Study among nurses links region’s traditional rural diets to lower heart and stroke risks
by Craig Weatherby
The perpetually radiant Sophia Loren—shown here at age 71—may or may not have followed a traditional Mediterranean diet, rich in fish and whole, green fare.
Regardless, today's topic provides a good excuse to present this ageless daughter of Naples as vivacious proof of the benefits claimed for the region's coastal cuisines!
The so-called “Mediterranean Diet” is based on vegetables, fruits, beans, and fish, with modest amounts of whole grains and olive oil and small amounts of meat, poultry, and cheese.
Compared with a typical U.S. diet, the ancestral diets of Italian and Greek coastal regions contain much less refined flour (white bread, pastries, pasta) and red meat, and few processed foods.
American researchers uncovered epidemiological evidence of the diet’s heart-health benefits in the 1960’s, by comparing the diet and health of people living in rural, coastal areas of Italy and Greece—especially Crete and similar Aegean islands—with those of people in several other countries.
Although the traditional Aegean diet differed markedly from diets across the Mediterranean region—with the important exception of reliance on olive oil as the primary cooking fat—the name “Mediterranean diet” stuck.
The Mediterranean diet is easy to follow because its primary foods are accessible and familiar.
Sadly, the standard American diet—low in fruits and vegetables but high in red meat, processed foods, and refined, pro-inflammatory oils, sugars, and flour—is spreading fast worldwide.
New affirmation of the Mediterranean diet’s healthful impacts comes from an analysis of data from the Nurses’ Health Study, which ranks high among the largest and lengthiest looks into the factors that influence women’s health.
Mediterranean diet found highly heart-healthful for women
Started in 1976 and continuing through today, the information provided by the 238,000-plus participating nurses delivers up new insights on health and disease.
Cancer prevention has been a primary focus, but the study has also produced landmark findings about the effects of diet and lifestyle on the risks for cardiovascular disease, diabetes and many other conditions.
Most importantly, these studies have shown that diet, physical activity and other lifestyle factors can promote better health very powerfully.
The new findings from an analysis in which researchers averaged data from six different diet surveys submitted by nurses between 1984 and 2002.
Lead author Teresa Fung, Sc.D., and her colleagues analyzed data on 74,886 women ages 38–63 (in 1984) who participated in the Nurses’ Health Study.
Researchers scored each nurse’s individual diet according to its nutritional similarity to the idealized Mediterranean diet … although the nurses’ specific food choices differed in many ways from those in Aegean Greece of the 1960’s.
The participants’ average scores were then divided into five groups (quintiles) arranged according to their similarity to or distance from the Mediterranean diet.
Fung and her team then compared the heart health status of the nurses in each group… and analysis that yielded two key findings.
First, the women whose diets most closely resembled the idealized “Mediterranean diet” were 29 percent less likely to have been diagnosed with coronary heart disease and 13 percent less likely to have suffered a stroke, compared to those whose diet least matched this diet.
And the women whose diets most closely matched the Mediterranean ideal were 39 percent less likely to have died from coronary heart disease or stroke, compared to the women whose diets least matched the idealized the Mediterranean diet.
As Ms. Fung said, “Those are dramatic results. We found that women whose diets look like the Mediterranean diet are not only less likely to die from heart disease and stroke, but they are less likely to have those diseases” (AHA 2009).
Previous studies have shown an association between the Mediterranean diet and a reduced risk of cardiovascular death in both men and women.
But this is one of the few with enough participants to provide statistically strong results regarding the separate risks of suffering cardiovascular disease or stroke.
What is the Mediterranean Diet?
Reams of research support the idea that such a diet is ideal for optimal health. But it isn’t what most Mediterranean people ate when the term was coined in the 1960’s, and they’re even less likely to follow that diet today.
It was disappointing to see the researchers attributing the cardiovascular benefits of Mediterranean-style diets to the monounsaturated fats that dominate olive oil.
(America’s dominant cooking oils—corn, soy, cottonseed, and regular safflower and sunflower oils—are dominated by omega-6 polyunsaturated fats… only canola oil and peanut oil have lots of monounsaturated fat, though much less than olive oil or macadamia nut oil.)
Strong evidence indicates that the cardiovascular benefits of olive oil rest largely on the super-potent tyrosol-type antioxidants that abound in extra virgin grade olive oil.
These rare antioxidants are less abundant in “virgin” grade olive oil and absent from the cheap, pale, solvent-extracted stuff labeled simply “olive oil.”
For more on this subject, see “Extra Virgin Olive Oil Confirmed as Best Cardiac Prevention Choice” and “Mediterranean Myths: Region's Actual Diets Differ from Ideal... Heart Benefits Stem Largely from EV Olive Oil”
Regardless of the accuracy of calling this diet “Mediterranean,” there’s no doubt that it is healthful for hearts, as one study after another has found.
In fact, the Mediterranean Diet has repeatedly been proved a better heart health ally than the extreme low-fat diets championed by Dean Ornish, M.D. and others (see “Mediterranean Diet Bests Low Fat Rival in Heart Health Face-off”).
As Ms. Fung said, “I think the Mediterranean diet is by far one of the easiest to follow because there are no extremes. It does not require you to cut out something or eat only a few number of foods. The types of food common to the Mediterranean diet are pretty easy to get as well. It has a good amount of plant oils, so you are not cutting out fats. You can eat red meat, beef and pork only once or twice a month, eat fish at least once a week and eat more chicken.”
This will sound like an insult if you read it out loud, but women, like men, should eat like Cretans.
- American Heart Association (AHA). Women on Mediterranean-type diets may lower heart, stroke risk. March 8, 2009. Accessed online at http://americanheart.mediaroom.com/index.php?s=43&item=671
- Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation. 2009 Mar 3;119(8):1093-100. Epub 2009 Feb 16.