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Mediterranean diet may hold a key to longevity
A 'divine mix' of fresh fruits and vegetables, fish, beans, olive oil and wine, combined with moderate exercise, could add years.
By MELISSA HEALY Times staff Writer
Drizzle on the olive oil, uncork a bottle of wine, and hit the cobblestones--you may not only reach old age but extend it longer than most, a pair of European studies has concluded.
The new research represents yet another victory for those espousing a diet rich in vegetables, fruits, beans, fish and olive oil, washed down with a daily glass or two of wine. In one 10-year survey of elderly European men and women, researchers found that those who adhered to a "Mediterranean diet," did not smoke, drank moderately and remained physically active were about half as likely to die during the study period than those whose diets and lifestyles were less healthy.
A second, smaller study found that when patients at risk for developing heart disease and Type 2 diabetes followed a Mediterranean-style diet for two years, they lost more weight and lowered their blood pressure, insulin and glucose levels and "bad" cholesterol--and increased "good" cholesterol--more than a similar group who were put on a low-fat diet.
Study author, Dr. Katherine Esposito of the Second University of Naples, Italy, said the study was the first demonstration that a diet rich in whole grains, fruits, vegetables, legumes, walnuts and olive oil might be effective in warding off diseases of the heart and vascular system. In the United States, where almost a quarter of the population is considered at risk for developing heart disease or diabetes, widespread adoption of a Mediterranean diet could improve health significantly, she and her coauthors surmised.
The studies, which drew together researchers from France, Spain, the Netherlands and Italy, were published in the Sept. 21 issue of the Journal of the American Medical Assn.
In the first study, researchers spent a decade following 2,339 men and women from 11 European countries who were age 70 to 90. The researchers tallied the participants' eating and drinking habits, activity levels and whether they smoked cigarettes, and then recorded who died and of what. Those who received a “lifestyle" score of 4 points ate a diet typical of the Mediterranean region, drank a moderate amount of alcohol daily, either did not smoke or had quit smoking cigarettes at least 15 years earlier, and engaged in at least 30 minutes of physical activity a day. When a study participant fell short on any one of these measures, his or her score would drop a point.
At the end of the study period, about 70% of those with a lifestyle score of 4 were still enjoying La dolce vita. Just over 40% of those with scores between 0 and 1 were still alive.
The Mediterranean diet, typically, is light on meat and dairy products and has higher levels of monounsaturated fats--found in walnuts and olive oil--relative to saturated fat, found in meat and dairy-rich products. A diet typical of the region would also include several servings of fish weekly and would be rich in vegetables and legumes such as chickpeas and lentils. All, of course, taken with a daily glass or two of red wine.
Scientists in recent years have begun to document how several components of a Mediterranean diet might help protect against disease.
Consuming the Omega-3 fatty acids in fish such as tuna, lake trout and salmon several times a week has been found to reduce the likelihood of heart disease, and the minerals and monounsaturated fats in olives and many nuts have been linked to lower levels of cardiovascular disease. Those who eat a diet rich in fresh vegetables--and fresh produce is at the heart of the Mediterranean diet--have a clearly documented lower risk of cancer. And red wine, taken in moderation, is a vasodilator that has been found to reduce the incidence of strokes when drunk regularly.
While anyone of these components might bring some benefit, it is also possible, scientists say, that the elements of a Mediterranean diet may work together to boost health even more. Dimitrios Trichopoulos of Harvard University's School of Public Health, who conducted some of the first research on the life-prolonging effects of the Mediterranean diet, has called the elements of that region's food a "divine mix" that seems to endow its adherents with special protections.
But Alice Lichtenstein, director of Tufts University's cardiovascular nutrition lab, says that physical activity is a key element of that mix, helping to ensure a healthy body weight in spite of a high intake of fat among those whose diets include large amounts of olive oil and nuts.
"It's the whole package, and we need to be thinking of it that way," said Lichtenstein, who chairs the American Heart Assn.'s Nutrition Committee. She added that the combination of diet and exercise that dominates in the Mediterranean region "is essentially the recommendation that the American Heart Assn. has been making for 10 to 15 years."
In the end, the first study found that staying physically active appeared to trump all other factors in its life-prolonging effects. Those who spent 30 minutes or more walking, cycling, gardening or performing vigorous household chores had a 37% lower risk of dying during the 10-year period. A nonsmoking history came in second--it was associated with a 35% lower risk of death.
But simply following a Mediterranean diet and drinking a moderate amount of alcohol had significant benefits on their own; they appeared to lower the risk of death during the study period by 23% and 22%, respectively.
In an accompanying editorial, Harvard School of Public Health professors Eric R. Rimm and Meir Stampfer wrote that the two studies, bolstered by past research, should underscore the urgency of promoting healthy lifestyles as a means of treating heart disease.
"The United States spends billions on chronic disease treatments and interventions for risk factors. Although these are useful and important, a fraction of that investment to promote healthful lifestyles for primary prevention among individuals of all ages would yield greater benefit," the authors wrote.