relax with whichever tea attracts at a particular time. If the
bitterness of green tea is not enjoyed, take advantage of the numerous
combinations with fruits and ginger.
How many cups a day?
Studies that have shown health benefits of tea have reported on populations that
consume, for example 3 cups a day. One large analysis of the studies to date
demonstrated an 11% reduction in risk of heart attack with this average
consumption.
Coffee
Antioxidants in coffee have been the subject of research in the last few years.
The picture has been confused however by claims that coffee contains toxins
that are harmful to the heart and might increase the risk of cancer. In addition,
the stimulant effect of caffeine has been reportedly associated with an increased
likelihood of irregularities of rhythm of the heart.
Essentially there is NO convincing evidence of harmful effects of coffee, drunk
in moderation ie 2 - 3 cups per day. Clearly, people who suffer from palpitations,
heart irregularities or adverse effects of caffeine overload should consider
drinking decaffeinated preparations.
The specific antioxidants include polyphenols, but the evidence for beneficial
effects of these compounds is not as compelling as the studies undertaken on tea.
www.tasteofthemed.com
39
STEP 9
A Secret chapter for Chocolate lovers
Ssshhhhhhh! Its positively good for you
During the 1990s there was an important scientific breakthrough demonstrating
the health benefits of wine. After years of negative messages in relation to the
potential harm of foods, this was a breath of fresh air. We could indulge a little,
enjoy, and be fitter and feel better. The joy of a positive dietary experience that
allowed us to experience pleasure in the knowledge that we were gaining health
benefits! And from wine! That which cheers the sad, revives the old, inspires
the young, makes weariness forget his toil, and fear her danger; opens a new
world when this, the present, palls.
The news gets better still with the fantastic taste of colourful fresh fruits,
vegetables and salads covered in olive oil significantly reducing risk of heart
disease and cancers.
40
www.tasteofthemed.com
41
STEP 10
Exercise for Energy
Fitness and health for bodily wealth
Exercise protects the body from heart disease, some cancers, obesity, diabetes
and stress...
But more than that it gives a sense of well being, fitness and energy.
www.tasteofthemed.com
43
44
Target HR Zone
50 -75%
20 years
200
25 years
195
30 years
190
35 years
185
40 years
180
45 years
175
50 years
170
55 years
165
60 years
160
65 years
155
70 years
150
Age
STEP 10: The Bottom Line Exercise for health and joy.
Catch the Buzz.
www.tasteofthemed.com
45
Conclusion
STEP 1
The Bottom Line Plan your meals and shopping around a well balanced
Mediterranean diet.
STEP 2
The Bottom Line Colourful fruits and Vegetables are packed with goodies to
prevent disease. Buy more, eat more.
STEP 3
The Bottom Line olive oil has numerous health giving effects. Make it readily
available for cooking, dressing, splashing and mixing. Get to know it, get to
love it.
STEP 4
The Bottom Line Indulge a passion for Fruit to protect from cancer and heart
disease. Create opportunities and variety.
STEP 5
The Bottom Line Pick great tasting, antioxidant snacks. Buy them, Bowl them,
Believe in them.
STEP 6
The Bottom Line A squirt of lemon, a pinch of herbs, and garlic everywhere to
keep a healthy state.
STEP 7
The Bottom Line Ground Flaxseed on cereal and boost your heart.
STEP 8
The Bottom Line Celebrate fine wine knowing it is good for you. Ensure your
three cups of tea a day.
STEP 9
The Bottom Line Add a little Dark chocolate to end your Evening Meal.
STEP 10
The Bottom Line Exercise for health and joy. Catch the Buzz.
Ten simple enjoyable steps to a longer and healthier life. Its positively good for
you. ENJOY!
46
Appendix
References much of this summary is reproduced by kind permission of Oldways, the nonprofit organisation supporting healthy eating;
48
The main finding of this study is that high adherence to the traditional Mediterranean dietary
pattern, characterized by high intakes of vegetables, fruits, legumes, fish, cereals, and nuts and low
and moderate consumption of meat and wine, respectively, is associated with a lower prevalence of
obesity in men and women in this Mediterranean population. This association held even after
controlling for age, leisure time physical activity, educational level, smoking, and alcohol consumption.
Adherence to the Traditional Mediterranean Diet Is Inversely Associated with Body Mass Index and
Obesity in a Spanish Population
Schroeder, H., Marrugat, J., et al. The Journal of Nutrition 134: 3355-3361 (2004)
Recent findings showing that elderly African Americans and Japanese living in the USA have a much
higher prevalence of AD (6.24% and 4.1%, respectively) than those still living in their ethnic homelands
(< 2%) suggest that the prevalence of Alzheimers disease is more strongly influenced by diet and
nutrition, environment and/or lifestyle than by genetics... In conclusion, the Mediterranean diet
pattern based on complex carbohydrates, fibre and non-animal fat appears to protect against agerelated cognitive decline and cognitive decline of vascular or degenerative origin.
Mediterranean diet and cognitive decline
Panza, F., Solfrizzi, V., et al. Public Health Nutrition 7(7): 959-963 (2004)
The present study provides a pathophysiologic explanation to the growing scientific evidence for the
beneficial effect of the Mediterranean diet on human health and, especially, atherosclerotic disease.
We found that greater adherence to this traditional diet was independently associated with a reduction
in the inflammation and coagulation indexes that are believed to have an important role in CVD. The
World Health Organization reports that the three major components involved in preventing
atherosclerotic disease are smoking, physical inactivity, and an unhealthy diet, as they are factors that
can be changed. Our findings emphasize the need for actions from public health care professionals in
order to prevent the development and progression of atherosclerotic diseases through the adoption of
low animal fat diets, like the Mediterranean diet.
Adherence to the Mediterranean diet attenuates inflammation
and coagulation process in healthy adults: the Attica study
Chrysohoou, C., Panagiotakos, D.B., et al. Journal of the American College of Cardiology 44:152-158
(2004)
Greater adherence to the Mediterranean diet is associated with a significant reduction in total
mortality. A one unit increase in a diet score, devised a priori on the basis of eight key features of the
traditional common diet in the Mediterranean region, was associated with a 17% reduction in overall
mortality.
Adherence to a Mediterranean diet and Survival in a Greek Population
Trichopoulou A. et al. The New England Journal of Medicine, 348:2599-2608 (2003)
Dietary intervention with the Mediterranean diet and statin treatment improve flow-mediated
vasodilatation in the brachial artery in patients with ischemic heart disease and hyper-cholesterolemia
to a greater degree than statin treatment alone.
Effect of dietary intervention and lipid-lowering treatment on brachial
vasoreactivity in patients with ischemic heart disease and hypercholesterolemia
Sondergaard, E., Moller JE., Egstrup K. American Heart Journal 145(5):E19 (2003)
The results indicate that patients with Rheumatoid arthritis, by adjusting to a Mediterranean diet, did
obtain a reduction in inflammatory activity, an increase in physical function, and improved vitality.
An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis
Skoldstam,L., Hagfors, L., Johansson G. Annals of the Rheumatic Diseases 62(3):208-14 (2003)
Myocardial infarction patients can respond positively to simple dietary advice, and this can be expected
to lead to a substantial reduction in the risk of early death. Regardless of any drug treatment
prescribed, clinicians should routinely advise patients with myocardial infarction to increase their
frequency of consumption of Mediterranean foods.
Mediterranean diet and all-causes mortality after myocardial infarction:
results from the GISSI-Prevenzione trial
Barzi, F. et al. European Journal of Clinical Nutrition 57(4):604-11 (2003).
www.tasteofthemed.com
49
Efforts to combat nutrient deficiencies have centered on supplemental nutrient administration and
addition of selected nutrients to the food chain in the form of food fortification. In addition to
supplementation or fortification with specific nutrients, the consumption of certain dietary patterns
(such as the Mediterranean diet) is associated with a reduced risk of chronic diseases, particularly
cardiovascular diseases.
Fortification, supplementation, and nutrient balance
Caballero, B. European Journal of Clinical Nutrition 57 1:S76-8, (2003)
Trichopoulou et al. report the results of a population-based study involved 22,043 apparently healthy
adults in Greece, in which adherence to a traditional Mediterranean diet was associated with
significantly lower total mortality, mortality from coronary heart disease, and mortality from cancer. To
measure adherence to this diet, a score was constructed that incorporated relatively high intakes of
vegetables, fruits and nuts, legumes, cereals, fish, and monounsaturated fat; relatively low intakes of
meat, including poultry, and moderate consumption of alcohol. One intriguing aspect of this study is
that despite a robust inverse association between the overall Mediterranean-diet score and mortality, no
appreciable associations were seen for most of the individual dietary components used to construct the
score. One possible explanation is that the effects of single nutrients of foods may be too small to
detect, whereas the cumulative effective of multiple dietary components may be substantial. In
addition, there may be synergistic or interactive effects among nutrients or foods, which the score
automatically takes into account.
The Mediterranean Diet and Mortality Olive Oil and Beyond
Hu, F.B. New England Journal of Medicine 348:26, 2595-2596 (2003)
Until the picture can be clarified, lipid modification with strategies proved to reduce the risk for
coronary events, such as statins or dietary changes in the style of the Mediterranean diet, should be
better implemented in clinical practice.
Antioxidants, statins, and atherosclerosis
Gotto, AM. Journal of American College of Cardiology 41:1205-10 (2003)
In the Lyon Heart Study, higher ALA consumption in the context of a Mediterranean diet dramatically
reduced total and cardiovascular mortality as well as nonfatal MI. These trials strongly support the
protective effects of omega-3 fatty acids, including both ALA and fish oil, in secondary prevention of
CHD. Mediterranean diet enriched with ALA reduced death by more than 70%.
Optimal Diets for Prevention of Coronary Heart Disease
Hu, F.B., Willet, W.C. Journal of the American Medical Association, 288: 2569-2578 (2002)
The traditional Mediterranean diet as outlined in this article is an ideal eating pattern for prevention
of cardiovascular disease. We believe that current understanding and scientific evidence are adequate
to recommend this diet widely as a practical, effective, and enjoyable strategy the new gold
standard in heart disease prevention.
Understanding the Mediterranean Diet: Could This Be the New
Gold Standard for Heart Disease Prevention?
Curtis, B., OKeefe, J., Postgraduate Medicine, 112(2): 35-8. 41-5 (2002)
The Indo-Mediterranean diet is a safe and economical way to improve the health of a non-Western
population over 2 years. A diet enriched with fruit, vegetables, nuts, whole grains, and mustard or soy
bean oil is associated with a pronounced decline in CAD morbidity and mortality, without an increase in
non-cardiac deaths, and in the presence of improved metabolic profiles. The long-term benefits may be
even more substantial.
Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high
risk patients (Indo-Mediterranean Diet Heart Study): a randomized single-blind trial
Singh, R.B., Dubnov, G., et al. The Lancet 360; 1455-1461 (2002)
Our data support the hypothesis that a Mediterranean diet (that emphasizes olive oil, fibre, fruits,
vegetables, fish and alcohol and reduces meat/meat products) can be an effective measure for reducing
the risk of myocardial infarction. However, our results support the exclusion of refined cereals with a
high glycaemic load as healthy elements of this pattern.
Mediterranean diet and reduction in the risk of a first acute myocardial
infarction: an operational healthy dietary score
Martinez-Gonzalez, M.A., Fernandez-Jarne, E., et al.
European Journal of Nutrition 41(4): 153-160 (2002)
50
We studied the acute and longer-term effects of vitamin C compared to a Mediterranean-type diet
on endothelial function in healthy older subjects. A Mediterranean-type diet rich in vitamin C improves
vascular function. Neither acute intra-arterial nor sustained administration of oral vitamin C improves
vascular function in healthy older subjects.
Effects of a healthy diet and of acute and long-term vitamin C
on vascular function in healthy older subjects
Singh, N., Graves, J., et al. Cardiovascular Research. 56(1): 118-25 (2002)
Based on the estimated risk model we found that the Mediterranean type of diet reduces
significantly the risk of developing acute coronary syndromes even in the presence of unfavourable
lifestyle situations, such as sedentary life, smoking habit, as well as hypertension, hypercholesterolemia and diabetes mellitus.
The role of traditional Mediterranean type of diet and lifestyle in the development
of acute coronary syndromes: preliminary results from CARDIO 2000 study
Panagiotakis, D.B., Pitsavos, Ch., et al. Central European Journal of Public Health. 10(1-2): 11-5 (2002)
Long-term success in weight loss with dietary treatment has been elusive. A moderate-fat,
Mediterranean-style diet, controlled in energy, offers an alternative to a low-fat diet with superior
long-term participation and adherence, with consequent improvements in weight loss.
A randomized controlled trial of a moderate-fat, low-energy diet compared
with a low-fat, low-energy diet for weight loss in overweight adults
McManus, K., Antinoro, L., Sacks, F. International Journal of Obesity & Related Metabolic Disorders
25(10):1503-11 (2001).
It would be short-sighted not to recognize the enormous public health benefit that the Mediterraneanstyle diet could confer... there is a pressing need to identify unknown risk Mediterranean diet itself
on CHD. Other characteristics of factors and effective intervention strategies... The findings from the
Lyon Diet Heart Study illustrate the importance of a [Mediterranean] dietary pattern that emphasizes
fruits, vegetables, breads and cereals, and fish, within the context if a Step I diet... to dramatically
lower CVD risk in the population and can be followed by free living people.
Lyon Diet Heart Study: Benefits of a Mediterranean-Style, National Cholesterol Education Program
American Heart Association Step I Dietary Pattern on Cardiovascular Disease
Kris-Etherton, P., et al. Circulation 103: 1823-1825 (2001).
A Mediterranean-style diet demonstrates impressive effects on cardiovascular disease. Early reports
from the Lyon Heart Study caused us to commission this advisory and to examine the current scientific
basis for the effect of such dietary modifications in general; this led to recommendations for the AHA,
practitioners, and the public. Because of the potentially substantial significance of their findings, we
believe an aggressive pursuit of the issues raised in the study and the advisory must be undertaken. It
does seem that substantial enhancement to the effectiveness of our current dietary recommendations
may be provided by integrating the features of the diet used in the Lyon Diet Heart Study with current
AHA guidelines. Studies addressing the issues listed in the scientific advisory will need to be completed
before this conclusion can be drawn. Such studies should be aggressively pursued because of their
major potential and societal impact.
Can a Mediterranean-Style Diet Reduce Heart Disease? Editorial
Robertson, R.M., Smaha, L. Circulation 103: 1821 (2001)
The DART and the Mediterranean diet trials did show significant reduction in coronary heart disease
in comparison with the placebo.
What Role for Statins: A Review and Economic Model [Treatment and Prevention]
Updated 31-05-2001 NHS Centre for Reviews and Dissemination, University of York, U.K. (2001)
The most effective means of reducing the risk of sudden cardiac death (apart from the prophylactic
implantation of a defibrillator) appears to be dietary prevention in the light of animal experiments,
epidemiological studies and four randomized trials... Adoption of a dietary pattern, for instance a
Mediterranean type of diet, seems to be the best way.
Diet and medication for heart protection in secondary prevention
of coronary heart disease. New concepts [Review]
de Lorgeril, M., Salen, P., et al. Nutrition, Metabolism & Cardiovascular Diseases 10(4): 216-22 (2000)
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51
There is increasing scientific evidence of positive health effects from diets which are high in fruits,
vegetables, legumes, and whole grains, and which include fish, nuts and low-fat dairy products. Such
diets need not be restricted in total fat as long as there is not an excess of calories, and emphasize
predominantly vegetable oils that are low in saturated fats and free of partially hydrogenated oils. The
traditional Mediterranean Diet, whose principal source of fat is olive oil, encompasses these dietary
characteristics.
2000 Consensus Statement on Dietary Fat, the Mediterranean Diet
and Lifelong Good Health: Summary Statement
The Mediterranean diet is a centuries-old tradition that contributes to excellent health, provides a
sense of pleasure and well-being, and forms a vital part of the worlds collective cultural heritage. For
Mediterranean peoples, this way of eating describes a traditional diet that can be readily preserved and
revitalized within a modern lifestyle. For Americans, Northern and Eastern Europeans, and other who
wish to improve their diets, the Mediterranean way of eating describes a dietary pattern that is
attractive for its famous palatability as well as for its health benefits, and one that can be adopted in its
entirety or adapted to a Mediterranean-style diet.
From the Scientific Exchange of the 2000 International Conference on the Mediterranean Diet
The Mediterranean diet and moderate consumption of red wine have complementary, mostly
beneficial effects on haemostatic cardiovascular risk factors.
Complementary effects of Mediterranean diet and moderate red wine
intake on haemostatic cardiovascular risk factors
Mezzano, D., et al. European Journal of Clinical Nutrition 55(6): 444-451 (2001)
The data confirms the impressive protective effect of the Mediterranean diet. The protective effect of
the Mediterranean dietary pattern was maintained up to 4 years after the first infarction.
Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular
Complications After Myocardial Infarction. Final Report of the Lyon Diet Heart Study
de Lorgeril, M., Salen, P., Martin, J.L., et al. Circulation, 99: 779-785 (1999)
Adherence to the principles of the traditional Mediterranean diet ... is likely to be associated with
lower overall mortality. Moreover, key features of this diet appear to be transplantable to other dietary
cultures and cuisines, and may have a substantial beneficial impact on the general mortality of elderly
people who have the Westernized dietary habits. We conclude that a diet that adheres to thee principles
of the traditional Mediterranean diet is associated with longer survival.
Are the Advantages of the Mediterranean Diet Transferable to Other Populations?
A Cohort Study in Melbourne, Australia
Kouris-Blazos, A. British Journal of Nutrition 82: 57-61 (1999)
Adoption of a Mediterranean diet results in a significant reduction of total and LDL-cholesterol with
also a significant effect on triglycerides and a small positive or no effect on HDL-cholesterol. However,
the Mediterranean diet has been shown to be cardioprotective (for instance, prevention of sudden
death) through biological effects (probably induced by omega-3 fatty acids) independent of its effect on
blood lipoproteins. The association of these cardioprotective and beneficial effects on blood lipids, in
addition to gastronomic properties, renders this type of diet extremely attractive for public health
purposes.
Hyperlipidemias. Concern with the Mediterranean diet
Salen, P., de Lorgeril, M. Presse Medicale 28(36): 2018-24 (1999)
There is increasing scientific evidence that there are positive health effects from [Mediterranean-type]
diets which are high in fruits, vegetables, legumes, and whole grains, and which include fish, nuts, and
low-fat dairy products. Such diets need not be restricted in total fat as long as there is not an excess of
calories, and the diet is low in saturated fats and partially hydrogenated oils. Diets that emphasize
vegetable oils (predominantly monounsaturated), nuts, and fish are preferable to those high in animal
products and partially hydrogenated oils. Many individuals will have to limit their intake of fat or
carbohydrate to avoid excess calories.
1998 Consensus Statement on Total Dietary Fat and the Overall Dietary Pattern
American Journal of Medicine, January 30, 2003 Supplement (in press)
From the Scientific Exchange of the 1998 International Conference on the Mediterranean Diet
52
Patients who followed a Mediterranean-type diet had reduced... combined all-cause mortality,
nonfatal cancer, and myocardial infarction compared with those who followed an approximate
American Heart Association Step 1 diet. The Mediterranean-type diet also showed a trend toward a
decreased risk for cancer. A Mediterranean-type diet reduced mortality in patients with a first MI.
Mediterranean dietary pattern in a randomized trial:
prolonged survival and possible reduced cancer rate
de Lorgeril, M., Salen, P., et al. Arch Intern Med.; 158: 1181-1187 (1998)
The Mediterranean diet or its elements have repeatedly been shown to provide remarkable
protection against chronic diseases.
Albanian Paradox, Another Example of Protective Effect of Mediterranean Lifestyle?
Gjona, A., Bobak, M. Lancet 350: 1815-1817 (1997)
As conceptualized in the Mediterranean and Asian-vegetarian types of diet, it is very important
that a healthy diet should be thought of as a whole rather than as a recitation of good and bad
components. Although these protective dietary modifications should probably all be used in each
patient to obtain maximal efficacy, these scientifically quantitated principles should be adapted to the
culture, ethnic origin and image of the world of each patient in order to create an environment
favourable to the perception of positive associations between various foods and healthy habits.
The diet heart hypothesis in secondary prevention of coronary heart disease
de Longeril, M., Salen, P., et al. European Heart Journal 18(1): 13-8 (1997)
The Mediterranean diet was found not only to produce favourable effects on blood lipid profiles, but
also to protect against oxidative stress and carcinogenesis... the dietary profile has maintained its basic
features, and vital statistics still demonstrate a comparative advantage of eating behaviors in
Mediterranean countries.
Mediterranean Diet, Italian-style: Prototype of a Healthy Diet
Ferro-Luzzi, A., Branca, F. American Journal of Clinical Nutrition 61: 1338S-1345S (1995).
We present a food pyramid that reflects Mediterranean dietary traditions, which historically have
been associated with good health. This Mediterranean diet pyramid is based on food patterns...
where adult life expectancy was among the highest in the world and rates of coronary heart disease,
certain cancers, and other diet-related chronic diseases were among the lowest. The pyramid describes
a dietary pattern that is attractive for its famous palatability as well as for its health benefits.
Mediterranean Diet Pyramid: A Cultural Model for Healthy Eating
Willett, W.C. et al., American Journal of Clinical Nutrition 61: 1402S-1406S (1995)
A Mediterranean diet with more cereal, vegetables, fruit, less saturated fats and more n-3 fatty acids
has recently been shown to afford a rapid and exceptional protection from recurrences and death in
coronary patients.
Nutrition, atherosclerosis and coronary heart disease
Renaud, S., de Lorgeril, M. Reproduction, Nutrition, Development 34(6): 599-607 (1994)
An alpha-linolenic acid-rich Mediterranean diet seems to be more efficient than presently used diets
in the secondary prevention of coronary events and death.
Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease
de Lorgeril, M., Renaud, S., et al. Lancet 3 43(8911): 1454-9 (1994).
13th Congress of Dietetics 2000; High MUFA diet beats low fat and weight reducing diets in
cardioprotection (Dr Kris-Etherton, Am J Clin Nut 1999)
Following Myocardial Infarction between 9 and 19 people will need to be given Mediterranean dietary
advice to prevent 1 death NHS Centre for reviews and dissemination. Source British Dietetics
Association
BNF Report 2000; The adoption of a Mediterranean-style diet and lifestyle would confer substantial
health benefits to populations in Northern Europe. Growing evidence suggests that this diet provides an
alternative to the low fat diet for improving lipid profile and promoting weight maintenance
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53
The wide range of antiatherogenic effects associated with olive oil consumption could contribute to
explain the low rate of cardiovascular mortality found in Southern European countries in comparison
with other Western countries, despite a high prevalence of CVD factors
Review of olive oil and health, M.Covas, Pharmacological Research, 2007.01.010
Olive oil is the principle source of fat in the Mediterranean Diet which is associated with low
mortality for cardiovascular disease ... a large body of knowledge exists providing evidence of the
benefits of olive oil consumption on secondary end points for cardiovascular disease. The benefits of
olive oil consumption are beyond a mere reduction of the low density lipoprotein cholesterol.
Pharmacol Research 2007 March; 55 175-86
The Mediterranean Diet, rich in olive oil, improves the major risk factors for cardiovascular
disease ... some of these effects are attributed to components of virgin olive oil.
International conference on the healthy effects of virgin olive oil.
European Journal clinical Investigation 2005, July 35 421-4
Olives and olive oil contain antioxidants in abundance..and substantial amounts of other compounds
that are deemed to be anticancer agents
Olives and Olive oil in cancer prevention. Owen et al,
European Journal Cancer Prevention, 2004 Aug 13 (4), 319-26
The role of dietary extra virgin olive oil in preventing the onset of atherosclerosis and inflammatory
bowel disease.
A report to the 12th international symposium on atherosclerosis
Stockholm, Sweden. June 25-29. Masella et al, Rome
Antioxidant polyphenolic compounds such as quercetin which is abundant in olive oil help switch
off the mechanisms which lead to atherosclerosis by inhibition of endothelial activation, the process by
which the lining of the blood vessels contribute to the development of atherosclerosis.
Report to the 12th Congress of the European society of cardiology,
Amsterdam, 2000. Carluccio, University Milan
Olive oil intake showed a significant reduction of oesophageal cancer risk, even allowing for total
vegetable consumption.
International Journal of Cancer 2000, 87;2 289-94. Bosetti et al
Olive oil contains a vast range of substances such as monounsaturated free fatty acids (e.g., oleic
acid), hydrocarbon squalene, tocopherols, aroma components, and phenolic compounds. Higher
consumption of olive oil is considered the hallmark of the traditional Mediterranean diet, which has
been associated with low incidence and prevalence of cancer, including colorectal cancer. The
anticancer properties of olive oil have been attributed to its high levels of monounsaturated fatty acids,
squalene, tocopherols, and phenolic compounds. Nevertheless, there is a growing interest in studying
the role of olive oil phenolics in carcinogenesis. This review aims to provide an overview of the
relationship between olive oil phenolics and colorectal cancer, in particular summarizing the
epidemiologic, in vitro, cellular, and animal studies on antioxidant and anticarcinogenic effects of olive
oil phenolics.
Components of olive oil and chemoprevention of colorectal cancer.
Nutr Review 2005 Nov63 374-86. Hashim et al
In the Mediterranean basin, olive oil, along with fruits, vegetables, and fish, is an important
constituent of the diet, and is considered a major factor in preserving a healthy and relatively diseasefree population. Epidemiological data show that the Mediterranean diet has significant protective
effects against cancer and coronary heart disease. We present evidence that it is the unique profile of
the phenolic fraction, along with high intakes of squalene and the monounsaturated fatty acid, oleic
acid, which confer its health-promoting properties. The major phenolic compounds identified and
quantified in olive oil belong to three different classes: simple phenols (hydroxytyrosol, tyrosol);
secoiridoids (oleuropein, the aglycone of ligstroside, and their respective decarboxylated dialdehyde
derivatives); and the lignans [(+)-1-acetoxypinoresinol and pinoresinol]. All three classes have potent
antioxidant properties. High consumption of extra-virgin olive oils, which are particularly rich in these
phenolic antioxidants (as well as squalene and oleic acid), should afford considerable protection
against cancer (colon, breast, skin), coronary heart disease, and ageing by inhibiting oxidative stress.
Olive-oil consumption and health: the possible role of antioxidants,
Lancet Oncol 2000 Oct;1:107-12. owen et al. Division of Toxicology and Cancer Risk Factors,
German Cancer Research Center, Heidelberg
54
Ref 4;
Eurosciences communications 2000; American Diabetes Association 1998 clinical practice
recommendation
Ref 5;
AHA Science Advisory Committee Monounsaturated Fatty Acids and Risk of Cardiovascular Disease
Penny M. Kris-Etherton, PhD, RD; for the Nutrition Committee
Ref 6, 7;
Menendez et al; Annals of Oncology Jan 2005. Goldacre et al. Olive oil, diet and colorectal cancer...
Community Health 2000;54:75660
Ref 8;
Espino-Montoro nutr metab cv dis 6 147-154; Katsilambros et al nutr metab cv dis 164-167
Associations of Dietary Fat, Regional Adiposity, and Blood Pressure in Men . Paul T. Williams, PhD;
Stephen P. Fortmann, MD; Richard B. Terry; Susan C. Garay, MS; Karen M. Vranizan, MA; Nancy
Ellsworth; Peter D. Wood, DSc JAMA. 1987;257(23):3251-3256.
Ref 9;
American Journal of Clinical Nutrition, Vol. 70, No. 6, 1077-1082, December 1999
Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables Athena Linos
Ref 10;
Epic Study reports Trichopoulou BMJ 2009; 338: b2337
Ref 11;
Bosetti et al, International Journal of Cancer 2000, 87; 2; 289-94
Ref 12;
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