Amongst all the current controversy surrounding fat intake and heart disease, The Mediterranean diet remains the gold standard for heart health. Dr Aseem Malhotra, leading cardiologist and author of the recent BMJ paper “Saturated fat is not the issue” advocates adopting a Mediterranean diet, claiming that it has shown to be “three times as effective at reducing cardiovascular deaths as [the cholesterol-lowering drugs] statins”. The PREDIMED trial, a five-year study of 7,447 subjects carried out between 2003 and 2011, found that a Mediterranean diet supplemented with extra-virgin oil or nuts reduced the incidence of major cardiovascular events (cardiovascular death, myocardial infarction or stroke) by 30%, compared to a control group following a low-fat diet.
What are the key components of the Mediterranean Diet?
The traditional Mediterranean diet is high in olive oil, fruit, nuts, vegetables and wholegrains, with moderate amounts of fish and poultry, and low amounts of red meat, dairy food and sweet foods. Whilst some experts may now argue, in the light of current research, that the proportion of saturated fat in the form of red meat and dairy could form a larger part of the diet; the principles of the plan remain undisputed. Here we will look at some of the individual components of the Mediterranean diet and their cardio protective properties.
Nuts (walnuts, hazelnuts, pecans, Brazil nuts, almonds, and cashews) – these nutritional powerhouses are chock-full of heart-healthy vitamins and minerals including vitamin E, magnesium and zinc. One of the most important for heart health is magnesium, a mineral that helps maintain muscular function, and regulates blood pressure. Nuts are also a good source of L-arginine, an amino acid used by the body to make nitric oxide, a gas that relaxes blood vessels and supports blood flow. In fact a large study found that individuals who reported eating nuts 5 times per week were 29% less likely to die from heart disease than those who didn’t eat nuts at all.
Wholegrains (brown rice, rye, quinoa, oats) – contain antioxidants, phytoestrogens and phytosterols which are all protective against heart disease. They are also an excellent source of fibre; a Harvard study of female health professionals found those consuming a high-fibre diet had a 40% lower risk of heart disease than those on a low-fibre diet.
Fruit & vegetables– a study in Greece found that individuals eating a Mediterranean diet were found to have generally lower levels of C-reactive protein, fibrinogen and homocysteine compared to those whose diet was less typical for the region. Elevated levels of all of these compounds are markers of poor cardiovascular health. The B vitamins, and in particular folate, play a vital role in keeping homocysteine levels down. Excellent dietary sources of folate include romaine lettuce, spinach, asparagus, parsley, collard greens, broccoli, cauliflower and beetroot. Antioxidants are also of vital importance in keeping levels of these compounds lowered, and can be obtained from eating a wide range of fruit & vegetables. Here the saying “eat a rainbow” holds great significance, as every colour represents a different disease-fighting antioxidant.
Olive Oil –rich in healthy monounsaturated fats and polyphenols, compounds that can dampen inflammation in the body and may reduce the risk of blood clotting. These monosaturates can also be found in avocados and nuts. To get the full health benefits of olive oil, choose cold-pressed extra virgin, and drizzle over salads and vegetables after cooking, as heating the oil can damage some of the good fats.
Fish – a rich source of omega-3 fatty acids which have been shown to improve blood vessel function, decrease risk of blood clotting, lower blood pressure and reduce inflammation. Oily fish (salmon, mackerel, trout and sardines) in particular contain significant amounts of the omega-3 fatty acids DHA and EPA which have shown to be cardio protective.
And finally, the Mediterranean diet recommends a moderate intake of red wine may be beneficial for the heart! Red wine is rich in polyphenols, a type of antioxidant that can help protect blood vessels, lower blood pressure and reduce LDL (bad) cholesterol.
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