Newly Discovered Longevity Benefits of Mediterranean DietApril 2017
By Michael Campbell
A study published in the New England Journal of Medicine showed that following a Mediterranean diet contributed to a 30% reduction in the combined risk of acute heart attack, stroke, or cardiovascular death.1
This study further validates that a Mediterranean diet is an effective health intervention capable of significantly lowering cardiovascular disease risk.
While it is now clear that following a Mediterranean diet leads to cardiovascular benefits, researchers continue to examine how the diet provides such strong protection.
New studies reveal that the high content of polyphenols found in the foods that comprise the Mediterranean diet is a key factor in its ability to reduce the risk of dying.2-4
The beneficial impact of a healthy diet on human physiology remains grossly underappreciated.
Virtually every degenerative disease can be favorably influenced by dietary intervention. Yet modern medicine relies almost exclusively on prescription drugs to treat chronic illnesses.
The challenge is that many people feel “addicted” to food groups that are highly toxic. The good news is that following a lifesaving Mediterranean diet does not require deprivation of delicious foods, and the healthy polyphenols can be obtained in dietary supplements.
In a recent study presented at the European Society of Cardiology Congress 2016, researchers looked at survival rates of cardiovascular disease patients who followed a Mediterranean-style diet.
The study tracked 1,197 people over seven years. It found that those who most closely followed a Mediterranean diet died 37% less often than those with the least compliance with the diet.5
A separate analysis of 92 studies involving about 200,000 people found that statin (cholesterol-lowering) drugs reduce the risk of death by 18% in those with cardiovascular disease.6
Although these are not directly comparable studies, they nevertheless suggest that a healthier diet is more effective in keeping those with pre-existing cardiovascular disease alive.
These findings were presented at the world’s largest conference on cardiovascular disease. Scientists at this conference hailed the new findings as “extraordinary,” showing that adhering to a Mediterranean diet is “more powerful than any drug.”7
This is not the first report showing reductions in mortality in those who follow a Mediterranean-style diet. Food/drinks that comprise this diet provide plant polyphenols along with olive oil and omega-3s, all of which have been shown to confer longevity.
Another feature of a Mediterranean-style diet is that it’s low in foods that are harmful, such as meats. A growing body of data implicates heavy meat eating with a host of degenerative illnesses such as Alzheimer’s dementia and chronic kidney disease.8
Proving Cardiovascular Benefits of Mediterranean Diet
A study published in the New England Journal of Medicine utilized the preferential full, randomized, controlled study design.1
Called PREDIMED (PREvención con DIeta MEDiterránea), the study involved 7,447 women (aged 60 to 80) and men (aged 55 to 80) who were at a high cardiovascular risk but did not have cardiovascular disease when they enrolled in the study.
Subjects were randomly assigned to one of three groups:
- Mediterranean diet plus 4 tablespoons of extra virgin olive oil daily
- Mediterranean diet plus one ounce of nuts daily
- Control diet
By the end of the study, both Mediterranean diet groups experienced a significant 30% reduction in the combined risk of acute heart attack, stroke, or cardiovascular death over the five-year period, compared with the control group.
What is compelling about these findings is that the people in the Mediterranean diet groups had fewer dietary restrictions compared with the control group, and none of the groups restricted their caloric intake or boosted their exercise at all. (See Table 1 on page 29 for more foods contained in Mediterranean-style diets.)
More importantly, this study validated the Mediterranean diet as a true health intervention that can significantly lower cardiovascular disease risk.
This is a radical advance over many previous studies, which could only show correlation between diet and heart disease risk.
Why the Mediterranean Diet is so Beneficial
While this study demonstrated the benefits of the diet itself, it did not evaluate how it conferred this protection.
The researchers believe, however, it was likely due to the high amounts of polyphenols found in the typical Mediterranean diet. Based on calculations from Phenol-Explorer, a comprehensive database on polyphenol content in foods, the diet used in the study delivered an approximate 1,500 mg of total combined polyphenols daily.9
Plant polyphenols are complex biological molecules produced by natural processes. More than 8,000 different polyphenol compounds have been identified in plants, with several hundred readily available in edible plants.2
While best known for their ability to fight and protect against oxidative stress, polyphenols have numerous other properties. These include anti-inflammatory, anticarcinogenic, antidiabetic, antiobesity, and anti-allergic properties, along with liver and stomach protective effects.2
Epidemiological studies compellingly demonstrate the clinical impact of these mechanisms in preventing cardiovascular and neurodegenerative diseases, as well as certain cancers.2,10-20
In order to determine if polyphenols were in fact the reason for the dramatic risk reductions in cardiovascular disease and death in those following a Mediterranean diet, the researchers conducted two sub-studies as part of the original PREDIMED randomized controlled trial. Each study evaluated the connection between polyphenols and a risk factor for cardiovascular disease.
Let’s examine each study.
Polyphenols Reduce Blood Pressure
The first study evaluated a subgroup of 200 people from the PREDIMED study.3 The researchers examined the impact of the two Mediterranean diets (one with extra virgin olive oil and one with nuts) on blood pressure at the start of the study, and after just one year of being on the diet.
Their goal was to determine if there was a connection between polyphenol levels and blood pressure.
They found that those patients on either of the two Mediterranean diets experienced significant reductions in both diastolic and systolic blood pressure compared with those on the control or non-Mediterranean diet.
What’s more, these blood pressure reductions were associated with significant increases in total urinary polyphenols as well as plasma nitric oxide (NO) levels.3 Endothelial nitric oxide is the body’s natural blood-vessel relaxant, and is a biomarker of good cardiovascular function and healthy aging.21
This study gives us our first clue as to how the polyphenols in the Mediterranean diet promote healthy aging and protection against cardiovascular disease: by directly improving vascular function and reducing blood pressure.
An additional follow-up study provides insight into another key mechanism of action.
Polyphenols Reduce Inflammation
To learn more, researchers followed a subset of 1,139 subjects in the PREDIMED study in order to determine if polyphenol levels were connected with inflammatory markers.4
Chronic inflammation is a recognized fundamental contributor to cardiovascular disease, and polyphenols are known anti-inflammatory agents, so this was a sensible area of investigation.
At the end of one year, subjects with the greatest increases in urinary polyphenols had significantly lower levels of five important markers of inflammation that correlate with cardiovascular risk. These include:
- 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).
In addition, subjects with the greatest rise in polyphenol levels had significantly lower systolic and diastolic blood pressure, and significantly increased levels of beneficial HDL cholesterol, compared with those with the lowest polyphenol elevations.
It is clear from these studies that the polyphenols in the Mediterranean diet account for a large proportion of its value in preventing catastrophic heart disease, stroke, and cardiovascular deaths.
Polyphenols Reduce Risk of Dying
One of the most compelling studies on polyphenols was one published in the Journal of Nutrition showing that polyphenol intake reduces the overall risk of dying.
This study examined the natural intakes of polyphenols in 807 men and women aged 65 years and older using a measurement of total urinary polyphenols.2 The subjects provided 24-hour urine specimens at baseline, and were then followed up for 12 years.
By the end of the study, it was clear that those who had begun the trial with the highest total urinary polyphenols (indicating the highest actual circulating levels of polyphenols in the blood) had lower all-cause mortality, compared with those with the lowest levels.
|A. Mediterranean Diet – 37% lower mortality|
|Recommended Foods||Goal for Consumption|
|Olive Oil||At least 4 tbsp./day*|
|Tree nuts and peanuts||At least 3 servings/week|
|Fresh Fruits||At least 3 servings/day|
|Vegetables||At least 2 servings/day|
|Fish (especially fatty fish) and seafood||At least 3 servings/week|
|Legumes (beans)||At least 3 servings/week|
|White meat||Instead of red meat|
|Wine with meals (optional)||At least seven glasses/week|
|Foods to Be Discouraged||Goal for Restriction|
|Soda drinks||Less than one/day|
|Commercial baked goods, sweets, pastries||Less than 3 servings/week|
|Spreadable fats (butter, etc.)||Less than one serving/day|
|Red and Processed meats||Less than one serving/day|
|B. Control Low-Fat Diet – Inferior to Mediterranean Diet|
|Recommended Foods||Goal for Consumption|
|Low-fat dairy products||At least 3 servings/day|
|Bread, potatoes, rice, pasta||At least 3 servings/day|
|Fresh Fruits||At least 3 servings/day|
|Vegetables||At least 2 servings/day|
|Lean fish and seafood||At least 3 servings/week|
|Foods to Be Discouraged||Goal for Restriction|
|Vegetable oils||Not more than 2 tbsp./day|
|Commercial baked goods, sweets, pastries||Not more than one serving/week|
|Nuts and fried snacks||Not more than one serving/week|
|Red and Processed meats||Not more than one serving/week|
|Visible fat in meats and soups||Always remove|
|Fatty fish, seafood canned in oil||Not more than one serving/week|
|Spreadable fats (butter, etc.)||Not more than one serving/week|
A) Mediterranean diet with added nuts or olive oil.
*Olive oil polyphenols can be obtained in supplements for those who don’t want to eat this much extra-virgin olive oil.
Intriguingly, this worked out to an overall 30% reduction in the risk of dying for those in the highest third of urinary polyphenols compared with those in the lowest third.
This study demonstrates that higher overall polyphenol intake is associated with a significantly lower risk of dying.
Promote Longer Survival2
Survival graph showing the probability of
survival at each year of the 12-year study,
according to low (red line), middle (blue line)
and high (green line) urinary polyphenol levels.
GAE (gallic acid equivalents) are a
standardized measure of polyphenol activity.
A New England Journal of Medicine paper showed that the Mediterranean diet can reduce the risk of cardiovascular events—including death—by 30%.
This was not an epidemiologic study showing simple correlation, but instead was a true intervention study, from which one can conclude that the diet produced the observed health benefits.
Follow-up studies showed that a large part of the cardiovascular protective effect of the Mediterranean diet comes from its high concentration of polyphenols.
Life Extension has long recommended that people make every attempt to follow a Mediterranean-style diet. Studies cited in this article provide startling validation that eating these healthy foods confers significant longevity benefits.
It can be challenging, however, to adhere constantly to the Mediterranean diet. By supplementing with specific polyphenols, we can be sure we’re getting enough of these critical plant nutrients to benefit from their cardioprotective effects.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
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