The Secret Behind the Mediterranean Diet’s BenefitsNovember 2017
By Michael Downey
Abundant research continues to reveal the longevity benefits of the Mediterranean diet. But we never knew the main factor behind the diet’s remarkable effects…until now.
Research has revealed that the polyphenols (a plant-based compound) found in the Mediterranean diet may be responsible for its ability to reduce mortality risk.1-3
This is the diet’s prime weapon driving its capacity to lower risks of heart attack, stroke, high blood pressure, and inflammatory markers.2-4
In a just-published study, researchers found that those eating a Mediterranean diet experienced about a 60% reduction in cardiovascular risk.5
Most people fail to obtain sufficient polyphenols on a daily basis. A recent study recommended that people should ideally eat 10 servings of fruit and vegetables every day to reduce disease risk.6 For most people this is nearly impossible.
Using a water-based technology, researchers have found a way to naturally extract an array of polyphenols from Mediterranean food sources such as walnuts, artichokes, lentils, grapes, pomegranates, olives, and more.
Health and Longevity Effects
The Mediterranean diet is rich in fresh fruits and vegetables, whole grains, nuts, legumes, fish, wine, olive oil, and lean meat. Its overall longevity benefits have been well-documented in published studies.
Research has shown that following this diet is specifically associated with improvements in blood pressure, insulin sensitivity, lipid and lipoprotein profiles, inflammation, oxidative stress, and carotid atherosclerosis.7,8
In fact, not only has the Mediterranean diet been linked in epidemiological research to a remarkable 37% reduction in mortality among cardiovascular-disease patients9—but scientists have also demonstrated in a controlled clinical trial that this diet reduces mortality as a direct intervention.4 Even greater reductions in heart disease and stroke risk of about 60% were recently discovered by Italian scientists.5
The benefits of the Mediterranean Diet have been of great interest to scientists for years, and recent research is confirming that, with its impressive content of polyphenols, it can reduce mortality.
Human Studies on Heart-Disease Reduction
Last year at the European Society of Cardiology Congress, a study was presented that analyzed the survival rates for cardiovascular disease patients who followed the Mediterranean Diet. The study lasted over seven years and showed that people who ate the Mediterranean Diet died 37% less than those who ate a non-Mediterranean Diet.9
In many ways, following the Mediterranean Diet provides more protection against heart disease than many of today’s prescription drugs.10
In one study, investigators wanted to evaluate the impact of the diet on blood pressure in the elderly, a high-risk population for heart disease and stroke.
During this year-long study, patients were provided with a choice of two slightly different versions of the Mediterranean diet or a low-fat diet. One was the typical Mediterranean diet with added extra-virgin olive oil and the other, a typical Mediterranean diet with added nuts. It is important to note that both of these diets were rich in healthy fats as opposed to the low-fat diet eaten by the control group.3
After one year, both of the Mediterranean diets (with added olive oil or added nuts) led to reductions in diastolic and systolic blood pressure. Interestingly, what the scientists found in the Mediterranean diet group were increased levels of polyphenols being excreted in the urine and increased production levels of nitric oxide, the body’s natural blood-vessel relaxant and a biomarker of good cardiovascular function and healthy aging.11 The implication was that the rich supply of polyphenols in this diet stimulated the body’s natural defense mechanisms against high blood pressure.3
In a larger follow-up substudy published in 2017, researchers analyzed 1,139 participants at high risk for cardiovascular disease on the two Mediterranean diets (with added olive oil or nuts) or the control low-fat diet to determine if polyphenol levels were associated with inflammatory markers.2 Chronic inflammation is a recognized fundamental contributor to cardiovascular disease, and polyphenols are known anti-inflammatory agents.
After one year, participants who followed either of the two Mediterranean diets showed the greatest increase in urinary polyphenols vs those who ate the low-fat diet.
In a vivid illustration of the impact that increased polyphenols have on reducing inflammation, the Mediterranean diet groups not only had increased urinary polyphenols but also had significantly lower levels of five important markers of inflammation that correlate with cardiovascular risk. These include:2
- Vascular cell adhesion molecule-1 (VCAM-1),
- Intercellular adhesion molecule-1 (ICAM-1),
- Interleukin-6 (IL-6),
- Tumor necrosis factor alpha (TNF-alpha), and
- Monocyte chemotactic protein-1 (MCP-1).
The people who experienced the greatest rise in polyphenol levels were shown to have significantly lower systolic and diastolic blood pressure, as well as increased levels of beneficial HDL cholesterol, compared to those with the lowest polyphenol elevations.2
Reduction in Brain Shrinkage
In a 2017 study published in the journal Neurology, researchers demonstrated that individuals who closely followed the Mediterranean diet experienced half as much age-related brain shrinkage as those who were less faithful to the diet.12
But aside from recognizing the role of the Mediterranean diet, the exact details of the underlying secret behind the diet’s benefits had never been established. Finally, scientists have found strong evidence that the credit goes to the specific polyphenols abundantly found in the key foods.
The takeaway from these studies? The diverse array of polyphenols in the specific foods of the Mediterranean diet constitute what is very likely one of the most important factors behind its protection against catastrophic heart disease, stroke, brain shrinkage, and cardiovascular-related mortality.1-3,7,8,12
Intense Bioactivity of Polyphenols
Consuming the foods in the Mediterranean diet—including fruits, olive oil, nuts, legumes, and vegetables—delivers a potent arsenal of polyphenols. Polyphenols play critical roles in neutralizing free radicals, anti-inflammation, and cell signaling, and they have been associated with a reduced risk of many of the same diseases as the Mediterranean diet itself.7
When the diverse polyphenols arrive in the colon, bacteria break them down into smaller molecules, notably phenols.7 These phenols (and other polyphenol-derived molecules) are then carried to the liver, where they are further transformed before being released into the circulation for transport to specific tissues that greatly benefit from their bioactive effects.7
For example, one of these phenols, resulting from the breakdown of polyphenols in the colon, travels to the liver. There it can act on various bone-marrow progenitor cells that circulate to tissues throughout the body, where they signal for new cell and tissue generation, particularly turning on bone-cell lines and turning off fat-cell lines.7
This body-wide bioactivity explains a compelling study conducted on 807 men and women aged 65 and over that was published in The Journal of Nutrition. Those in the highest third of total urinary polyphenols (which reflect circulating levels of polyphenols in the blood) had a 30% lower all-cause mortality over the 12-year follow up, compared with those in the lowest third.1
Harnessing the full power of the Mediterranean diet requires including sufficient amounts of the broad assortment of its key polyphenol-rich foods. Fortunately, an exciting new option is available.
Meeting the Polyphenol Targets of the Mediterranean Diet
Data shows that achieving the longevity benefits of the Mediterranean diet may require eating ten servings of fruits and vegetables a day.6 For most people this is a major challenge and may hinder their chances of receiving all the longevity benefits associated with this diet.
However, an innovative water-based process has been developed that safely extracts high quality polyphenols from a number of Mediterranean foods.
After pressurization, water can more powerfully break down plant-cell walls and solubilize bioactive compounds, which substantially enhances extraction. By lowering its polarity, this unique technology causes the water to create purified and potent phytonutrient extracts.
This process is then combined with a method that preserves the bioactive compounds by removing water through evaporation. The result is a highly concentrated extract, free of solvents and containing bioactives previously considered unrecoverable.
Using this process, scientists have concentrated a wide array of polyphenols extracted from seven of the most polyphenol-rich foods in the Mediterranean diet.
Let’s examine each of these extracts separately.
Polyphenol Extracts of Mediterranean Foods
Research documents that 87% of Americans fail to get the recommended intake of vegetables,13 76% fall short on fruit intake,13 and most do not consume sufficient legumes and nuts.14,15
The following extracts support the Mediterranean diet’s capacity to block insulin insensitivity, oxidative stress, inflammation, brain shrinkage, and especially reduce cardiovascular disease—and to lower all-cause mortality.1-4,7,9,12
Loaded with polyphenols, grape-seed extracts reduce oxidized LDL cholesterol (an early atherosclerosis trigger) and prevent oxidized LDL from binding to its receptor on endothelial cells, a highly vascular-protective effect.16,17 They prevent the death of cardiac muscle cells18 and activate eNOS (the enzyme responsible for producing nitric oxide).19,20
Critically, grape-seed extracts also prevent low-grade inflammation—a key contributor to atherosclerosis and cardiovascular risk—by inhibiting the production of inflammatory signaling molecules (cytokines).21
Olives are central to the Mediterranean diet. Polyphenol extracts of the leaf of the olive have been shown to powerfully protect cultured heart muscle cells from destruction caused by intense oxidative damage.22 They decrease oxidative-stress-induced tissue damage and boost intracellular resistance systems.23
In a rat model of metabolic syndrome, these extracts improved or normalized abdominal- and liver-fat accumulation, excessive collagen deposition in the heart and liver, cardiac stiffness, poor glucose tolerance, and abnormal lipid profiles.24
The various anti-inflammatory effects of pomegranate peel extracts are particularly beneficial for people at risk for cardiovascular disease.25
For example, these extracts increase resistance to oxidative stress in animals with high cholesterol.26,27 They have been found to reduce the accumulation of oxidized LDL cholesterol in the foam cells found in the earliest stages of atherosclerosis, shrinking plaque size by up to 39%.28 And impressive studies show that pomegranate extracts reduce the overall cholesterol burden by promoting cholesterol flow out of these cells by 147%.26
Extracts of polyphenol-rich29 walnuts inhibit highly inflammatory LDL oxidation in human plasma.30 In addition, walnuts have been shown to reduce aortic plaque development in mice by 55%, while lowering plasma triglycerides 36%, cholesterol 23%, and prothrombin (a blood-clot formation enhancer) 21%, compared to controls.31
Associated with reductions in cardiovascular disease risk—in part due to their important role in reducing LDL cholesterol32—pecans boost plasma antioxidant capacity in the critical after-meal period, helping to decrease the oxidation of LDL cholesterol that leads to atherosclerosis.33
Extracts made from the leaf, stem, and root of artichokes—another staple of the Mediterranean diet—have demonstrated numerous cardioprotective effects, such as inhibiting cholesterol synthesis and LDL oxidation.34,35
Prominent in the Mediterranean diet, lentils abound in fiber, B vitamins—and polyphenols. Lentil extracts have been shown to prevent high blood pressure induced by the hormone angiotensin-II (a vessel-constricting signaling molecule), which helps protect against arterial narrowing.36
When combined into a single supplement, these food extracts provide the broad spectrum of unique polyphenols that give the Mediterranean diet its unparalleled longevity effects.
The Mediterranean diet is well known for its cardioprotective, metabolic, and longevity effects. Recent studies have confirmed that these impressive benefits may stem primarily from the diet’s extremely rich polyphenol content.
For most people, consuming enough Mediterranean diet foods every day can be extremely difficult.
Fortunately, a novel extraction process has made it possible to concentrate these specific polyphenols into a capsule. This allows you to be certain that you’re getting enough of the Mediterranean diet’s polyphenol content on a daily basis.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
- Zamora-Ros R, Rabassa M, Cherubini A, et al. High concentrations of a urinary biomarker of polyphenol intake are associated with decreased mortality in older adults. J Nutr. 2013;143(9):1445-50.
- Medina-Remon A, Casas R, Tressserra-Rimbau A, et al. Polyphenol intake from a Mediterranean diet decreases inflammatory biomarkers related to atherosclerosis: a substudy of the PREDIMED trial. Br J Clin Pharmacol. 2017;83(1):114-28.
- Medina-Remon A, Tresserra-Rimbau A, Pons A, et al. Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial. Nutr Metab Cardiovasc Dis. 2015;25(1):60-7.
- Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.
- Bonaccio M, Castelnuovo AD, Pounis G, et al. High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study. Int J Epidemiol. 2017.
- Aune D, Giovannucci E, Boffetta P, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017.
- Anderson JJ, Nieman DC. Diet Quality-The Greeks Had It Right! Nutrients. 2016;8(10).
- Martinez-Gonzalez MA, Salas-Salvado J, Estruch R, et al. Benefits of the Mediterranean Diet: Insights From the PREDIMED Study. Prog Cardiovasc Dis. 2015;58(1):50-60.
- Bonaccio M, Castelnuovo AD, Costanzo S, et al. Higher adherence to Mediterranean diet is associated with lower risk of overall mortality in subjects with cardiovascular disease: prospective results from the MOLI-SANI study. Paper presented at: ESC Congress 2016; Rome, Italy.
- Available at: http://www.telegraph.co.uk/news/2016/08/28/eating-a-mediterranean-diet-is-better-for-the-heart-than-taking/. Accessed January 19, 2017.
- Gradinaru D, Borsa C, Ionescu C, et al. Oxidized LDL and NO synthesis--Biomarkers of endothelial dysfunction and ageing. Mech Ageing Dev. 2015;151:101-13.
- Luciano M, Corley J, Cox SR, et al. Mediterranean-type diet and brain structural change from 73 to 76 years in a Scottish cohort. Neurology. 2017;88(5):449-55.
- Available at: https://www.cdc.gov/MMWR/preview/mmwrhtml/mm6426a1.htm. Accessed December 28, 2016.
- Available at: https://www.cdc.gov/nchs/data/databriefs/db176.pdf. Accessed December 28, 2016.
- Available at: https://www.washingtonpost.com/lifestyle/wellness/inside-the-new-dietary-guidelines-beans/2011/04/13/AFyvyIqE_story.html. Accessed December 28, 2016.
- Nishizuka T, Fujita Y, Sato Y, et al. Procyanidins are potent inhibitors of LOX-1: a new player in the French Paradox. Proc Jpn Acad Ser B Phys Biol Sci. 2011;87(3):104-13.
- Ursini F, Sevanian A. Wine polyphenols and optimal nutrition. Ann N Y Acad Sci. 2002;957:200-9.
- Du Y, Guo H, Lou H. Grape seed polyphenols protect cardiac cells from apoptosis via induction of endogenous antioxidant enzymes. J Agric Food Chem. 2007;55(5):1695-701.
- Cui X, Liu X, Feng H, et al. Grape seed proanthocyanidin extracts enhance endothelial nitric oxide synthase expression through 5’-AMP activated protein kinase/Surtuin 1-Krupple like factor 2 pathway and modulate blood pressure in ouabain induced hypertensive rats. Biol Pharm Bull. 2012;35(12):2192-7.
- Edirisinghe I, Burton-Freeman B, Tissa Kappagoda C. Mechanism of the endothelium-dependent relaxation evoked by a grape seed extract. Clin Sci (Lond). 2008;114(4):331-7.
- Bali EB, Ergin V, Rackova L, et al. Olive leaf extracts protect cardiomyocytes against 4-hydroxynonenal-induced toxicity in vitro: comparison with oleuropein, hydroxytyrosol, and quercetin. Planta Med. 2014;80(12):984-92.
- Coban J, Oztezcan S, Dogru-Abbasoglu S, et al. Olive leaf extract decreases age-induced oxidative stress in major organs of aged rats. Geriatr Gerontol Int. 2014;14(4):996-1002.
- Poudyal H, Campbell F, Brown L. Olive leaf extract attenuates cardiac, hepatic, and metabolic changes in high carbohydrate-, high fat-fed rats. J Nutr. 2010;140(5):946-53.
- Ismail T, Sestili P, Akhtar S. Pomegranate peel and fruit extracts: a review of potential anti-inflammatory and anti-infective effects. J Ethnopharmacol. 2012;143(2):397-405.
- Aviram M, Rosenblat M. Pomegranate Protection against Cardiovascular Diseases. Evid Based Complement Alternat Med. 2012;2012:382763.
- Sharifiyan F, Movahedian-Attar A, Nili N, et al. Study of pomegranate (Punica granatum L.) peel extract containing anthocyanins on fatty streak formation in the renal arteries in hypercholesterolemic rabbits. Adv Biomed Res. 2016;5:8.
- Aviram M, Volkova N, Coleman R, et al. Pomegranate phenolics from the peels, arils, and flowers are antiatherogenic: studies in vivo in atherosclerotic apolipoprotein e-deficient (E 0) mice and in vitro in cultured macrophages and lipoproteins. J Agric Food Chem. 2008;56(3):1148-57.
- Sanchez-Gonzalez C, Ciudad C, Noe V, et al. Health benefits of walnut polyphenols: An exploration beyond their lipid profile. Crit Rev Food Sci Nutr. 2015:0.
- Anderson KJ, Teuber SS, Gobeille A, et al. Walnut polyphenolics inhibit in vitro human plasma and LDL oxidation. J Nutr. 2001;131(11):2837-42.
- Nergiz-Unal R, Kuijpers MJ, de Witt SM, et al. Atheroprotective effect of dietary walnut intake in ApoE-deficient mice: involvement of lipids and coagulation factors. Thromb Res. 2013;131(5):411-7.
- Rajaram S, Burke K, Connell B, et al. A monounsaturated fatty acid-rich pecan-enriched diet favorably alters the serum lipid profile of healthy men and women. J Nutr. 2001;131(9):2275-9.
- Hudthagosol C, Haddad EH, McCarthy K, et al. Pecans acutely increase plasma postprandial antioxidant capacity and catechins and decrease LDL oxidation in humans. J Nutr. 2011;141(1):56-62.
- Lupattelli G, Marchesi S, Lombardini R, et al. Artichoke juice improves endothelial function in hyperlipemia. Life Sci. 2004;76(7):775-82.
- Rondanelli M, Monteferrario F, Perna S, et al. Health-promoting properties of artichoke in preventing cardiovascular disease by its lipidic and glycemic-reducing action. Monaldi Arch Chest Dis. 2013;80(1):17-26.
- Yao F, Sun C, Chang SK. Lentil polyphenol extract prevents angiotensin II-induced hypertension, vascular remodelling and perivascular fibrosis. Food Funct. 2012;3(2):127-33.
Terra X, Montagut G, Bustos M, et al. Grape-seed procyanidins prevent low-grade inflammation by modulating cytokine expression in rats fed a high-fat diet. J Nutr Biochem. 2009;20(3):210-8.