地中海式饮食能够预防心血管疾病

Mediterranean-style. Eating Staves Off CVD in Diabetes

Joene Hendry

It's no secret that eating a Mediterranean-style. diet—morefresh vegetables, fruit, and fish, less red meat, and fewerprocessed foods high in sugar and carbohydrates—tendsto result in better cardiovascular health for people in general(DOC News,January 2005, page 16).^1,2Now a new Australian studysuggests it benefits heart health in the high-risk diabetespopulation too.³

The researchers gauged eating patterns among >40,000 Australianmen and women, ages 40–69 years, over 10 years. Questionnaireresponses show that people who ate the most Mediterranean-dietfoods had a 30% decreased risk for cardiovascular mortalitycompared with those who ate the least amount.³Findings alsoreveal that, in a subsample of individuals with diabetes, thosewho ate a predominantly Mediterranean-style. diet had a reducedrisk for ischemic heart disease.³

"Those people in our study with diabetes who most frequentlyconsumed traditional Mediterranean foods had a 79% lower riskof dying from ischemic heart disease compared to those who werein the lowest category," notes lead researcher Linton Harriss,a PhD student in the Department of Epidemiology and PreventiveMedicine at Monash University in Melbourne, Australia.

MEDITERRANEAN DIET CHARACTERISTICS

Compared with traditional Western eating patterns, the Mediterranean patterncomprises higher intake of vegetables, fruits, legumes, nuts,grains, unrefined cereals, breads, olive oil, and garlic; moderatelyhigh intake of fish; and moderate intake of wine consumed primarilywith meals, Harriss says.

This pattern also consists of low-to-moderate intake of low-fatdairy products such as cheese and yogurt and lower intake oflean meats and poultry, compared with Western eating patterns.In Mediterranean-style. diets, healthier fats come mostly frompolyunsaturated oils such as sesame or soy and from nuts andseeds, while olive oil is the primary source of the monounsaturated fats.

A Mediterranean dietary model consists of a wide variety ofhigh-fiber, low-saturated-fats foods—important in managingrisk factors associated with heart disease and diabetes, Harrissnotes.

Harriss and colleagues note a significantly lower ischemic threatamong study participants with diabetes who, over a 10-year period,ate greater amounts of garlic, cucumbers, olive oil, salad greens,capsicum, cooked dried legumes, legume soups, feta and ricottacheeses, olives, steamed fish, and boiled chicken; and infrequentlyconsumed biscuits, cake, cream, sour cream, ice cream, chocolate,sausages, jams, and honey.³

In comparison, research studies on diets that do not correspondto Mediterranean-style. eating have demonstrated very differentresults. They show that women who consume large amounts of softdrinks, refined grains, potatoes, french fries, and processedmeats and who eat lower amounts of cruciferous and yellow vegetables,wine, and coffee are at increased risk for type 2 diabetes.^4,5

CHOOSE WISELY, SEEK VARIETY

Transforming a Western-style. diet into one with Mediterraneanaspects requires improving the quality and portions of the carbohydratesone consumes, notes American Dietetic Association (ADietA) spokespersonLisa Dorfman, MS, RD.

Clinicians can help by advising patients to choose only whole-grainbreads, pasta, and rice and to eat more fish rich in omega 3fatty acids—such as salmon, mackerel, and tuna—aswell as fresh vegetables and fruits. Patients also should limittheir intake of steak.

Dorfman suggests the use of olive oil in lieu of, not in additionto, other fats such as butter and margarine. The combinationof smaller amounts of meat or poultry with larger amounts ofvegetables, beans, and whole-grain pastas, rice, and bread istypical of a Mediterranean eating pattern, notes ADietA spokespersonBonnie Taub-Dix, RD.

Such food combinations, she adds, play an especially importantrole in controlling diabetes. Absorption of a bread or fruitcarbohydrate is mitigated when combined with foods that containprotein, such as cheese or chicken, according to Taub-Dix. Beansare beneficial, says Taub-Dix, because they combine carbohydrateand protein in one nutrient source.

Mediterranean-style. combinations might include:

• Abundant portions of fresh spinach or kale, lightly cooked witholive oil, garlic, onions, and chopped tomatoes, blended withbeans, and sprinkled with fresh lemon juice to maintain colorand add flavor;
  
• Salad greens with cucumbers, mushrooms, onions,tomatoes, slicedyellow peppers, a sprinkling of slivered almonds,feta cheese,and dried fruit or a chopped pear, topped off witha small portionof broiled chicken; and
  
• Yogurt and fresh fruitfor a snack or dessert.
  

Compared with Western-style. pasta dishes, those with a Mediterraneanflair often contain greater amounts of vegetables flavored witha small portion of hard cheese, such as grated Romano, and aminimal portion of meat, poultry, or fish over a moderate servingof pasta.

"Mediterranean dishes include a bouquet of colors," Taub-Dix says.And eating foods in a variety of colors ensures a variety ofnutrients for people who have diabetes, are at cardiovascularrisk, are watching their weight, or are simply trying to stayhealthy.

Footnotes

FYI

The American Diabetes Association offers advice for meal planningand recipe resources for people with diabetes atwww.diabetes.org/nutrition-and-recipes/nutrition/healthyfoodchoices.jsp.

American Dietetic Association nutrition fact sheets on beans,pasta meals, whole grains, and other foods are available atwww.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_350_ENU_HTML.htm.

A Mediterranean diet pyramid can be viewed atwww.oldwayspt.org/med_pyramid.html.

References

1.Estruch R, Martinez-Gonzalez M, Corella D, et al.: Effects of a Mediterranean-style. diet on cardiovascular risk factors: A randomized trial.Ann Intern Med145:1–11, 2006.[Abstract/Free Full Text]

2.Tortosa A, Bes-Rastrollo M, Sanchez-Villegas A, et al.: Mediterranean diet inversely associated with the incidence of metabolic syndrome: The Sun Prospective Cohort.Diabetes Care. Published online athttp://care.diabetesjournals.org/cgi/reprint/dc07-1231v1August 21, 2007, DOI: 10.2337/dc07-1231. Accessed October 15, 2007.

3.Harriss L, English D, Powles J, et al.: Dietary patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study.Am J Clin Nutr86:221–229, 2007.[Abstract/Free Full Text]

4.Schulze M, Hoffmann K, Manson J, et al.: Dietary pattern, inflammation, and incidence of type 2 diabetes in women.Am J Clin Nutr82:675–684, 2005.[Abstract/Free Full Text]

5.Halton T, Willett W, Liu S, et al.: Potato and french fry consumption and risk of type 2 diabetes in women.Am J Clin Nutr83:284–290, 2006.[Abstract/Free Full Text]