TUESDAY, Sept. 21, 2004 (HealthDayNews) -- A Mediterranean diet, coupled with a few healthy lifestyle habits, can add years to the lives of even the elderly, a new Dutch study finds.

"A Mediterranean diet rich in plant foods in combination with nonsmoking, moderate alcohol consumption, and at least 30 minutes of physical activity per day is associated with a lower mortality rate even in old age," said lead researcher Kim Knoops, a professor of human nutrition at Wageningen University. In the case of this study, the combination of changes led to a 65 percent reduction in overall death rates.

"This supports the hypothesis that subjects with a Mediterranean diet and healthy lifestyle are less likely to die from all causes, and from coronary heart disease, cardiovascular diseases and cancer, even at ages 70 to 90," Knoops added.

Knoops and her colleagues collected data on 1,507 healthy men and 832 women, aged 70 to 90, in 11 European countries from 1988 to 2000. Their findings appear in the Sept. 22/29 issue of the Journal of the American Medical Association.

A Mediterranean diet is one rich in fruits, vegetables, fish, nuts, whole grains, and fats such as olive oil. The diet is low in red meat and dairy products.

"Diet and lifestyle can reduce mortality from cardiovascular diseases, coronary heart diseases and cancer," Knoops stressed.

In another study in the same issue, Italian researchers report that a Mediterranean diet benefits those with metabolic syndrome, which is an early sign of type 2 diabetes and heart disease.

Signs of metabolic syndrome (also known as Syndrome X) include obesity, high blood pressure, high cholesterol, high levels of blood glucose, high blood insulin levels, and high levels of triglycerides.

In addition, the syndrome affects endothelial cells. These cells line blood vessels, and they are important in reducing vascular inflammation, which is believed to lead to cardiovascular disease.

"A Mediterranean-style diet, like that used in our study, reduced the prevalence of the metabolic syndrome by a half," said lead researcher Dr. Dario Giugliano, a professor of metabolic diseases at the Second University of Naples.

In the study, 180 patients with metabolic syndrome were randomly assigned to follow a Mediterranean diet while the other patients followed a prudent diet that included 50 percent to 60 percent carbohydrates, 15 percent to 20 percent proteins, and less than 30 percent fat.

After two years, those following the Mediterranean diet had significant reductions in weight, blood pressure, levels of blood glucose, insulin levels, and cholesterol and triglyceride levels when compared to the group that simply followed a prudent diet. In addition, markers of inflammation were also reduced.

Giugliano's team found that endothelial function also improved for those on the Mediterranean diet, but stayed the same in those on the prudent diet.

Of the 90 people on the Mediterranean diet, 40 still had metabolic syndrome compared with 78 of the 90 patients not on that diet. However, when the components of metabolic syndrome were taken together, there was an overall 50 percent reduction in the syndrome, the researchers reported.

"Metabolic syndrome is a forerunner of type 2 diabetes and cardiovascular disease," Giugliano said. "Patients with the metabolic syndrome -- a quarter of the adult population in the U.S. -- are at high risk for developing type 2 diabetes and for cardiovascular events."

"This study may be particularly important in reducing the incidence of the metabolic syndrome, and hence that of diabetes and cardiovascular risk," Giugliano said. "Eat well and stay well; this is particularly important for those persons who fail to lose weight or increase exercise, which are other means to reduce cardiovascular risk."

The advantage of the Mediterranean diet is that it is not as restrictive as some of the other diets that are out there, said Eric B. Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health.

"It's not the Atkins diet, it's not the Zone, it's relatively close to the South Beach diet, but the Mediterranean diet includes alcohol. I think it's very easy to fit it into a lifestyle in this country," said Rimm.

"I think it's important to pick something you are comfortable with and that you can live with as a lifestyle choice forever -- the Mediterranean diet fits that quite nicely," he said.

"I am amazed at how much chronic disease mortality can be prevented," Rimm said. "There are really some pretty simple lifestyle choices that can be made so people can prolong their life substantially."

Rimm, co-author of an accompanying editorial, pointed out that billions are spent each year on treating people for chronic conditions such as diabetes and heart disease. "This country should wake up and spend a lot more money on training people to live a healthy lifestyle. It could be a substantial benefit for health-care costs as well as for longevity," he said.

More information

The American Heart Association can explain the Mediterranean diet.

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