Friday, August 15, 2014

The Truth About The Mediterranean Diet

The Cretan diet that gave rise to the interest in the so-called Mediterranean diet was not high in fat, fish, feta, or Greek yogurt as advertised or implied by advertisers. It was high in bread, beans, potatoes, vegetables, and fruits and for adult men derived only ~7 percent of energy from all animal products. 

Men in the general Mediterranean consumed almost twice as much fish as the men in Crete but had a coronary heart disease mortality rate 20 times higher than Cretan men.  Less than 4% of the Cretan men's diet consisted of fish.  That data does not provide any support for the idea that fish consumption was responsible in any degree for the very low coronary heart disease mortality rate in Crete. 

Meanwhile, men in Crete consumed almost 4 times as much bread (and therefore, wheat) as men in the U.S. cohort of the Seven Countries study; and men in the U.S. consumed 4 times as much meat, fish, eggs, and dairy products than men in Crete. Yet the men in the U.S. had a heart disease death rate about 57 times that of the men in Crete.  This data does not support claims that wheat causes heart disease (it was a large part of the protective Cretan diet) nor claims that eating more low-carbohydrate animal products protects against heart disease.  

Cretans did not consume large amounts of feta cheese or "Greek yoghurt" either.  Only about 3% of their calories came from dairy products.  That amounts to about one-half cup of yoghurt or milk, or about one-half ounce of cheese, daily, for a man consuming 2500 kcal daily. 

In addition, the Cretans who had a low risk of heart disease did not consume large amounts of olive oil nor a diet providing 40% of energy as fat as commonly claimed.  In fact, a large portion of Cretans followed Greek Orthodox fasting rituals which prescribed avoidance of olive oil on fasting days amounting to at least half the days of the year (180 to 200 days). 

The commercialized mythical Mediterranean diet rich in olive oil, feta cheese, yoghurt and fish crosses the general Mediterranean diet and the Western diet, both of which supported high rates of cardiovascular disease – 20 to 57 time that of Cretan men – when Cretan men had the lowest recorded rate.  The lowest rate of heart disease death was found among the men who ate the least animal products and got 93% of their calories from a primarily whole foods plant based diet with small amounts of added olive oil.


Charles Grashow said...
Getting More People on Statins W Clifford Roberts
"But what serum cholesterol numbers are necessary to prevent atherosclerotic plaques from forming. The evidence is substantial that if over decades the serum total cholesterol is <150 mg/dl, the LDL cholesterol <100mg/dl, and the high-density lipoprotein (HDL) cholesterol 〉20 mg/dl, the chances of forming atherosclerotic plaques are slim. (I realize that many readers will be shocked by the mention of an HDL-cholesterol of only 〉20 mg/dl. But this number is only when the total cholesterol is <150 mg/dl and the LDL-cholesterol is <100mg/dl [5]. If the total cholesterol is 200 mg/dl and the HDL-cholesterol is only 21mg/dl an atherosclerotic event is likely.) Because about 45% of adults in the Western World die from cardiovascular diseases, these numbers need to be the goals of all adults, not just adults with atherosclerotic events and/or diabetes mellitus, and now lipid-lowering agents, which can achieve these goals in most patients, are available. Thus, lower the bar for those eligible for statin therapy!"
William C. Roberts, MD
"What level of total cholesterol and specifically LDL cholesterol is required for atherosclerotic plaques to develop? Symptomatic and fatal atherosclerosis is extremely uncommon in societies where serum total cholesterol levels are <150 mg/dL and serum LDL cholesterol levels are <100 mg/dL (8). If the LDL cholesterol level is <100— and possibly it needs to be <80 mg/dL—the other previously mentioned risk factors in and of themselves are not associated with atherosclerosis. In other words, if the serum total cholesterol is 90 to 140 mg/dL, there is no evidence that cigarette smoking, systemic hypertension, diabetes mellitus, inactivity, or obesity produces atherosclerotic plaques. Hypercholesterolemia is the only direct atherosclerotic risk factor; the others are indirect. If, however, the total cholesterol level is >150 mg/dL and the LDL cholesterol is >100 mg/dL, the other risk factors clearly accelerate atherosclerosis."
"Dr. Scott Grundy, chairman of the NCEP, proclaimed approximately 14 years ago22 that 90% of heart attacks could be prevented if the population's cholesterol was 150 mg/dL or less"

There are also many other studies and papers that show that TC S/B <150 and LDL S/B <70

SO - on my last blood work my TC was 100 and my LDL-C was 47!

Does it matter how I achieved it??

Sunny said...

Glad to read this article. I had a discussion with someone who is very paleo and believe it's ok to ingest tons of oil because people on this diet have done it for centuries. I am a plant based eater and have read several credible people say fat/oil makes one FAT not CARBS. So this was the base of our discussion. This person was NOT going to except anything that was said by me no matter what. I don't believe that foods like olives or avocados are BAD, it's the extracting of oil that can be harmful to the body. Just like caffeine is harmful to the body but coffee has beneficial properties...because it is from a plant!

Anonymous said...

Hallo Don,

Having high- cholesterol is a MAJOR risk factor for erectile dysfunction. Why doesn't scammer Anthony Colpo and the rest of the Paleosphere mention this? Jonah Falcon embarrasses them in that department.


Robert said...

Hi Don,

Where did you go to find the details regarding the Cretan diet for this article?

Thank you,