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What's behind Mediterranean diet and lower cardiovascular risk (medicalxpress.com)
44 points by dnetesn on Dec 9, 2018 | hide | past | favorite | 42 comments


Researchers at the Monell Chemical Senses Center in Philadelphia and the University of Pennsylvania found that extra-virgin olive oil contains an anti-inflammatory agent that acts similarly to how ibuprofen does. They named the substance oleocanthal:

https://www.monell.org/news/news_releases/olive_oil_contains...

So a lot of people in the Mediterranean consume an anti-inflammatory as part of their daily diet. I believe the thinking is that this is part of the lower cardiovascular risk, but not the only factor by any means.


"The team also explored why and how a Mediterranean diet might mitigate risk of heart disease and stroke by examining a panel of 40 biomarkers, representing new and established biological contributors to heart disease. ... The team saw changes in signals of

* inflammation (accounting for 29 percent of the cardiovascular disease risk reduction)

* glucose metabolism and insulin resistance (27.9 percent),

* and body max index (27.3 percent).

The team also found connections to blood pressure, various forms of cholesterol, branch-chain amino acids and other biomarkers, but found that these accounted for less of the association between Mediterranean diet and risk reduction."

The suggestion from the data being that inflammation and insulin resistance might be more important factors than the usual cholesterol panel that people tend to fixate on.


I have friends in Athens, whom I visit. I’ve observed that most of the time they put their virgin olive oil on the food once it is done cooking. When asked about it they claimed that the oil is ‘full of healthy things that turn cancerous when burned.’

They rarely use extra-virgin to cook with, either.


Greeks use virgin olive oil (and good quality one, often from some friend/relative in a village making their own) raw on top of salads, bread, and other stuff. Raw oil is also common over grilled fish and such.

They do use it to cook all the time, in soups, stews, oven foods, pasta, meats, fish, etc.

Often, however, they'll fry french fries) with some other oil like sunflower. But many still fry with olive oil as well, and usually consider it better.

"In fact, olive oil may be one of the better oils to fry with. "Smoke points tend to increase with olive oil quality, as the free fatty acid content tends to decrease and the antioxidant content increases," explained Rachel Adams, a health science professor at Cardiff Metropolitan University in the U.K. "The high antioxidant content of olive oil could even reduce the amount of harmful chemicals produced during cooking," Adams told The Conversation. According to the Cleveland Clinic, flaxseed oil has a low smoking point, meaning you really shouldn't heat it up. Light olive oil, by comparison, has a high smoking point, meaning you can make it pretty hot. If you're going to deep fry, light refined olive oil is a good way to go. Extra virgin olive oil and canola oil are more in the middle – you can stir fry or bake with them, but don't deep fry. "Bottom line – if you cook at high heat, stick with refined olive oil," Berkowitz explained. "Medium temperature on most stoves is 250-350, which even extra virgin olive oil can handle. But high temp cooking or frying deserves high smoke point oils."


Extra virgin olive oil is the first press oil. It contains particulates that have a very low smoke point. You should not be cooking with extra virgin olive oil. Pure olive oil is a later hot press extraction and does not have the particulates. It has a much higher smoke point. Im not convinced that US stores are actually selling extra virgin olive oil anyway outside of specialty shops. Olive oil is supposed to be fresh and should taste spicy at first.


Your suspicion is substantiated [1]. Olive oil bought from U.S. producers will have had substantially less opportunity for adulteration, as their processes are certified by U.S. authorities (this is a mitigation and not a guarantee).

1. https://www.telegraph.co.uk/news/worldnews/europe/italy/1198...


Pretty common for us sold EVOO to be a mix. They’ll put some good stuff in it but the rest will be lower quality olive oil.

https://www.forbes.com/sites/larryolmsted/2016/09/30/its-ext...


I’ve always wondered if Americans can follow the Mediterranean diet with all the reports of our olive oil being conterfiets.


Look for olive oil from California. It's really only olive oil.


I developed a... not quite an obsession, maybe a strong interest, in olive oil six or seven years ago. My interest was initially piqued by a report I heard on NPR about the health benefits. I learned the importance of the date the olives were pressed (fresher is better, go figure) and that, while countries in Europe might produce high quality olive oil, the quality stuff typically gets sold in Europe and the dregs get shipped to America and other countries.

I have tried many different brands of olive oil in the interim years and I can say the best I have personally found in America come from California. I have absolutely no personal interest in either of the companies below, they just produce quality olive oil.

My favorite by a wide margin is Sciabica, the oil they produce has that peppery bite people describe that makes you cough when you take a swig of it. I have never seen it sold in stores though, only online. Also, it is a little pricey.

The other quality oil I have found is Californian Olive Ranch. It is not as good as Sciabica in my opinion but they have a wide distribution. I have found them at grocery stores on both the west and east coast of the US. There is one BIG caveat with this brand though. More often than not stores are carrying bottles that are one or even two years old. It's easy to tell how old it is because they are one of the few companies that print the pressed on date on the back of the bottle.

In general the two most important qualities of an olive oil in my experience are purity (not mixed with other oils) and pressed on date. If a brand doesn't print the pressed on date on the bottle walk away, it is garbage; very few brands do this. Olives are typically harvested between September and December, that is when you are going to get the freshest best tasting oil.


Yeah cause there's no way they'd fake that


Exactly.

Domestic production is regulated and certified by the US government, transported through short supply chains subject to auditing. Tampering with food supplies is very difficult to execute and harshly punished when inevitably detected. Food safety and consumer confidence are a high priority for commercial and public interests... you have never worried about watered down milk, you shouldn't worry about 100% domestic olive oil.

Compared to imported goods... foreign governments are trusted to do their job before goods make their way through long and slow international supply chains. Plenty of time for undetected tampering before goods make it to American distributors. Tracking down diluted olive oil across an ocean is difficult, the other side has plausible deniability, the risk/reward of the crime is much better.

I'm not saying our oil is better - just trustworthy. You get what the label says.


Well you know for sure there's no goose liver in it


Just avoid Italian oil unless you know the source / trust the distributor. Spanish and Greek oils are better, in general.


Is Aldi brand ok?


Here's a simple trick to avoid cardiovascular risk: any diet that reduces the amount of meat people consume. Overwhelming majority of Americans eat too much meat (with respect to health), so any diet that has less meat in it will on average improve their health. No surprise: https://nutritionfacts.org/2018/02/06/how-healthy-is-the-med...


What if it's not diet.

I read somewhere that Silicy has higher life expectancy although it's poor (probably worse healthcare) in comparison to North Italy.

Maybe it's not diet but the family values? Maybe being family focused increases life expectancy despite having not superior diet.


You are assuming that poorer means worse diet.

That is simply not true at all in relation to having a healthy diet, and the opposite is perhaps true.

In many places the traditional diet is healthy. Then, when people become richer they eat more, eat more meat, more fat, more sugar, more processed food, etc., and obesity and cardiovascular diseases shoot up.


As a poor person who's always been surrounded by poor people, you are wrong.

Poor and less educated people know nothing about nutrition and don't have the money to buy good food.

When you don't have the money you are forced to fill up with cheap calories like bread, rice, pasta, sugar, etc.


>Poor and less educated people know nothing about nutrition and don't have the money to buy good food.

In societies with traditional agriculture and village culture, they don't have to "know about nutrition". Their traditional recipes and ways of eating are healthier, and cheaper.

That's not an absolute rule, but that's exactly the case with Mediterranean diet for one.

>When you don't have the money you are forced to fill up with cheap calories like bread, rice, pasta, sugar, etc.

Some of which is fine. The healthier people in Japan eat a lot of rice, and bread is mighty fine too, as are noodles etc.

Sugar and highly refined breads are recent inventions. They poor people in Italy pre-70s would hardly have much sugar in their meals except from natural sources (tomatoes etc, not refined). No fast-food and crappy supermarket tv-diner style food either. People cooked religiously.

Also the poor masses in Italy etc were traditionally not destitute (e.g. developing world-like). Just poor. They could still afford basic meals, and had strong family support.


Nothing unhealthy with bread, rice, pasta...

In Sicily, as that is the example given, people are poorer than the European average and significantly poorer than the American average. Yet they have a healthier diet.

The issue of unhealthy diets in the US/Europe is not so much poverty but a culture of junk food and not knowing better.


In the US, absolutely. In other countries, not so much.


What if it's the lifestyle? You certainly feel more relaxed when living in Italy or Spain, people seem to prioritize a simple life full of social interactions. Work is something one needs to do, but does not get obsessed with. Talking from my own experience.


They are studying women in the US on the diet. I suppose they could consider other factors:

“A new study by investigators from Brigham and Women's Hospital, Harvard Medical School, and the Harvard T.H. Chan School of Public Health offers insights from a cohort study of women in the U.S. who reported consuming a Mediterranean-type diet. Researchers found a 25 percent reduction in the risk of cardiovascular disease among study participants who consumed a diet rich in plants and olive oil and low in meats and sweets.”


It might be that a 'poorer' diet can be better. Reason being that they use more raw foods rich in fiber rather than processed flour, sugar, oil, etc.

See research on the Okinawan diet. People there had the some of the longest lifespans ever recorded and they ate mostly potatoes (albeit a very nutritious variety of purple sweet potato).

Today Okinawa is rich, there are 3 KFCs on the island, and their lifespan has declined.


Stats on this kind of thing are certainly difficult. What if the med diet effect is from something like fasting?


I can tell you I've struggled with my diet for years. The thing that I finally hit upon was intermittent fasting, and it gave me back energy and weight loss at the same time. And, it doesn't feel like a diet. It is my new lifestyle.


Sicily’s main industry is agriculture. So it is poorer financially because most are employed as manual labor. Diet wise it’s very hard to eat poorly. Fresh food is abundant and eating processed, frozen foods is considered a luxury.


It could be as simple as they do more walking. Or walk after meals.


Could another factor be physical activity? The extent of many Americans' physical activity is walking from the car to the entrance of a building; the fad goal of 10,000 steps is fairly trivial to hit if you walk to work or use transit on a regular basis.

Survey from NYC comparing exercise by primary modes of transportation: https://www1.nyc.gov/assets/doh/downloads/pdf/epi/PAT-survey...


I always feel apprehensive about ‘region X’s diet is the healthiest’ articles. To me, the strongest example for this is the Japanese diet. Whilst their diet is healthy in many ways, it also raises your risk for stomach cancer by quite a lot.


I agree that I think that diet is one significant part of a (probably complex) equation - not a single deciding factor.

But regarding Japanese stomach cancer... if you're saying they get stomach cancer more than others because of their diet, how do they still live so long? Do they also have a secret way of beating the cancer so it doesn't cut their lives short?


For one they are aware they (as a population) get stomach cancer more often, so they actively screen for it, in the way most countries in the West screen for colon cancer.

Remember that some types of cancer, if caught early enough, are more akin to a chronic condition than a delayed death sentence. Once treated there are quarterly or bi-annual checkups and any suspicious tissue will be removed preventatively. You still have a much higher chance of stomach cancer popping up again vs. someone who never had it, but with the checkups it’ll be nipped in the bud before it grows into something severe.

That might sound offhand but that is how it is for (as far as I’m aware) bladder cancer and most gastrointestinal cancers. Cancer in the lungs, liver or brain usually is much much more dangerous because there’s little screening and they’re much more resistant to treatment.


Mediterranean countries also have some of the worst economies. Could this also be related to diet? (I ask this as a legitimate question, not as an attack on Mediterranean countries)


Hardly.

It has more to do with gastronomical culture, I think. In Italy, for example, eating quality food is _important_, it is something people care about and actively look for.

This has a low correlation with social or economical status, is something deeper, something that people learn to do since kids, looking at their parent's behavior, going with them at the market and learning how to choose good ingredients, spending time cooking.


I think the high usage of olive oil overshadows everything else. Also I don't think that France or Italy have the "worst" economy.


Worst economies relative to what? Certainly not on a global scale.


Valter Longo’s research has a good explanatory framework for this effect. For an introduction, The Longevity Diet (2016) is worth a read.


[deleted]


I think they don't mean people in Mediterranean, but people following Mediterranean diet - frequently advised for heart health


[deleted]


This study looked at Americans following the Mediterranean diet.




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