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Mediterranean Diet for Heart Health

| Last Updated on September 14, 2022

If you have ever been curious about following a heart healthy diet, you likely have heard of the Mediterranean Diet (MED). This diet is one of the most popular and well-studied diets around. Let’s go over what the mediterranean diet for heart health is all about.

What is the Mediterranean Diet?

This diet is essentially a representation of eating habits of people living in areas bordering the Mediterranean Sea. The MED focuses on high intake of vegetables, fruit, grains (whole grains mostly), legumes, and healthy fats. The MEDrecommends an intake of fish once per week, drinking wine and eating dairy in moderation, limiting red meat consumption, being physically active, and eating meals with others.

What is the Latest Research on the Mediterranean Diet?

Research continues to show that this diet can be powerful in preventing chronic disease. This includes a seemingly protective effect against cardiovascular disease (CVD), cognitive impairments, and cancer, among other conditions.

Cardiovascular Benefits:

Many studies have found an association between the MED and improved cardiovascular outcomes, but let’s take a look at three recent studies with high enrollment rates and particularly impactful findings:

  • A 2018 study found that better adherence to a MED pattern was significantly associated with lower average triglyceride levels, body mass index, and waist circumference in 6,874 older adults who were overweight or obese and had metabolic syndrome. [1] It also lowered cardiovascular risk factors in women, which is impactful considering that heart disease is the leading cause of death in women in the United States. [1] [2]
  • A study published in 2019 reflects that 12 months of the MED diet in combination with physical activity and behavioral support helped over 600 older participants lose weight, improve circulation, and lower their risk factors for CVD. [3
  • Another 2019 study that found a Mediterranean-style diet improved cardiovascular health in 1,142 participants aged 65 to 79. The results also showed reductions in blood pressure and arterial stiffness. [4]

While research on this diet has consistently found an association between following the MED with reduced risk of CVD-related incidences, some scientists are still calling for more research to more directly link the MED with improved cardiovascular outcomes. [5]

Cognitive Benefits:

The MED has also shown promising results in improving cognitive health. In a large prospective cohort study of over 16,000 adults published in 2021, researchers followed up with participants over 20 years after enrolling them and found those who followed the MED had a 20% lower risk of developing dementia as compared to those who did not [6]. 

Cancer:

Many studies demonstrate a relationship between the MED and reduced cancer risk. 

In one study, nearly 48,000 males living in countries bordering the Mediterranean sea were followed from 1986 to 2010, roughly 45,000 of whom were diagnosed with prostate cancer. Men who followed the MED had significantly lowered risk of incidences of advanced prostate cancer. Deathy due to prostate cancer was 22% less likely among men following the MED[7]. 

Research patterns have emerged in recent years to suggest that the MED may have many impactful positive health outcomes for people of various genders, ethnicities, and weights. There are no magical or secret ingredients in this diet, yet it is still making headlines and scientists continue to study it for its potential benefits against chronic illness. 

We think the MED’s success has to do with a few unique aspects of the Mediterranean diet that honestly, make a lot of sense.

Unique Aspects of the Mediterranean Diet

1. Enjoy Eating with Others

One lesser-known feature of the Mediterranean diet is its emphasis on enjoying meals with others. As a fairly individualistic society here in the U.S., it is relatively common for people to eat alone, during meetings, in their cars, etc. While this may be unavoidable, it means people miss out on the benefits of slowing down and sharing mealtimes with others.

Studies have shown that eating with others not only increases the quality of the meal consumed [8], but that it improves digestion by decreasing stress response.[9] This might be, at least in part, because we are more likely to have a better balance between the sympathetic nervous system (“fight or flight”) and the parasympathetic nervous system (“rest and digest”) when we eat with others. Constant overfiring of the sympathetic nervous system takes a toll [10]. 

Eating with other people can increase food enjoyment and help us connect with others. Mindfulness can be instrumental in helping us enjoy our meals, reduce stress and aid the digestive process. The MED and its recommended meal composition is scientifically sound yet, the fact that it emphasizes eating meals with others speaks to the importance of not only what we eat, but how we eat.

2. Herbs and Spices — The Antioxidant Secret

Another element of the MEDis its emphasis on herbs and spices, meaning moving away from the salt shaker and leaning into more varied and complex flavors. The MED was inspired by specific geographical locations where herbs and spices are key in developing distinct and bright flavors. Common herbs and spices included in the MED are: bay leaves, oregano, mint, allspice, rosemary, turmeric, nutmeg, and thyme. 

Interestingly, these spices are some of the richest antioxidant sources we can eat [11]. Research has shown that antioxidants can protect our bodies from some types of cell damage.The MED is high in antioxidants and has shown to provide this very benefit, reduced risk of chronic disease and reduction in oxidative stress. 

3. Healthy Fats

With a focus on olive oil, olives, nuts, seeds, and fish, the MED is rich in healthy unsaturated fats. The Dietary Guidelines for Americans 2020–2025 recommends limiting saturated fats and instead focus on increasing unsaturated fats.[12]. The importance of the type of fat in this diet can likely explain why the MED has been famously linked to improved cardiovascular outcomes. It is well known that unsaturated fats play a role in lowering LDL (bad) cholesterol and lowering triglyceride levels within the blood [13]. 

There is also evidence that a diet rich in monounsaturated and polyunsaturated fats lowers risk of cardiovascular disease [13]. The MED does not eliminate fats from the diet but rather includes the types of fat that can aid in cardiovascular health.

4. Enjoy Movement Daily

Lastly, but certainly not least, this diet recommends daily physical activity. Daily physical activity plays an important role in our overall health, with research indicating an association between more exercise and lower rates of cardiovascular disease, cancer, Alzheimer’s disease, and more. [14]

Conclusion

The MED is a scientifically supported nutritional powerhouse of a diet. This diet does not contain any hidden secrets or magical ingredients. The combination of eating meals with others, antioxidants, healthy fats, and physical activity may prevent, slow down, or even help manage chronic diseases, especially those that threaten heart health. 

Written by Catalina Ruz Gatica, RD, MS and Kelly Wagner, RD, MS from Nutriving LLC, a virtual private practice for nutrition counseling.

Sources

  1. Álvarez-Álvarez, Ismael, Miguel Á Martínez-González, Ana Sánchez-Tainta, Dolores Corella, Andrés Díaz-López, Montserrat Fitó, Jesús Vioque, et al. 2019. “Adherence to an Energy-Restricted Mediterranean Diet Score and Prevalence of Cardiovascular Risk Factors in the PREDIMED-Plus: A Cross-Sectional Study.” Revista Espanola De Cardiologia (English Ed.) 72 (11): 925–34. https://doi.org/10.1016/j.rec.2018.08.010.
  2. CDC. 2020. “Women and Heart Disease.” Centers for Disease Control and Prevention. January 31, 2020. https://www.cdc.gov/heartdisease/women.htm.
  3. Salas-Salvadó, Jordi, Andrés Díaz-López, Miguel Ruiz-Canela, Josep Basora, Montse Fitó, Dolores Corella, Luís Serra-Majem, et al. 2019. “Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial.” Diabetes Care 42 (5): 777–88. https://doi.org/10.2337/dc18-0836.
  4. Jennings, Amy, Agnes M. Berendsen, Lisette C. P. G. M. de Groot, Edith J. M. Feskens, Anna Brzozowska, Ewa Sicinska, Barbara Pietruszka, et al. 2019. “Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults.” Hypertension (Dallas, Tex.: 1979) 73 (3): 578–86. https://doi.org/10.1161/HYPERTENSIONAHA.118.12259.
  5. Rees, Karen, Andrea Takeda, Nicole Martin, Leila Ellis, Dilini Wijesekara, Abhinav Vepa, Archik Das, Louise Hartley, and Saverio Stranges. 2019. “Mediterranean-Style Diet for the Primary and Secondary Prevention of Cardiovascular Disease.” The Cochrane Database of Systematic Reviews 3 (March): CD009825. https://doi.org/10.1002/14651858.CD009825.pub3.
  6. Andreu-Reinón, María Encarnación, María Dolores Chirlaque, Diana Gavrila, Pilar Amiano, Javier Mar, Mikel Tainta, Eva Ardanaz, et al. 2021. “Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study.” Nutrients 13 (2). https://doi.org/10.3390/nu13020700.
  7. Kenfield, Stacey A., Natalie DuPre, Erin L. Richman, Meir J. Stampfer, June M. Chan, and Edward L. Giovannucci. 2014. “Mediterranean Diet and Prostate Cancer Risk and Mortality in the Health Professionals Follow-up Study.” European Urology 65 (5): 887–94. https://doi.org/10.1016/j.eururo.2013.08.009.
  8. Chae, Wonjeong, Yeong Jun Ju, Jaeyong Shin, Sung-In Jang, and Eun-Cheol Park. 2018. “Association between Eating Behaviour and Diet Quality: Eating Alone vs. Eating with Others.” Nutrition Journal 17 (1): 117. https://doi.org/10.1186/s12937-018-0424-0.
  9. Cherpak, Christine E. 2019. “Mindful Eating: A Review Of How The Stress-Digestion-Mindfulness Triad May Modulate And Improve Gastrointestinal And Digestive Function.” Integrative Medicine (Encinitas, Calif.) 18 (4): 48–53.
  10. Shively, Carol A., Susan E. Appt, Haiying Chen, Stephen M. Day, Brett M. Frye, Hossam A. Shaltout, Marnie G. Silverstein-Metzler, et al. 2020. “Mediterranean Diet, Stress Resilience, and Aging in Nonhuman Primates.” Neurobiology of Stress 13 (November): 100254. https://doi.org/10.1016/j.ynstr.2020.100254.
  11. Carlsen, Monica H., Bente L. Halvorsen, Kari Holte, Siv K. Bøhn, Steinar Dragland, Laura Sampson, Carol Willey, et al. 2010. “The Total Antioxidant Content of More than 3100 Foods, Beverages, Spices, Herbs and Supplements Used Worldwide.” Nutrition Journal 9 (1): 3. https://doi.org/10.1186/1475-2891-9-3.
  12. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pd
  13. Sacks, Frank M., Alice H. Lichtenstein, Jason H.Y. Wu, Lawrence J. Appel, Mark A. Creager, Penny M. Kris-Etherton, Michael Miller, et al. 2017. “Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association.” Circulation 136 (3): e1–23. https://doi.org/10.1161/CIR.0000000000000510.
  14. Lobelo, Felipe, Deborah Rohm Young, Robert Sallis, Michael D. Garber, Sandra A. Billinger, John Duperly, Adrian Hutber, et al. 2018. “Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association.” Circulation 137 (18): e495–522. https://doi.org/10.1161/CIR.0000000000000559.
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