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Mortality Due to Cardiovascular Diseases – Is Mediterranean Diet Helpful?

Submitted by on January 30, 2014 – 9:29 AM

med-dietCardiovascular diseases (CVDs) are the first major cause of death globally. According to World Health Organization, in 2008, 17.3 million people died of CVDs, representing about 30% of all the deaths occurring in the world [1].  In spite of being such a fatal disease, with proper approach, its risk factors can be controlled and mortality reduced. A number of measures have been reported for this healthy purpose.

 

The first is of course to reduce the severity of hypertension, diabetes and hypercholesterolemia, and second is to adopt measures which will help reduce these, including cessation of smoking, cutting down obesity and alcohol, increasing physical activity and living a relaxed life without stress [2]. All these strategies go hand in hand to achieve the desired goal.
Red meat has been linked to produce an additive effect in causing cardiac diseases. Likewise, reduction in its consumption is associated with decrement in the mortality due to CVDs [3].

 

In this regard, Mediterranean Diet (MD) is found to be a very healthy diet. It includes high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of meat and meat products. It is low in saturated fats but contains large amount of monounsaturated fats and dietary fibers. Salt content is also higher, due to products like olives, cheese, anchovies, etc.

 

Olive oil is the main constituent behind all the healthy advantages of MD. The high levels of monounsaturated fats and antioxidants in olive oil help to regulate cholesterol levels and prevent hypertension, inflammation and heart diseases. [4].

 

Scientists have come across gains in terms of reducing mortality due to CVDs in MD. A study published in New England Journal of Medicine claimed that MD is helpful in reducing the risks and mortality due to CVDs. They tested the efficacy of two MD, one supplemented with extra virgin olive oil and the other with nuts, in control with a low fat non-MD. Drug therapy was similar in all the three groups, and none had caloric restriction or advocacy of physical activity.

 

The outcome was a reduction in fatality due to CVDs in MD groups, which is attributed more to the beneficial effects of olive oil and nuts that produce favorable changes in the metabolism of cardiovascular risk factors [5].
The findings of this study were consistent with the results of Women’s Health Initiative Dietary Modification Trial. This dietary trial studied the effect of a low-fat, high fruit, vegetable and grain diet on breast cancer, colorectal cancer and heart diseases in postmenopausal women [6]. A study conducted on Women’s Health Initiative Randomized Controlled Dietary Modification Trial showed only a modest reduction in the mortality due to CVDs after reducing the fat diet, suggesting that reduction in fat intake is not significantly associated with the risk of CVDs [7].

 

The beneficial effects of MD are not only limited to CVDs. A number of studies have shown it to be equally effective in maintaining neurological, general and cardiovascular health. A study published in British Medical Journal showed reduction in the risk of developing type 2 diabetes following MD [8].  MD is also helpful in reducing weight, more so than a low-fat diet. This was demonstrated by a study published in 2008 in New England Journal of Medicine [9]. MD is also profitable as it helps to reduce general mortality (9%), incidence and mortality of cancer (6%) and Parkinson and Alzheimer disease (13%) [10].

 

MD has proved its worth through its numerous benefits. There is a need to employ it more and more in our dietary habits to enjoy its full effects. Of course, regional differences are present and they will need to be addressed as well. It can be anticipated that in near future, due to the vast majority of its benefits, MD will be prescribed more often to combat against heart diseases and other disorders.

 
References:
1.      Cardiovascular Diseases, Key Facts.  March 2013. http://www.who.int/mediacentre/factsheets/fs317/en/index.html
2.      Cardiovascular Disease. January, 2014. http://en.wikipedia.org/wiki/Cardiovascular_disease
3.      Pan A, Sun Q, Bernstein AM, Schulze MB, Manson JE, Stampfer MJ, Willett WC, Hu FB. Red meat consumption and mortality: results from 2 prospective cohort studies. Arch Intern Med. 2012 Apr 9;172(7):555-63.
4.      Mediterranean Diet, Wikipedia. January, 2014. http://en.wikipedia.org/wiki/Mediterranean_diet
5.      Estruch R, Ros E, Salvadó JS, Covas MI, Corella D, Arós F, Gracia EG, Gutiérrez VR, Fiol M, Lapetra J, Raventos RML, Majem LS, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, González MAM. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. N Engl J Med 2013; 368:1279-1290.
6.      WHI Clinical Trial/Observational Study Locations. Sept. 21st, 2010. http://www.nhlbi.nih.gov/whi/diet.htm
7.      Howard BV; Horn LV; Hsia J; Manson JE; Stefanick ML; Smoller SW; Kuller LH; LaCroix AZ; Langer RD; Lasser NL; Lewis CE; Limacher MC; Margolis KL; Mysiw WJ; Ockene JK; Parker LM; Perri MG; Phillips L; Prentice RL; Robbins J; Rossouw JE; Sarto GE; Schatz IJ; Snetselaar LG; Stevens VJ; Tinker LF; Trevisan M; Vitolins MZ; Anderson GL; Assaf AR; Bassford T; Beresford SAA; Black HR; Brunner RL; Brzyski RG; Caan B; Chlebowski RT; Gass M; Granek I; Greenland P; Hays J; Heber D; Heiss G; Hendrix SL; Hubbell A; Johnson KC; Kotchen JM. Low-Fat Dietary Pattern and Risk of Cardiovascular DiseaseThe Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295(6):655-666.
8.      González MAM; Arrillaga CF; Cordoba JMN; Gortari FJB;  Beunza JJ; Vazquez Z; Benito S; Tortosa A; Rastrollo MB. Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ. 2008 June 14; 336(7657): 1348–1351.
9.      Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ; Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008 Jul 17;359(3):229-41.
10.     Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344.
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