Download The Mediterranean Diet

The Mediterranean Diet
Syracuse University Florence
Why Change the Way We Eat?
• What has influenced the way we eat
today?
• How can we change the way we eat?
• What does research say?
What has influenced the way we
eat today?
Missing Vitamin
Vitamin C
Vitamin A
Vitamin D
Vitamin B1(thiamin)
Vitamin 3 (niacin)
Iron
Calcium
Zinc
Deficiency
Scurvy
Night Blindness
Rickets in Children
Beri Beri
Pelagra
Anemia
Stunted growth & Osteoporosis
Growth failure in children
What has influenced the way we eat
today? (cont.)
• British Investigators Mann and Orr in the
first half of XX th century
• Milk and meat produced growth in
malnourished working class
– Farmland was cleared to support milk and
dairy industry
What has influenced the way we eat
today? (cont.)
• Change in Public Policy since World War II
• Farming became a big business, extra
efficient and major money maker
• Food Processing – huge development
– Easy distribution, provides all the Kcal,
micronutrients, long shelf life.
– Little thought given to additional ingredients
such as fats, sugars and other refined items
Consequences
• This preventative approach lead to
unforeseen problems:
– High caloric content of processed foods vs
lower caloric needs
– Lack of important components:
phytochemicals, fiber
– Increased incidence of heart disease and
other chronic diseases (cancer, diabetes)
Rockefeller Foundation Study
• First major study to examine the diet of
Mediterranean population
• Crete 1948 Allbaugh hired by Greek Gov.
to improve Greeks post-war conditions
– However no improvement was needed as
Cretan Diet was described as “surprisingly
good” and “very conducive to heart health”
The Mediterranean Diet
Activity One - Food Misconceptions
In groups discuss the following (I assume you read
the “The Mediterranean Diet” book)
• Protein, do we get enough or should we be
concerned about deficiency?
• Are all fats created equal?
• Is a low fat diet helpful to someone at with
compromised heart health?
• What is the best way to prevent deficiencies?
The Mediterranean Countries
A Shared Cuisine
A Shared Cuisine
• Bread, Olive oil and wine
• Similar attitudes about food
• Ancient populations relied on plant foods
and only occasionally on meat & seafood
• 1950s and 1960s eating habits similar to
ancient diet
A Shared Cuisine
• Seasonal and fresh produce consumed
within miles of harvest
• Meat as flavoring not a staple
• Bread as a staple; in rural areas dark and
heavy
• Olive Oil
• Flavoring: garlic, onions, lemons, basil,
oregano, parsley,
The Mediterranean Diet
•
•
•
•
•
•
•
Whole Grains
Fresh Fruits and Vegetables
Beans and Legumes
Olive Oil (High in Monounsaturated fats)
Some dairy
Very little meat
Very little refined, processed foods
A Shared Eating Philosophy
• Food as expression of life
• Meals as gatherings for family and friends;
genuine events not inconvenient chores
• Food as reflection of quality of life:
– Reflected in the preparation of food
– In the way food is selected, prepared, shared
Importance of Food
• Food not seen as a source of anxiety as it
is today
– Food for thought: As an American, what is
your personal relationship with food?
• Yet food is important as it means vitality;
– a ritual to be shared with love and in integral
part of life
Learn the secrets
Italians Secret # 1: Three meals, period.
Rome, Italy
Rome, NY
• Eat at meals only.
Snacking is low. And
when Italians do snack,
it's fruit and nuts. Fast
food? Not popular.
• Snacking is a way of life.
This city is snack-happy like
the rest of America, where
consumption of corn chips,
pretzels, and crackers has
gone up 200% since the '70s.
Fast food is big too
Prevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4c
Learn the secrets
Italians Secret # 3: Olive Oil Rules.
Rome, Italy
Rome, NY
• Olive oil is served in
salads, pasta, and
cooked veggies in
generous amounts. It
continues to be the
principle source of fat
in the diet. Result? Lots
of heart-smart monounsaturated fat.
• Cheese and meat rule.
Cheese-laden lasagna fill
plates. Italian bread is
served with butter.
Submarine sandwiches
bulge with Italian ham
and provolone. Result?
Lots of artery-gumming
saturated fat.
Prevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4c
Learn the secrets
Italians Secret # 5: Drink water.
Rome, Italy
Rome, NY
• Italians drink water
when thirsty.
• Drinking super sized
soda is common even
at breakfast.
Learn the secrets
Italians Secret # 2: Dark greens daily.
Rome, Italy
Rome, NY
• Packed with nutrients,
fresh, dark greens are
served with most meals,
often as a salad course
that comes right before
dessert.
• Salads mostly consist of
nutrient-poor iceberg
lettuce. Overall
consumption of dark
green veggies such as
spinach is low.
Prevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4c
Learn the secrets
Italians Secret # 4: Fruit for Dessert.
Rome, Italy
Rome, NY
• Italians end most meals
with fresh fruit, served
plain or marinated in
wine with a little sugar.
Sweets are saved for
special occasions.
• Doughnuts are a daily
event for many people.
Candy bars and sweets
are often eaten daily as
a snack.
Prevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4c
Ancel Keys – Key Findings
• 1950s – People in the
States were suffering
from heart disease
• No heart disease in
the Mediterranean
• He spearheaded the
most influential
epidemiological study
of our times
The Seven Countries Study
• Goal: To identify CHD risk factors and
disease rates
• Population: 13,000 men – 40-55 y.o.
during a 5 year period in the following
Countries: Greece, Italy, (Croatia, Serbia),
Japan, Finland, Netherlands, U.S.A.
• Methods: RDs stationed in the homes of
study subjects measuring everything eaten
– Far more accurate than any questionnaire
The Seven Countries Study
Conclusions (main points)
• This study related saturated fat with CHD
• Americans, Dutch and Finns had heart
disease rates:
– Twice those of Italians
– Four times those of the Greeks,
Japanese and Yugoslavs
• Lowest all cause age specific death rates were
found in the Mediterranean region
The Seven Countries Study
Conclusions (main points)
• This study revealed the universal risk
factors for CHD
– Blood cholesterol appears to have the
strongest correlation
– Age
– Blood Pressure
– Cigarette smoking
Discovery of Different Types of Fat
Type of fat
Studied effects
Saturated (SFA)
↑ T cholesterol levels (both
total and LDL)
Monounsaturated (MUFA)
The Mediterranean Fat
Polyunsaturated (PUFA)
↓ T cholesterol levels (both
total and LDL) may ↑ HDL
Omega 3
↓ blood tendency to cloth so
↓ risk of heart attack
Trans
↑ T cholesterol levels (both
total and LDL) ↓ HDL
↓ T cholesterol levels (both
total and LDL) ↓ HDL
The Magic is a Combination of
Factors
• Olive oil MUFA
• Fiber
• Omega 3
• Vitamins
• Minerals
• Phytochemicals
Some Things are Hard to Prove
Scientifically
• The effect of mind over body is in the
news today
– Lifestyle seems to be as important as food
– Slower pace, less stress, enjoyment of food
– Physical activity and lots of sunshine
• Common sense tells us the above are
important
Chapter 2
Comparing Notes
• How does the Mediterranean diet compare
to the guidelines of major health
organizations?
American Heart Association
• www.americanheart.org
• AHA position is updated according to
new research
• Fat is always a target especially SFA
• Three main risk factor for CHD
– ↑ blood pressure, ↑ blood lipids, obesity
My Pyramid USDA
• http://www.mypyramid.gov/py
ramid/index.html
Dietary Guidelines 2005
• Emphasis on weight control and continued
importance of physical activity.
• Recommendation on dietary fats
– trans fats should be as low as possible
– saturated fat should be limited. Recommends
between
– 20 and 35% of daily calories from fat
– recognizes potential health benefits of MUFA
and PUFA
• Urge Americans to limit sugar intake and
they stress the benefits of whole grains.
Some things have not changed
• It is fine to consume half of our grains as refined
starch.
• Red meat, poultry, fish, and beans (including soy
products) are lumped together.
• The recommendation to drink 3 glasses of lowfat milk or eat 3 servings of other dairy per day
to prevent osteoporosis ignores the lack of
evidence between consumption of dairy and
prevention of osteoporosis. It also ignores the
possible increases in risk of ovarian cancer and
prostate cancer associated with dairy products
and the fact that millions of Americans are
lactose intolerant
What to do if I am gaining weight?
Do you have access to internet?
Learn how much and what to eat for YOUR calorie level
Then go to MyPyramid tracker
Check
here for
more
information
on food
groups
& related
topics
Submit age,
sex and
activity
level for a
personalized
MyPyramid
The Mediterranean Diet
Oldways Preservation and
Exchange
• Based in Cambridge, MA
• Looks at ways of eating before food
processing
• Publicizes own guidelines compatible with
current knowledge of nutritional science
• Considers USDA guideline ineffective
Harvard Food Pyramid
Obesity Trends* Among U.S. Adults
1990
BMI = Weight (Kg) / Height2 (Meters)
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults
2005
No data
<10%
10%-14%
15%-19%
Source: Behavioral Risk Factor Surveillance System, CDC.
20%-24%
25%-29%
30% +
The Mediterranean Diet