By Sally Squires
Tuesday, June 3, 2008
Fresh fruit and vegetables, whole grains, fish, olive oil and wine are the makings of a great meal, and they may also be the prescription to help prevent Type 2 diabetes.
A large new study published in the journal BMJ finds that people who adhered closely to a traditional Mediterranean diet, which is also low in meat and dairy products, had "substantial protection" against Type 2 diabetes.
That's good news for those who like to eat flavorful fare, because the Mediterranean menu is widely varied. Its culinary foundation features popular items often demonized in recent years, including nuts, fruit and pasta. Those foods, along with dried beans, olive oil and plenty of vegetables as well as moderate amounts of wine are on the Mediterranean table -- a plus for those who have struggled to adhere to low-fat diets or very-low-carbohydrate Atkins approaches.
"The Mediterranean diet has been around for thousands of years for a good reason," says Michael Ozner, a professor of medicine at the University of Miami and medical director of wellness and prevention at Baptist Hospital of Miami.
"At the end of the day, satiety is what is important."
So, of course, is health. It already appears from a number of major clinical trials that the Mediterranean approach can provide both. Not only does this way of eating help lead to a healthier body weight, but there's strong evidence that it can lower the risk of heart disease, reduce some types of cancer and perhaps even cut the risk of Alzheimer's disease.
How? It seems to produce these benefits by reducing inflammation. This chronic heightened state produces high levels of substances that are known to accelerate aging and contribute to chronic conditions, including arthritis and heart disease.
The newest findings underscore the added possible benefits of a Mediterranean diet's ability to reduce Type 2 diabetes, a disease that is reaching epidemic proportions in the United States and throughout the world. In the District, rates of Type 2 diabetes and gestational diabetes are among the highest in the country.
Previous research had suggested that the Mediterranean diet could help reduce diabetes risk in those who already have health problems, such as heart disease. But this is one of the first studies to look at the effects in healthy people.
In 1999, researchers at the University of Navarra in Pamplona, Spain, began recruiting some 13,000 healthy university graduates, aged 20 to 90, for the study. Participants answered extensive questionnaires about their diet, lifestyle, risk factors and medical status. Follow-up questionnaires were sent twice over the next four years.
The study found that those who most closely adhered to the traditional Mediterranean diet had the lowest risk of developing Type 2 diabetes. This held true even for those who were older, heavier and had a family history of Type 2 diabetes -- all factors that placed them at increased risk for the disorder.
Those findings don't surprise Ozner, who has been prescribing a Mediterranean approach to his patients for years. He regularly gives his patients a set of instructions and recipes to try for a month, and he throws in a $1 bet: If the food doesn't taste as good, takes longer to prepare or costs more than what they have been eating, Ozner pays up.
"Ninety-nine percent of the time, I don't have to pay the bet," says Ozner, who has since compiled his instructions into "The Miami Mediterranean Diet" (Benbella Books, $24.95).
Even so, Ozner is quick to note that the traditional Mediterranean approach doesn't simply mean liberally pouring olive oil on foods and drinking a lot of wine -- common misconceptions. That olive oil adds 120 calories per tablespoon. Wine is beneficial only in moderation, which means one drink a day for women, two for men. (A drink is equal to five ounces of wine, 12 ounces of beer or 1.5 ounces of distilled spirits.)
The traditional Mediterranean diet contains fresh fruit and vegetables, whole-grain cereal, bread and pasta, dried beans, nuts and fish. Olive oil is used for cooking and flavoring rather than butter or oils with unhealthy trans fatty acids. Red meat and dairy products are eaten sparingly. Processed or fast food is not on the menu.
As Ozner says, "Of all the diets that are out there, the Mediterranean diet has been one of the most studied, and it has shown in clinical trials to reduce the risk of heart disease, cancer and overall mortality."
In other words, a delicious way to eat and be healthy.