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Mediterranean Diet Extends Lives

Large study confirms benefit of fish, fruit, vegetable-rich regimen

THURSDAY, April 7, 2005 (HealthDay News) -- Older folks who follow a modified Mediterranean diet high in fish, fruit and vegetables tend to live longer.

That's the conclusion of a major study involving almost 75,000 seniors in nine countries. The findings, published online in the British Medical Journal, lend more support to a diet many experts consider one of the healthiest around.

"This is the largest study on the topic of the Mediterranean diet and health, and the results are the most generalizable concerning elderly people, since the study was undertaken in several European populations," said lead author Dr. Dimitrios Trichopoulos, of both the University of Athens Medical School and Harvard School of Public Health, Boston.

He added that "there is not yet sufficient information about the effects of this diet on mortality among younger adults, but it is unlikely that the effects would differ by age."

Evidence has been gathering in support of the Mediterranean diet's health benefits, so the news is not particularly surprising to people in the field.

"All of the research that has been done on this type of diet has been extremely positive. This is nothing new," said Nancy Restuccia, a bariatric dietitian with the Center for Obesity Surgery at New York Presbyterian Hospital/Columbia University Medical Center in New York City. "It's a very, very healthy diet. Unfortunately, even in some of the Mediterranean countries they're moving away from it as our fast foods move into the area."

The traditional Mediterranean diet emphasizes vegetables, legumes, fruits, nuts, cereals and olive oil. It goes light on saturated fats and involves a moderately high intake of fish, a low-to-moderate intake of dairy products, a low intake of meat and poultry and a regular, albeit moderate, intake of alcohol, mostly in the form of wine at meals.

Most of the studies of the Mediterranean diet done thus far have involved only small numbers of people or only individuals from Greece.

The authors of this study wanted to see if the same positive results could be replicated in a more diverse group of people so they modified the diet, using unsaturated fats instead of monounsaturated fats. Unsaturated fats are plant-based fats and include monounsaturated fats which are found in olive oil, seeds and nuts.

They also widened the study population to include almost 75,000 healthy men and women aged 60 and over from nine European countries.

Participants followed the modified diet and their adherence to that diet was measured using a recognized 10-point scale.

Those who followed the diet more closely had a lower overall mortality, the researchers report. A two-point increase on the scale corresponded to an 8 percent reduction in mortality, while a three- or four-point increase was associated with a reduction of 11 percent and 14 percent, respectively.

That means that a healthy 60-year-old man who followed the diet closely would live on about one year longer than a man of the same age who did not adhere to the diet.

The association between diet and mortality was strongest in Greece and Spain, probably because, in these countries, the diet is "genuinely" a Mediterranean diet, the authors stated. The authors also noted that most of the deaths in Italy occurred in the northern part of the country, "where the diet cannot be considered as Mediterranean."

It was not clear from this study whether monounsaturated fats from olive oil or specific categories of polyunsaturated fats were more beneficial.

Restuccia treats patients who have undergone surgery for obesity and therefore have different dietary requirements. Nevertheless, she does suggest they snack on nuts and to eat plenty of fruits and vegetables. If they're eating starches, she recommends whole grains such as brown rice, whole-wheat bread and cooked oatmeal as opposed to instant oatmeal, all of which is in line with a Mediterranean diet.

New dietary guidelines in the United States recommend nine servings of fruits and vegetables, which, again, would fit with the Mediterranean diet. "That tells you something right there," Restuccia said. "When you read the research throughout the years, it's definitely the way to go."

Exercise, too, is part of the equation, she pointed out: "Mediterranean countries are more active than we are."

More information

The American Heart Association can explain the Mediterranean diet.

SOURCES: Dimitrios Trichopoulos, M.D., Ph.D., professor, hygiene and epidemiology, University of Athens Medical School, Greece, and professor, cancer prevention and epidemiology, Harvard School of Public Health, Boston; Nancy Restuccia, M.S., R.D., bariatric dietician, Center for Obesity Surgery, New York Presbyterian Hospital/Columbia University Medical Center, New York City; April 9, 2005, British Medical Journal
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