Mediterranean diet may also benefit your brain, not just your heart

After last year’s widely reported finding that the Mediterranean Diet (fish, poultry, olive oil, fruits, nuts and whole grains, with little meat and dairy) indeed benefits cardiovascular health, now here’s a new study, published in the April 30, 2013 issue of the journal Neurology, and taken up by our hometown newspaper the New York Times, in their online blog “Well”:

Researchers prospectively followed 17,478 mentally healthy men and women 45 and older, gathering data on diet from food questionnaires, and testing mental function with a well-validated six-item screening tool. They ranked their adherence to the Mediterranean diet on a 10-point scale, dividing the group into low adherence and high adherence. […]
During a four-year follow-up, 1,248 people became cognitively impaired. But those with high adherence to the diet were 19 percent less likely to be among them. This association persisted even after controlling for almost two dozen demographic, environmental and vascular risk factors, and held true for both African-Americans and whites.

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Diet and depression — a follow-up note

In the Summer 2009 SUPPLEMENT, our feature story was entitled “Are You Ready to Join the Food Revolution?” The article referred to recent research highlighting a relationship between traditional diets, such as the Mediterranean or Chinese diet, and lower risk of certain cancers, heart disease, and even depression. So we were interested to read in our hometown newspaper The New York Times about a new report of findings about the health benefits of the Mediterranean diet. A large-scale epidemiological study in Spain again showed an association between the traditional Mediterranean diet and lower rates of mental health conditions like depression. Very interesting as well is this line of thinking from one of the researchers about why this diet should be linked to lower risk of both cardiovascular disease and depression:

Both cardiovascular disease and depression share “common mechanisms related to endothelium function and inflammation,” said Dr. Miguel Angel Martinez-Gonzalez, professor of preventive medicine at University of Navarra in Pamplona, Spain, and senior author of the paper, published in the October issue of Archives of General Psychiatry.

“The membranes of our neurons are composed of fat, so the quality of fat that you are eating definitely has an influence on the quality of the neuron membranes, and the body’s synthesis of neurotransmitters is dependent on the vitamins you’re eating,” Dr. Martinez-Gonzalez added. “We think those with lowest adherence to the Mediterranean dietary plan have a deficiency of essential nutrients.”

The elements of the diet most closely linked to a lower risk of depression were fruits and nuts, legumes and a high ratio of monounsaturated to saturated fats, the study found.

From:

http://www.nytimes.com/2009/10/13/health/research/13nutrition.html?scp=1&sq=Mediterranean%20diet&st=cse

ARE YOU READY TO JOIN THE FOOD REVOLUTION?

 Maybe it was the glory of our neighborhood community garden in June that inspired us to write this piece for the next issue of the New York Buyers’ Club newsletter, THE SUPPLEMENT:

 

Is it just our imagination, or have we detected a growing public interest in the impact of food on our health? Maybe you’ve heard about our new first family, the Obamas, and the vegetable garden they’ve planted at the White House to supply their kitchen with locally grown, healthy vegetables and berries. Or—not such cheerful news–maybe you’ve read about the obesity epidemic sweeping the US, caused largely by mass consumption of fast food and highly processed food products, and linked to devastating increases in diabetes and cardiovascular disease across the population. Or maybe you’ve dipped (or dug) into the writings of food revolutionary Michael Pollan, who’s become celebrated for urging us to eat real food (like our great-great-grandparents ate), shun the supermarket and shop the greenmarket whenever possible, and even plant a garden.

Though the New York Buyers’ Club is a nutritional supplements co-op, we understand very well that food is first. The food we eat every day, what kind and how much, has an enormous impact on our health, and research on diet has brought to light ever more clearly the effects of nutrition on both our physical health and our mental well-being. A few things have been obvious for a while: traditional diets, such as the “Mediterranean diet” or the “Chinese diet,” are much better for you than the standard modern American diet with its refined carbohydrates, bad fats (saturated or trans), excessive salt, super-sized portions of red meat, and mighty rivers of high fructose corn syrup. It’s simple epidemiology: populations that eat lots of whole grains, fruits, nuts, vegetables, moderate amounts of fish and poultry (and little red meat), and rely on traditional seasonings (from rosemary to turmeric) and good fats (like olive and fish oils) end up having significantly lower rates of heart disease, cancer, and even mental health conditions like depression.

Can the clear health benefits of traditional diets be translated in any useful way to the field of supplements? (Supplements are, to repeat, a supplement to food, not a replacement.) One obvious “yes” comes in the increased study and use of fish oil/omega-3 fatty acid supplements over the last few decades, first of all for cardiovascular health, but also—as has been highlighted more recently—to reduce susceptibility to depression, bipolar disorder and schizophrenia. Here’s a case in which an individual nutrient within a healthful diet has been isolated and can be delivered as a supplement that bestows health benefits. (Fish oil supplements have a particular advantage over food sources, too: they can be refined to eliminate mercury or other contamination, a growing concern these days, whether you’re eating fresh or canned fish.)

We also know that it’s possible to extract a component from food and use its particular properties to confer a health benefit, while leaving behind other parts that you don’t want or need. This is the case with whey protein powders, which leave behind milk fat, but keep the whey protein with its high nutritional value.  It’s not news that whey protein can help to build and sustain the body’s lean muscle mass (crucial for maintaining long-term health, and especially important for people with chronic conditions like HIV that may impair absorption of nutrients), but research has uncovered as well several important indications of its value in supporting immune function, decreasing the risk of cardiovascular disease, and even serving as an anti-cancer agent.

Foods found in traditional diets continue to be the focus of scientific research on what’s healthy in what we eat, and why. Recently, we looked into a study showing that Chinese women who regularly ate mushrooms and drank green tea had lower rates of breast cancer, or less severe manifestations of breast cancer, than those who didn’t. This kind of nutrition research is about putting two and two together. It was known that the rate of breast cancer in China is four to five times lower than that in most Western industrialized countries; and there had been previous lab studies suggesting the anti-cancer properties of green tea and mushrooms—so why not investigate more rigorously the relationship between breast cancer rates and consumption of these traditional foods?

And here’s another bit of evidence-based food advice. A few months ago our hometown newspaper, The New York Times, featured a piece entitled “The Power of Berries” (Jan. 22, 2009), which detailed the accumulating research on how these fruits help ward off cancers of the colon, esophagus, and mouth. This research built on the well-documented association between diets rich in berries (including black and red raspberries, blackberries, strawberries and elderberries) and lower rates of cancer. One new suggestion emerging from the recent studies is that berries may exert a “genome-wide” anti-cancer effect, meaning that, unlike many current cancer treatments that target only one cancer-promoting gene at a time, berries may target a whole spectrum of cancer-promoting genes, causing them to shut down development of pre-cancerous and cancerous growths. Exciting stuff from the berry researchers! And, there’s a further, practical note: investigations have demonstrated that freeze dried berries and berry powders are as effective as fresh fruit in terms of anti-cancer effect. So even if you can’t eat fresh berries several times a week (an obvious problem for those of us who don’t live where the growing season is year-round), mixing a powdered berry supplement into a smoothie could be just as useful to your health. 

We gave this piece a somewhat tongue-in-cheek title, asking if you, dear reader, were ready to join the “food revolution.” Actually, it strikes us that the current revolution in thinking about our eating habits in many ways involves returning to the old days—to the traditional diets of previous generations, to the old-fashioned idea of raising your own food, or to shopping for locally-grown produce at a greenmarket. Of course we return to these older ways armed with a store of advanced knowledge about why some dietary traditions are healthful, and how they can be adapted to our modern lives. If that’s the definition of the “food revolution,” we at NYBC heartily encourage you to sign up—for your health!

Time to throw out the supplements? Comments on The New York Times article: “Vitamin Pills: A False Hope?”

Several people have asked us to comment on recent news stories about research showing that taking vitamin pills has little if any health benefit, and in fact may be harmful in certain instances (such as for people with a cancer diagnosis). A representative article in this vein is the New York Times piece “Vitamin Pills: A False Hope?” by Tara Parker-Pope, published Feb. 16, 2009, and accessed by us online at http://www.nytimes.com/2009/02/17/health/17well.html.

Here’s our commentary, which takes its start from a key passage in the article:

NYT: In any event, most major vitamin studies in recent years have focused not on deficiencies but on whether high doses of vitamins can prevent or treat a host of chronic illnesses. While people who eat lots of nutrient-rich fruits and vegetables have long been known to have lower rates of heart disease and cancer, it hasn’t been clear whether ingesting high doses of those same nutrients in pill form results in a similar benefit.

NYBC BLOG: 1. In fact, most of the studies making news are surveys of people with no known vitamin deficiency and no evident health problem. The studies cited generally found that there was no improvement in rates of disease development over time (heart disease and cancers, primarily) for people taking the vitamins, as opposed to those who didn’t. On the other hand, NYBC’s interest has focused on the detection of vitamin deficiencies in people with chronic illnesses such as HIV, and then targeted supplementation and its results. For example, supplementation with Vitamin D (plus calcium) in people that are deficient has been found to have benefit, both for bone health and for reduction of cardiovascular disease risk (and, according to more recent research, for cancer risk as well). The same goes for supplementation with people deficient in minerals; in a well-known study, University of Miami researchers identified selenium deficiency in people with HIV, and also found that supplementing with this mineral improved health in this group. More generally, many vitamin and other nutrient deficiencies have been detected in people with HIV, and there have been many studies showing health benefits from supplementing to counteract these deficiencies. So, in conclusion, we are not terribly surprised if people with no known vitamin deficiencies and no known health problems are found not to gain much, if any, health benefit from taking vitamins–but that’s really a different question from those (many) studies showing that specific deficiencies and their related disease states can often be successfully addressed by supplementation.

2. Regarding vitamins and cancer: we certainly recommend caution here, and have frequently referred people to the Memorial-Sloan Kettering Cancer Center website on complementary medicine for guidance. Studies have indicated that vitamin supplementation (with C, for example) can accelerate certain cancers. However, as the MSKCC website shows, there is wide interest in, and much evidence for, use of certain dietary supplements as adjuncts in cancer therapy. The world of dietary supplements is much bigger than just the short list of vitamins; and research on supplements and cancer is a major topic among projects funded by such sources as the federal government’s National Center for Complementary and Alternative Medicine. Indeed cancer research has focused quite often on the therapeutic potential of botanical sources. The cancer drug paclitaxel, to give just one example, derives from the yew tree; and many traditional botanicals continue to be studied for their anti-cancer properties: turmeric/curcumin, green tea (with its polyphenols), silymarin, astragalus, to name just a few.

3. While the vitamin studies reported in the NYT article are negative, no one disputes the fact that nutrition has an enormous impact on health. In fact, the New York Times also recently ran articles reiterating the substantial health benefits of the “Mediterranean diet” (good fats like olive oil rather than bad fats; fish rather than meat; carbs from beans, peas, lentils; more veggies than meats), which has been associated with lower risk of heart disease and–in a newer area for research–a lower risk of depression and other mental health disorders. So, can the clear health benefits of a particular diet be translated in any useful way to the field of supplements? One obvious “yes” comes in the increased study and use of fish oil/omega-3 fatty acid supplements over the last few decades. Here’s a case in which an individual nutrient within a healthful diet has been isolated and can be usefully delivered as a supplement that bestows health benefits. (Fish oil supplements have a particular advantage over food sources, too: they can be refined to eliminate mercury contamination, a growing concern these days, whether you are eating fresh or canned fish.) We certainly know that it is possible to extract a component from food and use its particular properties to confer a health benefit, while leaving behind some other parts of the food that we don’t want or need. (This is the case with whey protein powders, which leave behind milk fat, but keep the whey protein with its interesting nutritional benefits.)There may also be increasing recognition that effective supplementation can require a wide-spectrum approach. Instead of emphasis on single vitamins, we’ve known for a while that the B vitamins work together and are usually best taken as a complex; or that a complex of carotenoids from vegetable sources is probably better than just a few select samples of these compounds. Of course, we would like to have more research about the particular value conferred by “food-based” supplements such as the popular “green foods.” In short: do choose a good diet to stay healthy, but don’t throw out the supplements, which can also make their contribution to your health and well-being!

“Good Fats/Bad Fats”: new dietary recommendations for supporting heart health and reducing cardiovascular risk

We were interested to read the Personal Health column by Jane Brody in the New York Times earlier this month. The article was entitled New Thinking About How to Protect the Heart, but you might also give this advice column on cardiovascular health the title of “Good Fats/Bad Fats.”

The main reason for revisiting diet recommendations for people trying to reduce their risk of heart attack is a new focus on the importance of inflammation in assessing cardiovascular risk. It’s been found, for example, that even people with normal cholesterol levels have a heightened risk of heart attack if they have a high reading of C-reactive protein (CRP), a marker of inflammation that correlates with clots that block blood flow to the heart.

So, if it’s not just cholesterol levels that people should be watching in order to minimize cardiovascular risk, what kind of diet should they be following to support a healthy heart? The short answer is not entirely new: it’s the Mediterranean diet, which actually turns out to be quite high in fats–think olive oil, oily fish, nuts, seeds and certain vegetables. It’s just that these are sources of “good fats”–not the heart-unfriendly saturated fats (=solid at room temperature) derived from red meats and cheese. And guess what? These “good fats” are found not only to lower cholesterol ratios, but also to decrease inflammation levels.

Recent studies, from the last 10 years or so, are pretty clear in showing the value of the Mediterranean diet, which is not only tasty and easy to follow for most people, but also appears to reduce the rates of heart disease recurrence and cardiac death by 50 to 70%.

As cardiovascular research sorted out the role of inflammation markers and the good fat/bad fat distinction, there also emerged a better understanding of the potential of supplements to maintain heart health. Fish oil, with its heart-healthy omega-3 fatty acids, is now widely recognized as a useful supplement for reducing cardiovascular risk. Other supplements, which incorporate elements of the Mediterranenan diet (such as olives), have also become available.

Here are a few entries from the NYBC catalog that are of special interest for this discussion:

Fatty Acids (see especially MaxDHA, and the ProOmega fish oil supplements)

C-1000 Ascorbic Acid plus Olea Fruit Extract This Vitamin C supplement from Jarrow has been enriched with an olive extract in a combination designed to support cardiovascular health.