Wellness Database
Wellness Database: Mediterranean Diet
The Mediterranean Diet is widely though of as the single healthiest diet for humans. This diet consists of plenty of fish, olive oil, and nuts. It is high in amino acids like Arginine and Omega-3 Fatty Acids. Individuals who follow this diet are less likely to develop obesity, diabetes, and heart disease.
Related Studies
Mediterranean Diet May Reduce the Risk of Premature Mortality
Summary: In a study involving an analysis of data from 120,852 men and women between the ages of 55 and 69 years, including 9,691 deaths, adherence to a Mediterranean diet was found to be significant associated with lower mortality in women, but not significantly in men. A "healthy lifestyle score" was calculated based on adherence to the Mediterranean diet, nonsmoking, normal weight, and regular physical activity, and this score was found to be strongly and inversely associated with mortality in women and men (comparing the least-healthy to the healthiest lifestyle scores: HR=4.07 in women and HR=2.61 in men), and the mortality rate advancement period ("aging effect") was 15.1 years in women and 8.4 years in men. The authors conclude, "This study suggests that adherence to 4 modifiable healthy lifestyle factors can substantially reduce premature mortality in women and men."
Reference: "The impact of a Mediterranean diet and healthy lifestyle on premature mortality in men and women," van den Brandt PA, Am J Clin Nutr, 2011 Sept; 94(3): 913-20. (Address: Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, Netherlands).
Omega 3 Fatty Acids May Reduce Suicide Risks
Summary: In a retrospective, case-control study involving 1,600 subjects (800 U.S. military suicide deaths and 800 controls), risk of suicide death was 14% higher per standard deviation of lower DHA percentage (OR=1.14), according to adjusted logistic regression analysis. In men, the risk of suicide death was 62% greater with lower serum DHA status (adjusted OR=1.62). The authors state, "This US military population had a very low and narrow range of n-3 HUFA status. Although these data suggest that low serum DHA may be a risk factor for suicide, well-designed intervention trials are needed to evaluate causality."
Reference: "Suicide Deaths of Active-Duty US Military and Omega-3 Fatty-Acid Status: A Case-Control Comparison," Lewis MD, Hibbeln JR, et al, J Clin Psychiatry, 2011 Aug 23; [Epub ahead of print]. (Address: Joseph R. Hibbeln, MD, USPHS, Section of Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcoholism and Alcohol Abuse, National Institutes of Health, 5625 Fishers Lane, Rm 3N-07, MSC 9410, Bethesda, MD 20892, USA. E-mail: .(JavaScript must be enabled to view this email address) ).
Fish and Omega 3 Fatty Acids Support Cardiovascular Health and Reduce Inflammation
Summary: In a study involving 301 healthy adult subjects, consumption of fish was found to be inversely associated with changes in endothelial dysfunction and low-grade inflammation and intake of EPA+DHA was inversely associated with changes in endothelial dysfunction and low-grade inflammation as well. Consumption of fruit, vegetables, alcoholic beverages and dairy products were not found to be associated with endothelial dysfunction and low-grade inflammation. These results add to the growing body of evidence supporting intake of fish and omega-3 fatty acids in supporting cardiovascular health and reducing inflammation.
Reference: "Fish Consumption in Healthy Adults Is Associated with Decreased Circulating Biomarkers of Endothelial Dysfunction and Inflammation during a 6-Year Follow-Up," van Bussel BC, Henry RM, et al, J Nutr, 2011 Sept; 141(9): 1719-25. (Address: Top Institute Food and Nutrition, Wageningen, The Netherlands. E-mail: .(JavaScript must be enabled to view this email address) ).
Fish Oil May Increase Cerebral Blood Flow
Summary: Supplementation with fish oil may significantly increase cerebral blood flow. This double-blind, placebo-controlled study assessed the effects of 12 weeks daily supplementation with docosahexaenoic acid (DHA) rich fish oil (1 g, 2 g) or placebo (olive oil) in 65 healthy adults (18-29 y). Relative changes in the concentration of oxyhemoglobin and deoxyhemoglobin were assessed in the prefrontal cortex using near-infrared spectroscopy during performance of 9 cognitive tasks. Supplementation with both doses of fish oil resulted in increased concentrations of cerebral blood flow (oxyhemoglobin and total levels of hemoglobin) during the cognitive tasks, suggesting that fish oil may benefit cerebral blood flow.
Reference: "Docosahexaenoic acid-rich fish oil modulates the cerebral hemodynamic response to cognitive tasks in healthy young adults," Jackson PA, Reay JL, et al, j.biopsycho, 2011 Oct; [Epub ahead of print]. (Address: Brain, Performance and Nutrition Research Centre, Northumbria University, Newcastle upon Tyne, UK. E-mail: .(JavaScript must be enabled to view this email address) ).
Omega 3 Fatty Acids Reduce Depression
Omega-3 fatty acids play a critical role in the development and function of the central nervous system. Emerging research is establishing an association between omega-3 fatty acids (alpha-linolenic, eicosapentaenoic, docosahexaenoic) and major depressive disorder. Evidence from epidemiological, laboratory and clinical studies suggest that dietary lipids and other associated nutritional factors may influence vulnerability and outcome in depressive disorders.
The author's conclude: [G]iven the current excess intake of omega-6 rich oils, and the emerging research on omega-3 fatty acids and MDD, all mental health professionals should at least ensure adequate intake of omega-3 fatty acids among patients with MDD. The current average North American intake of EPA and DHA is approximately 130 mg per day, well short of the minimum 650 mg recommended by the international panel of lipid experts. While it is not necessary for mental health professionals to become clinical nutritionists, consideration of a patient's dietary quality may be worthwhile. Hopefully future research will determine if dietary modifications or supplementation can influence the outcome of standard care.
Omega-3 fatty acids and major depression: A primer for the mental health professional. Lipids Health Dis. 2004; 3: 25. Published online 2004 November 9. doi: 10.1186/1476-511X-3-25
Omega 3 Fatty Acids Reduces Heart Disease
Numerous epidemiological and controlled interventional trials have supported the health benefits of long-chain omega-3 fatty acids in the form of docosahexaenoic acid (DHA, 22:6n-3) plus eicosapentaenoic acid (EPA, 20:5n-3) from fish and fish oils as well as from algal sources. The beneficial effects on cardiovascular disease and related mortality including various risk factors for cardiovascular disease (particularly lowering circulating triglyceride levels and the triglyceride:HDL-cholesterol ratio) have been observed in the absence of any concomitant blood cholesterol lowering. With appropriate dosages, consistent reductions in both fasting and postprandial triglyceride levels and moderate increases in fasting HDL-cholesterol levels have been observed with algal DHA in the majority of trials. These results are similar to findings for fish oils containing DHA and EPA. Related to greater fish intake, higher levels of DHA in circulating blood biomarkers (such as serum phospholipid) have been associated with reduced risks for the progression of coronary atherosclerosis and lowered risk from sudden cardiac death. Controlled clinical trials have also indicated the potential for algal DHA supplementation to have moderate beneficial effects on other cardiovascular disease risk factors including blood pressures and resting heart rates.
Docosahexaenoic acid (DHA) and cardiovascular disease risk factors. Prostaglandins, Leukotrienes and Essential Fatty Acids. Volume 81, Issues 2-3, August-September 2009, Pages 199-204. Workshop on DHA as a Required Nutrient.
Fish Oil Reduces Mortality
Studies on the relation between dietary n-3 fatty acids (FAs) and cardiovascular disease vary in quality, and the results are inconsistent. A systematic review of the literature on the effects of n-3 FAs (consumed as fish or fish oils rich in eicosapentaenoic acid and docosahexaenoic acid or as alpha-linolenic acid) on cardiovascular disease outcomes and adverse events was conducted. Studies from MEDLINE and other sources that were of > or =1 y in duration and that reported estimates of fish or n-3 FA intakes and cardiovascular disease outcomes were included. Secondary prevention was addressed in 14 randomized controlled trials (RCTs) of fish-oil supplements or of diets high in n-3 FAs and in 1 prospective cohort study. Most trials reported that fish oil significantly reduced all-cause mortality, myocardial infarction, cardiac and sudden death, or stroke. Primary prevention of cardiovascular disease was reported in 1 RCT, in 25 prospective cohort studies, and in 7 case-control studies. No significant effect on overall deaths was reported in 3 RCTs that evaluated the effects of fish oil in patients with implantable cardioverter defibrillators. Most cohort studies reported that fish consumption was associated with lower rates of all-cause mortality and adverse cardiac outcomes. The effects on stroke were inconsistent. Evidence suggests that increased consumption of n-3 FAs from fish or fish-oil supplements, but not of alpha-linolenic acid, reduces the rates of all-cause mortality, cardiac and sudden death, and possibly stroke. The evidence for the benefits of fish oil is stronger in secondary- than in primary-prevention settings. Adverse effects appear to be minor.
Am J Clin Nutr. 2006 Jul;84(1):5-17. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review.
Fish Oil Prevents Death from Heart Disease
Objective: To synthesise the literature on the effects of fish oil—docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)—on mortality and arrhythmias and to explore dose response and formulation effects.
Design: Systematic review and meta-analysis.
Data sources: Medline, Embase, the Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, Allied and Complementary Medicine, Academic OneFile, ProQuest Dissertations and Theses, Evidence-Based Complementary Medicine, and LILACS.
Studies reviewed: Randomised controlled trials of fish oil as dietary supplements in humans.
Data extraction: The primary outcomes of interest were the arrhythmic end points of appropriate implantable cardiac defibrillator intervention and sudden cardiac death. The secondary outcomes were all cause mortality and death from cardiac causes. Subgroup analyses included the effect of formulations of EPA and DHA on death from cardiac causes and effects of fish oil in patients with coronary artery disease or myocardial infarction.
Data synthesis: 12 studies totalling 32 779 patients met the inclusion criteria. A neutral effect was reported in three studies (n=1148) for appropriate implantable cardiac defibrillator intervention (odds ratio 0.90, 95% confidence interval 0.55 to 1.46) and in six studies (n=31 111) for sudden cardiac death (0.81, 0.52 to 1.25). 11 studies (n=32 439 and n=32 519) provided data on the effects of fish oil on all cause mortality (0.92, 0.82 to 1.03) and a reduction in deaths from cardiac causes (0.80, 0.69 to 0.92). The dose-response relation for DHA and EPA on reduction in deaths from cardiac causes was not significant.
Conclusions: Fish oil supplementation was associated with a significant reduction in deaths from cardiac causes but had no effect on arrhythmias or all cause mortality. Evidence to recommend an optimal formulation of EPA or DHA to reduce these outcomes is insufficient. Fish oils are a heterogeneous product, and the optimal formulations for DHA and EPA remain unclear.
BMJ 2008; 337:a2931 doi: 10.1136/bmj.a2931 (Published 23 December 2008)
Omega 3 Fatty Acids Reduce Cardiovascular Mortality
BACKGROUND: There is conflicting evidence on the benefits of foods rich in vitamin E (alpha-tocopherol), n-3 polyunsaturated fatty acids (PUFA), and their pharmacological substitutes. We investigated the effects of these substances as supplements in patients who had myocardial infarction.
METHODS: From October, 1993, to September, 1995, 11,324 patients surviving recent (< or = 3 months) myocardial infarction were randomly assigned supplements of n-3 PUFA (1 g daily, n=2836), vitamin E (300 mg daily, n=2830), both (n=2830), or none (control, n=2828) for 3.5 years. The primary combined efficacy endpoint was death, non-fatal myocardial infarction, and stroke. Intention-to-treat analyses were done according to a factorial design (two-way) and by treatment group (four-way).
FINDINGS: Treatment with n-3 PUFA, but not vitamin E, significantly lowered the risk of the primary endpoint (relative-risk decrease 10% [95% CI 1-18] by two-way analysis, 15% [2-26] by four-way analysis). Benefit was attributable to a decrease in the risk of death (14% [3-24] two-way, 20% [6-33] four-way) and cardiovascular death (17% [3-29] two-way, 30% [13-44] four-way). The effect of the combined treatment was similar to that for n-3 PUFA for the primary endpoint (14% [1-26]) and for fatal events (20% [5-33]).
INTERPRETATION: Dietary supplementation with n-3 PUFA led to a clinically important and statistically significant benefit.
Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet. 1999 Aug 7;354(9177):447-55.
Omega 3 Fatty Acids Reduce Triglycerides
In a randomized, double-blind, placebo-controlled study involving 229 diet-stable patients with very high fasting triglyceride levels (between 500 and 2000 mg/dL, with or without background statin therapy), supplementation with the omega-3 fatty acid agent, AMR101, containing 96% eicosapentaenoic acid ethyl ester, 4 g/d or 2/g, was found to be associated with significant reductions in triglyceride levels and improvements in other lipid parameters. In cases with baseline triglycerides over 750 mg/dl, AMR101 at 4 g/d reduced TG levels by 45.4% and AMR101 at 2 g/d reduced TG levels by 32.9%. No significant increases in LDL cholesterol were associated with AMR101 supplementation. The authors conclude that this eicosapentaenoic acid ethyl ester supplement, "significantly reduced the TG levels and improved other lipid parameters without significantly increasing the LDL cholesterol levels."
"Eicosapentaenoic Acid Ethyl Ester (AMR101) Therapy in Patients With Very High Triglyceride Levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] Trial)," Bays HE, Ballantyne CM, et al, Am J Cardiol, 2011 June 15; [Epub ahead of print]. (Address: Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky, USA).
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Nutrients and Diet
Alpha Lipoic Acid Amino Acids Antioxidants Arginine Calcium Carnitine Carotene Chromium Picolinate Citrulline Coenzyme Q10 DHEA Fat Fiber Fruit and Vegetables Garlic Ginkgo Biloba Glucosamine Vegetarian Diet Green Tea Iron Lutein Lycopene Magnesium Mediterranean Diet Multivitamins Nitric Oxide Nuts Olives Omega 3 Fatty Acids Policosanols Polyphenols Pomegranate Probiotics Pycnogenol Red Yeast Rice Salt Saffron Selenium Soy Theanine Vitamin A Vitamin B Vitamin C Vitamin D Vitamin E Vitamin K White Tea Zinc
