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Correlation of the Mediterranean Diet and the Prevention of Coronary Heart Disease

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Heart Disease is the leading cause of death for both men and women in the United States, with coronary heart disease being the most common form. Exploration of the role of the Mediterranean diet as an effective tool in prevention is vital for successful health care to come. Research-based literature offers an abundance of knowledge into the prevention of coronary heart disease, through a variety of Mediterranean dietary guidelines. Prevention research for the Mediterranean diet encourages sufficient intake of fruits, vegetables, whole grains, olive oil, legumes, nuts, fish and poultry, and other LDL-cholesterol lowering foods in people entering adulthood. Research also suggests limiting red meat in your diet and getting plenty of exercise.

Benefits of Nuts[edit]

Concerning the prevention of coronary heart disease, researchers have investigated the effectiveness of nuts in the Mediterranean diet. Nutritional components of nuts include fiber, minerals, unsaturated fatty acids, and vitamins (Bao, Y., Han, J., Hu, F. B., Giovannucci, E. L., Stampfer, M. J., Willett, W. C., & Fuchs, C. S. (2013). Casas, R., Sacanella, E., Urpí-Sardà, M., Chiva-Blanch, G., Ros, E., Martínez-González, M., . . . Estruch, R. (2014) found that consistency in a Mediterranean diet supplemented with nuts, (walnuts, hazelnuts, or almonds) is related to a major decrease in LDL-cholesterol, and inflammatory markers connected to atheroma plaque formation and plaque instability. Compared to participants who consumed nuts less often, those who ate nuts more often were slimmer, less likely to smoke, more likely to use multivitamin supplements, and more likely to exercise. The participants also drank more alcohol and consumed more vegetables and fruits (Bao, Y., Han, J., Hu, F. B., Giovannucci, E. L., Stampfer, M. J., Willett, W. C., & Fuchs, C. S. (2013). Overall, the beneficial effects of nuts could explain why the Mediterranean diet plays a preventive role in high-risk participants with cardiovascular disease.

While nuts are associated with having a protective component, researchers have found that future research is required. While studies showed major inverse connections between total and cause-specific mortality and nut consumption, not all data from observational studies have been established in randomized, controlled clinical trials (Bao, Y., Han, J., Hu, F. B., Giovannucci, E. L., Stampfer, M. J., Willett, W. C., & Fuchs, C. S. (2013).

Red Meat vs. Seafood[edit]

Regarding the Mediterranean diet recommendations, it is advised that red meat only be consumed 2-3 times a month. Excess red meat consumption is related to a higher risk of cancer, heart disease, shorter survival, and fatality (Bellavia, A., Stilling, F., & Wolk, A. (2016). Bovalino, S., Charleson, G., & Szoeke, C. (2016) found that consumption of processed and red meat 3 or more times per week is connected to a higher cardiovascular risk score, compared to consuming meat no greater than once a week. The connection is even stronger for processed meat alone. Compared with participants who consumed a low amount of meat, those who consumed a high amount of meat had a 21% greater risk of all-cause fatality, a 29% greater risk of cardiovascular disease fatality, and no increased risk of cancer fatality (Bellavia, A., Stilling, F., & Wolk, A. (2016).

In contrast, fish (sardines, tuna, herring, salmon, and black cod) is packed with omega-3 fatty acids. Oysters, shellfish, clams, and mussels have similar advantages for heart and brain health. Bonaccio, M., Castelnuovo, A. D., Curtis, A. D., Costanzo, S., Persichillo, M., Donati, M. B., . . . Gaetano, G. D. (2014) found that fish consumption is related to a decreased risk of fatal and non-fatal stroke and coronary heart disease. They found the association to most likely be motivated by fatty fish. Results show an association of 40% decreased risk of coronary heart disease in participants who consumed fish four or more times per week.

Benefits of Olive Oil[edit]

Comparatively, olive oil is another key element of the Mediterranean diet. It is the primary source of vegetable fat. It is especially full of monounsaturated fatty acids. Olive oil also contains many antioxidant and bioactive elements including vitamin E, polyphenols, and phytosterols (Guasch-Ferré, M., Hu, F. B., Martínez-González, M. A., Fitó, M., Bulló, M., Estruch, R., . . . Salas-Salvadó, J. (2014). Ros, E. (2013) conducted a study in which participants were randomized into three different diet groups. For four weeks, each participant supplemented their diet with either walnuts, almonds, or olive oil. After four weeks, researchers found that LDL cholesterol was reduced in participants by 7.3%, 10.8%, and 13.4% after the walnut and almond, and olive oil diets. Results show that the increased consumption of total olive oil, is connected to reduced mortality and cardiovascular disease risk (Guasch-Ferré, M., Hu, F. B., Martínez-González, M. A., Fitó, M., Bulló, M., Estruch, R., . . . Salas-Salvadó, J. (2014).

Benefits of Fruit and Vegetables[edit]

Furthermore, increased dietary fiber consumption has been known to reverse the effects of stroke and coronary heart disease. Various scientific studies have observed the correlation between vegetable and fruit intake, which are the main source of fiber in Mediterranean countries (Buil-Cosiales, P., Martinez-Gonzalez, M., Ruiz-Canela, M., Díez-Espino, J., García-Arellano, A., & Toledo, E. (2017). (Qin, B. (2011) found that women in the highest quartile of total vegetable intake were more active, more educated, had a greater percentage who drank less than one alcoholic drink per day, were former or current smokers, and had a slightly higher waist circumference. A small but significant relationship between vegetable and fruit consumption was detected. Consumption of a minimum of one serving/week of cruciferous vegetables (chard, spinach, salad greens, and other leafy greens), and two servings/day of fruit may have preventive effects against cardiovascular disease (Buil-Cosiales, P., Martinez-Gonzalez, M., Ruiz-Canela, M., Díez-Espino, J., García-Arellano, A., & Toledo, E. (2017).

Ultimately, cardiovascular disease is treatable with a healthful diet. Future studies will need to be conducted to collect further information on Mediterranean diet benefits. While there is a decent amount of research collected, there is not enough to prove the preventive effects of all Mediterranean foods. It’s possible for research to increase in the future. This would expectantly lead to a decrease in the cardiovascular disease mortality rate, and provide at-risk Americans with further Mediterranean diet benefits.

References[edit]

Bao, Y., Han, J., Hu, F. B., Giovannucci, E. L., Stampfer, M. J., Willett, W. C., & Fuchs, C. S.(2013). Association of nut consumption with total and cause-specific mortality. New England Journal of Medicine, 369(21), 2001-2011. doi:10.1056/nejmoa1307352

Bellavia, A., Stilling, F., & Wolk, A. (2016). High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake? American Journal of Clinical Nutrition, 104(4), 1137-1143. doi:10.3945/ajcn.116.135335

Bonaccio, M., Castelnuovo, A. D., Curtis, A. D., Costanzo, S., Persichillo, M., Donati, M. B., . . . Gaetano, G. D. (2014). Adherence to the mediterranean diet is associated with lower platelet and leukocyte counts: results from the moli-sani study. Blood, 123(19), 3037-3044. doi:10.1182/blood-2013-12-541672

Bovalino, S., Charleson, G., & Szoeke, C. (2016). The impact of red and processed meat consumption on cardiovascular disease risk in women. Nutrition, 32(3), 349-354. doi: 10.1016/j.nut.2015.09.015

Buil-Cosiales, P., Martinez-Gonzalez, M., Ruiz-Canela, M., Díez-Espino, J., García-Arellano, A., & Toledo, E. (2017). Consumption of fruit or fiber-fruit decreases the risk of cardiovascular disease in a mediterranean young cohort. Nutrients,9(3), 295. doi: 10.3390/nu9030295

Casas, R., Sacanella, E., Urpí-Sardà, M., Chiva-Blanch, G., Ros, E., Martínez-González, M., . . .Estruch, R. (2014). The effects of the mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease. A randomized trial. Plos One, 9(6). doi:10.1371/journal.pone. 0100084

Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M., Corella, D., Arós, F., . . . Martínez-González, M. A. (2013). Primary prevention of cardiovascular disease with a mediterranean diet. New England Journal of Medicine, 368(14), 1279-1290. doi:10.1056/nejmoa1200303

Guasch-Ferré, M., Hu, F. B., Martínez-González, M. A., Fitó, M., Bulló, M., Estruch, R., . . . Salas-Salvadó, J. (2014). Olive oil intake and risk of cardiovascular disease and mortality in the predimed study. BMC Medicine, 12(1). doi:10.1186/1741-7015-12-78

Qin, B. (2011). Regarding "Fruit, vegetables, and olive oil and risk of coronary heart disease in italian women: the epicor study". American Journal of Clinical Nutrition, 94(1), 287-288. doi:10.3945/ajcn.111.016766

Ros, E. (2013). Crossover study of diets enriched with virgin olive oil, walnuts or almonds. Effects on lipids and other cardiovascular risk markers. Http://isrctn.org/>. doi:10.1186/isrctn68210440


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