The Mediterranean Diet - It's Nuts!

Metabolic syndrome is a group of risk factors, including high blood pressure, high blood sugar, high cholesterol levels, and fat in the midsection that increase one's risk of heart disease and diabetes. Diet, exercise, and medications have been shown to improve metabolic syndrome and lower the risk of these complications.

Currently a study called Prevención con Dieta Mediterránea (PREDIMEDD) has enrolled 9000 high-risk participants aged 55 to 80 years who are assigned to one of three interventions: Mediterranean diet with the provision of 1 L/week of virgin olive oil, Mediterranean diet with 30 g/day of mixed nuts, or a low-fat diet. This is a long-term, multi-center, randomized controlled clinical trial is designed to assess the effects of the Mediterranean diet on the primary prevention of cardiovascular disease. (Primary prevention means the prevention of a disease that the person has never had before. Compare this to secondary prevention which means preventing a person who is known to have high cholesterol and blockages in the arteries from having a heart attack).

Already data from 1224 participants in the study have shown that adhering to a Mediterranean diet supplemented with mixed nuts appears to provide benefit to individuals with the metabolic syndrome. Investigators observed a reduced prevalence of metabolic syndrome at one year among individuals adhering to the Mediterranean diet plus mixed nuts compared with those adhering to the traditional Mediterranean diet alone.

"The novelty of our findings is that a positive effect on metabolic syndrome was achieved by diet alone, in the absence of weight loss or increased energy expenditure," wrote lead investigator Dr Jordi Salas-Salvadó (University of Rovira i Virgili, Reus, Spain) and colleagues in the December 8/22, 2008 issue of the Archives of Internal Medicine. At the beginning of this study, nearly 62% of the participants met the criteria for metabolic syndrome. After one year the rate of metabolic syndrome dropped by nearly 13.7% in the patients assigned to the Mediterranean diet plus mixed nuts, 6.7% in those consuming a Mediterranean diet alone, and only 2% among those on the traditional low-fat diet. (Is there anyone left out there who still thinks the ill-advised, poorly researched, low-fat diet benefited anyone but the companies making carbohydrate-rich junk foods?)

The beneficial effects of the diet happened without an increase in exercise habits, calories burned, or weight loss and add to the evidence that diets enriched with nuts do not induce weight gain, noted the authors. This author does note however that the amount of nuts was limited to 30 grams a day, which is one ounce or about 2 tablespoons). The researchers aren't sure yet what caused the improvement, but think that the diet plus mixed-nuts intervention may have positive effects on insulin resistance. Another possibility is the diet's effects on other factors such as oxidative stress and its related inflammation in the blood vessels. Previous analysis of the data have shown that the Mediterranean diet coupled with nuts protects against oxidative damage and reduces cardiovascular risk factors better than a low-fat diet.

Source: Salas-Salvadó J, Fernández-Ballart J, Ros E, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status. Arch Intern Med 2008; 168: 2449-2458.


Take care,

Laurie

Related Topics:

• Metabolic Syndrome? Nuts!
• Go Nuts on Your Diet!

World Diabetes Day

Today is World Diabetes Day (11/14). Stop for a moment and think about these facts:

Every 10 seconds someone dies from diabetes-related complications. In that same time period two new individuals develop the disease.

Over 250 million people in the world have diabetes; in less than 20 years this number will reach 380 million.

More than 200 children develop type 1 diabetes a DAY. This type of diabetes is increasing in preschool children at a rate of 5% annually.

Type 2 diabetes has been reported in children as young as eight. Type 2 diabetes is becoming increasingly common in school-aged children as a result of obesity. Just a generation ago this was a disease of adulthood, called "adult-onset" diabetes.

Even controlling for other risk factors, people living with diabetes are twice as likely as those without diabetes to die from cardiovascular disease (heart attack and stroke).

If you have diabetes or are at risk for developing diabetes, or you are one of us whose lives have somehow been touched by diabetes, take a moment today to talk about diabetes with anyone who'll listen. We need to increase awareness of this disease in the same way that heart disease and breast cancer have been recognized.

For more information: http://www.worlddiabetesday.org/

Related Topics:

• Warning Signs of Diabetes
• Diabetes and Other Risks: Assess Yourself

Something Fishy

Did you know that the American Heart Association recommends adding fish to your diet at least twice a week? The American Diabetes Association recommends 2-3 three ounce servings of fish per week for people with diabetes. Fish is a source of quality protein, vitamins, and minerals, and fatty fish are high in the heart-healthy omega-3 fatty acids known as EPA and DHA. Omega-3 fatty acids (FA's) are known to reduce inflammation in the body; inflammation is now thought to play an important role in the development of heart disease. Omega-3 FA's are also thought to decrease the risk of developing other inflammation-related diseases, such as Alzheimer's and vascular dementia. These fats are thought to be "brain food" for developing children's minds and for maintaining brain health in adults.

A recent study of women who have type 2 diabetes found that higher fish intake was associated with a significant decrease in risk of developing heart disease over a 16 year period of follow up. The fatty fish include salmon, mackerel, and tuna. While other fish such as cod, flounder, talapia, shrimp and shellfish aren't high in omega-3 FA's, they are a great source of protein that is low in calories and fat per 3 ounce serving, as long as it's cooked in heart-healthy ways. These include broiling, baking, steaming, and grilling your seafood choices.

Think you'd like to eat more seafood but don't know where to start? Try WebMD's Health and Cooking Resource page or do a web search for the particular item you want to cook and recipes, such as "cod recipes" or "shrimp recipes" and see what you find. Look for recipes at web sites that are promoting a healthy lifestyle, such as Eating Well and Weight Watchers.

If you are concerned about food safety and our environment as I am, you may be aware of some of the issues that surround the seafood industry, such as over-fishing some species, the loss of fish that are unwanted but are caught in net fishing, and the environmental damage done by some fish-farming methods. If you'd like more information on eating fish in an environmentally friendly way, try these resources at the Monterey Bay Aquarium and the Environmental Defense Fund (EDF). The EDF site also has information about mercury in fish and how to avoid it, and a link to recipes. Both sites have printable pocket guides to assist you in making sustainable choices in the grocery store.

Try some healthy fish soon; your mind, heart, and waistline will thank you for it!

Take care,

Laurie

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• Antioxidants and Omega-3 Fats: Functional Foods to Boost Health
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Blood Test to Detect Heart Disease?

A blood test that may identify those with heart disease is being tested by researchers at Duke University (North Carolina). Based on a set of genetic markers that indicate both the presence and the level of artery blockages, researchers are hopeful that this test will one day replace more expensive and time consuming preliminary testing, such as echocardiogram and exercise stress tests.

If a person having chest pain could be assessed for the presence and degree of coronary artery disease (CAD) based on a blood test, they could proceed directly on to catheterization and either stenting or bypass surgery. This kind of test could be very useful to assess a person acutely having chest pain who presents to the emergency room, or to streamline the assessment of a person at risk for heart disease who presents to their health care provider with symptoms suggesting heart disease.

Currently individuals who are suspected to have CAD undergo other tests first, because they are less invasive and less costly than going directly to catheterization. These tests also limit exposure to x-ray radiation. Insurance companies often require these preliminary tests to "prove" the presence of CAD before proceeding to the cath lab. Unfortunately these tests don't always determine the presence or absence of CAD, resulting in cardiac catheterization anyway. This process is both time consuming for the patient, expensive to our health care system, and allows time for an untoward event to happen.

The researchers report that the current study, published in the journal Circulation: Cardiovascular Genetics, is based on a small number of participants and will need to be verified in a larger number of people before the blood test is approved for use. It is currently undergoing additional trials at 28 sites around the US, with a wide variety of study recipients.

Commenting on the study results, Dr. Sidney Smith, a UNC-Chapel Hill cardiologist, noted, "If these findings hold for this broad group of population, the test could prove to be a valuable supplement in our management and treatment of patients with coronary heart disease."

Dr. Joe Falsone, an invasive cardiologist at Wake Heart & Vascular Associates, called the discovery "potentially exciting news," and said "we could probably use this as a screening tool for patients we thought were at high risk."

For more information about participating in clinical trials at Duke please see "Research at Duke Medicine." ClinicalTrials.gov is a registry of federally and privately supported clinical trials conducted in the United States and around the world.

Take care.

Laurie

Related Topics:

• Answers to 12 Common Questions About Clinical Trials
• WebMD Video: Blood Test for ARVD

Preventing "Brain Drain"

This week I'm thinking about time. It seems to me that my daughter was just born yesterday, yet next week she begins her senior year of high school. Where does the time go?

One thing I notice as I age is that my memory has days where it's not as sharp as it used to be. I resist making lists, because that makes me feel so old, but there are times when I know that my brain is on overload and I just have to do it, or something will be missed. For me these are the times when my life is very hectic, with many projects to be addressed, keeping track of family appointments and obligations, all thrown into a busy summer week of work in the ED. Whew! Makes my brain overwhelmed just thinking about it. These are the weeks when I have to take really good care of myself by getting plenty of rest, eating well, and making those darn lists. I have to admit though, I am less stressed when I have a list to fall back on.

A lot of things affect memory, including poorly controlled blood pressure, which contributes to "hardening of the arteries," (medically called atherosclerotic heart disease," or ASHD). Other causes include poorly controlled diabetes, stress, and certain diseases like dementia. Medications used to treat these health problems and others, such as those for chronic pain, can also cause difficulty with memory.

ASHD and poorly controlled diabetes both affect memory because they decrease circulation to the brain. With loss of circulation comes loss of oxygen and nutrients, and without them we can become forgetful. So if you are having difficulty remembering things start by seeing your health care provider to see if there is a cause for your memory loss that can be fixed. Once any so-called "organic" causes of memory loss are ruled out or corrected, you can try the following ideas to keep your brain sharp.

These suggestions are consistent with the types of successful strategies used in a study of 3,000 adults (average age 73 years), that was recently published in the Journal of The American Medical Association (JAMA). The brain training the study participants received consisted of three types: memory training, such as organizing a grocery list into categories which made it easier for them to remember, reasoning training, such as finding patterns in their daily activities, and speed training, which included quickly naming items as their pictures flashed on a screen.

Even before this study there had been evidence from other research that mental activities such as crossword puzzles and learning a new language helped to keep the brain fit. One small study even suggested that these types of activities might lessen the chance that a person would develop dementia. So here are the ideas, recently found in Diabetes Self-Management (July-August, 2008):

• Keep up your social life by visiting friends, volunteering, or joining a club.


• Keep learning by taking a class (you can audit a college or university class and learn the subject without paying for the class, although you won't get "credit" if you want it), buying a language program, or learning a new game that is challenging, such as bridge.


• Do puzzles, crosswords, Sudoku, or play cards or other games with friends.


• Move it! Exercise helps improve circulation, lowers blood pressure, and lowers blood glucose, which all affect memory.


• Challenge your brain by changing your daily routine, such as exercising before breakfast.


• Eat well: certain foods are good for our health, including the brain. These include the same foods you read about in relation to cardiovascular disease and diabetes prevention: green leafy veggies, blueberries, broccoli and cauliflower, the "good fats" in olive oil, avocados, nuts, and fish, fruit juice, calcium in dairy products, and even alcohol in moderation.

Ok, now off to make my "to do" list for tomorrow and get a bowl of blueberries and yogurt for my declining brain! Take care, Laurie


Related Topics:

• WebMD Video: Dr. Isadore Rosenfeld, MD on Healthy Aging
• 4 Ways to Stop Age-Related Memory Loss