Mediterranean Diet Linked to Lower Long-Term Cardiovascular Events in Women

MedicalResearch.com Interview with:

Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA

Dr. Mora

Samia Mora, MD, MHS
Associate Professor of Medicine
Harvard Medical School
Director, Center for Lipid Metabolomics
Brigham and Women’s Hospital
Boston, MA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit.

Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors.

Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites.  Continue reading

Mediterranean Diet Linked To Stroke Risk Reduction in Women

MedicalResearch.com Interview with:
“Vegetables” by Wagner T. Cassimiro "Aranha" is licensed under CC BY 2.0Professor Phyo Kyaw Myint MBBS MD FRCP(Edin) FRCP(Lond)
Clinical Chair in Medicine of Old Age
Academic Lead: Ageing Clinical & Experimental Research &
Director of Clinical Academic Training Development
The Lead Academic, Aberdeen Clinical Academic Training (ACAT) Programmes
School of Medicine, Medical Sciences & Nutrition
College of Life Sciences & Medicine, University of Aberdeen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: While Mediterranean Diet has been linked to reduced stroke risk it remains unclear
(1) its impact on populations within non-Mediterranean countries;
(2) its specific impact on different gender;
(3) the effect observed when using more robust dietary assessments; and (4) which specific components of the diet are most protective.

We therefore studied more than 23 thousand men and women (mainly British Caucasian) aged 40 years or older in Norfolk, UK as part of EPIC-Norfolk study and we found that the greater adherence to Mediterranean dietary pattern is linked to a significant reduction in stroke risk in women but not in men. This benefit was seen across the whole middle and older age population (particularly for women) regardless of their existing risk factors such as high blood pressure.

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Both Vegetarian and Mediterranean Diets Beneficial for Weight Loss and Heart Health

MedicalResearch.com Interview with:
“Vegetarian dan dan noodles” by Andrea Nguyen is licensed under CC BY 2.0Francesco Sofi, MD PhD
Department of Experimental and Clinical Medicine
University of Florence, Florence, Italy; Clinical Nutrition Unit, Careggi University Hospital
Don Carlo Gnocchi Foundation Italy, Onlus IRCCS
Florence, Italy 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Mediterranean and Vegetarian diets are two of the most beneficial dietary patterns for prevention of chronic degenerative diseases.

No studies have been conducted in the same group of subjects, by comparing these two dietary profiles.

Main results are that both diets have been found to be beneficial for cardiovascular prevention, in the same group of subjects at low risk of cardiovascular disease.

In particular, vegetarian diet determined a reduction of total and LDL-cholesterol, whereas Mediterranean diet resulted in lower levels of triglycerides and some inflammatory parameters

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Inverse Association Between Mediterranean Diet and Cardiovascular Disease

MedicalResearch.com Interview with:
Dr Nita Forouhi, MRCP, PhD, FFPHM
Programme Leader
MRC Epidemiology Unit
University of Cambridge School of Clinical Medicine
Institute of Metabolic Science
Cambridge Biomedical Campus

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The benefits of the Mediterranean diet for cardiovascular health are well documented in countries of the Mediterranean region and some other countries, but there is little such evidence in the UK general population. Our work fills this research gap.

In our study we followed up 23,902 initially healthy Britons living in Norfolk (Eastern England) for an average of 12 to 17 years, and determined the occurrence of new cases of cardiovascular diseases (CVD) and deaths due to CVD during that time period. Our results showed that those adults who adhered to a Mediterranean diet had 6% to 16% lower risk of developing CVD, compared to those who had dietary habits further away from the Mediterranean-type diet pattern. This was the case even when we accounted for several important risk factors and correlates of CVD, including as age, sex, body mass index, lifestyle habits such as smoking, alcohol intake and physical activity, and socio-economic factors.

We also modelled what would happen in the study population if all the participants increased their adherence to the Mediterranean-type diet. From this we estimated that nearly 4% of all new cardiovascular disease cases, or 12.5% of cardiovascular deaths in the population could potentially be avoided. This is novel information about the potential health benefit of a Mediterranean-type diet in a UK context. However, we should remember that our study was an observational study, not a clinical trial with a dietary intervention, and thus we cannot imply a cause and effect relationship between increasing adherence to the Mediterranean diet and reduction in cardiovascular disease.

We defined the Mediterranean diet using a 15 point score based on guideline recommendations from a Mediterranean dietary pyramid published by the Mediterranean Diet Foundation. The recommendations had not previously been specifically tested for their associations with health, so our findings, for the first time, show the utility of the Mediterranean dietary pyramid.

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Mediterranean Diet in Post Menopausal Women Linked to Better Bone Health

MedicalResearch.com Interview with:
Bernhard Haring, MD MPH
Department of Medicine I
Comprehensive Heart Failure Center
University of Würzburg
Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Haring: The primary aim of this study was to examine the association between adherence to a diet quality index constructed on the basis of dietary recommendations or existing healthy dietary patterns and bone outcomes in a large population of postmenopausal women.

We found that higher diet quality based on a Mediterranean diet may play a role in maintaining bone health in postmenopausal women.
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Significant Decrease in Breast Cancer With Mediterranean Diet and Olive Oil

MedicalResearch.com Interview with:
Miguel Ángel Martínez González MD

Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid
IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain

Medical Research: What is the background for this study?

Response: Several observational studies and mechanistic experiments in animal models and cell lines suggested that the Mediterranean diet and minor components of extra-virgin olive oil may reduce the risk of developing breast cancer.

The PREDIMED study was a randomized primary prevention trial for cardiovascular disease among high risk patients initially free of cardiovascular disease. The participants were 7,447 men and women (60-80 years old).

We have used the data from women in this trial to assess the effect of the randomized diets on the occurrence of new cases of breast cancer.

Medical Research: What are the main findings?

Response: Among 4,152 women randomized to 3 different diets
(1.- Mediterranean diet with free provision of extra-virgin​ olive oil;
2.- Mediterranean diet with free provision of tree nuts; and
3.- Advice to follow a low-fat diet, i.e. control group)

We confirmed 35 new cases of invasive breast cancer during 4.8 of follow-up. A statistically significant 68% relative reduction in the risk of breast cancer in the Mediterranean diet with free provision of extra-virgin​ olive oil versus the control group was found. There was a significant trend of risk reduction associated with progressive increments in the intake of extra-virgin olive oil during the trial (with repeated yearly measurements of diet) when the 3 groups were assessed together.

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PREDIMED Study Demonstrates Heart Health Benefits of Mediterranean Diet

Miguel Á. Martínez-González, MD, MPH, PhD Department of Preventive Medicine & Public Health School of Medicine, University of Navarra Navarra, SpainMedicalResearch.com Interview with:
Miguel Á. Martínez-González, MD, MPH, PhD
Department of Preventive Medicine & Public Health
School of Medicine, University of Navarra
Navarra, Spain

Medical Research: What are the main findings?

Response: The diet-heart hypothesis has been researched during decades. A common mistake was to assume that a high intake of all types of fat was detrimental for cardiovascular health and could cause heart attacks and strokes. Therefore a low-fat diet was proposed as the best way to prevent heart attacks and strokes. This was wrong.

Alternatively, the Mediterranean diet, rich in fat from natural vegetable sources (olive oil, tree nuts), was also considered a healthy dietary pattern.

However, most of the evidence to support these benefits of a fat-rich Mediterranean diet came from observational studies and no randomized clinical trial had ever assessed the Mediterranean diet in PRIMARY prevention (i.e. in initially healthy people) Continue reading

Mediterranean Diet May Delay Telomere Shortening, Increase Longevity

Immaculata De Vivo PhD Associate Professor Harvard Medical School Director, Dana Farber/Harvard Cancer Center High Throughput Genotyping Core Facility. Channing Division of Network Medicine Boston, MA 02115MedicalResearch.com Interview with:
Immaculata De Vivo PhD

Associate Professor Harvard Medical School
Director, Dana Farber/Harvard Cancer Center High Throughput Genotyping Core
Facility. Channing Division of Network Medicine
Boston, MA 02115

MedicalResearch: What is the background for this study? What are the main findings?

Dr. De Vivo: Our study found that greater adherence to the Mediterranean diet is associated with longer telomeres. Following a diet closer to the Mediterranean diet, can prevent accelerated telomere shortening. Our unique contribution to the literature is that we provide a potential molecular mechanism, preventing telomere shortening. Telomeres are bits of DNA that protect your chromosomes.

MedicalResearch: Is telomere shortening reversible?

Dr. De Vivo: Telomere shortening is a biological process, the shorten with age.

However, lifestyle choices can help to prevent accelerated shortening.

Fruits, vegetables, olive oil and nuts – key components of the Mediterranean diet have well known antioxidant and anti-inflammatory effects that could balance out the “bad effects” of smoking and obesity.

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Brief Mediterranean Diet Intervention May Have Long Term Benefits

MedicalResearch.com Interview with:
Dr. Markos Klonizakis
Centre for Sports and Exercise Science
Sheffield Hallam University, UK

Medical Research: What is the background for this study? What are the main findings?

Dr. Klonizakis: It is widely accepted that populations in the Eastern Mediterranean sea have historical lower rates of cardiovascular disease, diabetes and cancer. This has been attributed to a great extent, at following a diet based on dishes and ingredients, which are common in this region and are collectively known as “Mediterranean diet”.  Taking into consideration that cardiovascular disease is on the rise, particularly in the Western world, it did make sense to see if such a diet can be adapted for a population that has a largely different culinary tradition and what the results would be if this is combined with exercise of moderate-intensity. We therefore, designed and implemented an 8-week intervention, aiming at older, healthy but previously untrained people, comparing an exercise-only group vs one where exercise was combined with Mediterranean diet. Our work has shown that benefits of this intervention are still evident in the vascular function (measured by the function of the inner vein lining, called the endothelium) and the cardiopulmonary fitness, one year after the end of the intervention.

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Olive Oil and Mediterranean Diet May Improve Metabolic Syndrome

Jordi Salas-Salvadó Professor of Nutrition Human Nutrition Unit Department of Biochemistry & Biotechnology IISPV School of Medicine. Rovira i Virgili University CIBERobn, Instituto Carlos IIIMedicalResearch.com Interview with:
Jordi Salas-Salvadó Professor of Nutrition
Human Nutrition Unit Department of Biochemistry & Biotechnology
IISPV School of Medicine.
Rovira i Virgili University CIBERobn, Instituto Carlos III

Medical Research: What are the main findings of the study?

Response: In this large, multicenter, randomized clinical trial conducted in Mediterranean individuals at high cardiovascular risk, Mediterranean-diet supplemented with extra-virgin olive oil was associated to a lower increase in the prevalence of metabolic syndrome compared to the advice on a control low-fat diet. However, no beneficial effect of Mediterranean-diet on the incidence of metabolic syndrome among participants free of this condition at baseline was observed. Therefore, the lower increase in prevalence was especially due to the reversion of metabolic syndrome in those individuals with metabolic syndrome at baseline.
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Polyphenol Intake Linked To Decrease in Cardiovascular Mortality

Rosa M. Lamuela-Raventos, PhD Associate Professor Department of Nutrition and Food Science School of Pharmacy, University of BarcelonaMedicalResearch.com Interview with:
Rosa M. Lamuela-Raventos, PhD
Associate Professor
Department of Nutrition and Food Science
School of Pharmacy, University of Barcelona

MedicalResearch: What are the main findings of the study?

Dr. Lamuela-Raventós: We have found an inverse relationship between polyphenol intake and risk of overall mortality among elderly subjects at high cardiovascular risk. Adjusting for confounders and comparing the highest versus the lowest quintiles of intake, total polyphenols were inversely associated with total mortality (HR=0.63, 95 CI=0.41-0.97, P-trend=0.12), as well as stilbenes (HR=0.48, 95 CI=0.25-0.91, P-trend=0.04) and lignans (HR=0.60, 95 CI=0.37-0.97, P-trend=0.03). In fact, our results showed that all polyphenols subgroups, except for dihydrochalcones, trended to be protective although their intake did not reach statistical significance. In stratified analyses we also found a stronger association between total polyphenol intake and mortality risk for women and for those who did not drink alcohol.
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Olive Oil in Diet Linked To Cardiovascular Disease Prevention

Prof Jordi Salas-Salvadó Professor of Nutrition. Human Nutrition Unit (Director) Department of Biochemistry & Biotechnology, IISPV School of Medicine. Rovira i Virgili University. Reus, Spain. CIBERobn, Instituto Carlos III. Centre Català de la Nutrició - Institut d'Estudis Catalans (Director). Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President). Red Iberoamericana RIBESMET (Director) INC - World Forum for Nutrition Research and Dissemination (Chairman).MedicalResearch.com Interview with:
Prof Jordi Salas-Salvadó
Professor of Nutrition. Human Nutrition Unit (Director)
Department of Biochemistry & Biotechnology, IISPV
School of Medicine. Rovira i Virgili University. Reus, Spain.
CIBERobn, Instituto Carlos III.
Centre Català de la Nutrició – Institut d’Estudis Catalans (Director).
Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President).
Red Iberoamericana RIBESMET (Director)
INC – World Forum for Nutrition Research and Dissemination (Chairman).

MedicalResearch: What are the main findings of the study?

Answer: The main findings of our study are that olive oil consumption, especially the extra-virgin variety (which is the olive oil with the best quality because it has higher amounts of bioactive compounds than other varieties), is associated with a reduced risk of suffering from cardiovascular disease (stroke, myocardial infarction…) and also cardiovascular death in an elderly Mediterranean population from Spain who were at high cardiovascular risk (because they had several cardiovscular risk factors such as smoking, being overweight or obese, having a family history of cardiovascular disease…). We have conducted an observational study including more than 7000 individuals who had participated in a randomized clinical trial  to evaluate effects of a Mediterranean Diet in on the primary prevention of cardiovascular disease.
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Mediterranean Diet in Children Found Protective Against Obesity

Dr Gianluca Tognon University of Gothenburg Gothenburg, SwedenMedicalResearch Interview with:
Dr Gianluca Tognon
University of Gothenburg
Gothenburg, Sweden

MedicalResearch: What are the main findings of the study?

Dr. Tognon: We found that eating a pattern rich in vegetables, fruit, nuts, cereal grains and fish, that we call a Mediterranean-like diet was not only inversely associated to being overweight or obese, but also protective against an increase in body mass index and waist circumference at a 2-year follow up.
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Never Too Late To Switch to a Healthy Mediterranean Diet

Jordi Salas-Salvadó, MD, PhD Human Nutrition Unit, Faculty of Medicine and Healthy Sciences Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, SpainMedicalResearch.com Interview with:
Jordi Salas-Salvadó, MD, PhD
Human Nutrition Unit, Faculty of Medicine and Healthy Sciences
Universitat Rovira i Virgili, C/ Sant Llorenç, 21, 43201 Reus, Spain

MedicalResearch.com: What are the main findings of the study?

Answer: Randomized trials have shown that lifestyle interventions promoting weight loss can reduce the incidence of type-2diabetes, however, whether dietary changes without calorie restriction or increased physical activity also protect from diabetes development has not been evaluated in the past. In our study, we found that a long-term adherence to a high-quality dietary pattern akin to the traditional MedDiet and rich in extra-virgin olive oil was able to reduce the incidence of new cases of diabetes in older individuals at high cardiovascular risk. We have demonstrated for the first time that a beneficial effect on diabetes prevention could be obtained witha healthy dietary pattern (without calorie restriction, increased physical activity or weight loss). These benefits have been observed in participants between 55 to 80 years-old at high cardiovascular risk; therefore,the message is that it is never too late to switch to a healthy diet like the Mediterranean.
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Mediterranean Diet May Be Helpful in Midlife and Beyond

Cécilia Samieri, PhD Institut pour la Santé Publique et le Développement, Case 11, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, FranceMedicalResearch.com Interview with
Cécilia Samieri, PhD
Institut pour la Santé Publique et le Développement, Case 11, Université Bordeaux Segalen, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France


MedicalResearch.com: What are the main findings of the study?

Dr. Samieri: That women with healthier dietary patterns at midlife were 40% more likely to survive age 70 or over free of major chronic diseases and with no impairment in physical function, cognition or mental health.
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