Recently, the big news in the nutrition world was the PREDIMED (Prevencion con Dieta Mediterranea) study. It was a five year study involving 7,500 people in Spain with the results published by the New England Journal of Medicine. The study concluded that those who ate a Mediterranean-style diet had a 30% lower risk of major cardiovascular problems compared to those who were told to follow a low-fat diet. Olive oil and nuts were the main differences in the Mediterranean diet study. You can read how to properly get more olive oil in your diet here.
It was interesting to me last week when I received the May, 2013 edition of the Nutrition Action Healthletter published by the non-profit “watchdog” group called The Center for Science in the Public Interest. It’s one of many publications I read to keep on top of the constantly changing world of nutrition. The Center and Healthletter advocate “safer, more nutritious, and honestly marketed foods”, which you would think is right up my alley. But, honestly, this group continues to follow the flawed, outdated, industry sponsored, interest group supported research that the government espouses, even when it’s in complete opposition to the latest, best run, non-interest sponsored research. Proven once again by their “Mediterranean Mix-Up” article.
Mediterrean Diet Study Controversy
Now, I’m not picking on The Center for Science in the Public Interest but I am questioning the “public interest” part. The article takes issue with how the press reports misled the public regarding the value of the research regarding the Mediterranean diet. The article argues that the information is “garbled” because all three groups ate versions of the Mediterranean diet rather than having a control group including the Standard American Diet.
Let’s break this down – a Mediterranean diet study completed in Spain didn’t include the Standard American Diet because it wasn’t completed in America! Ok folks, it’s not all about America. And guess what? All three groups ate versions of the Mediterranean diet that are healthier than the Standard American Diet and they were still able to prove a 30% lower risk of major cardiovascular problems by increasing the dietary intake of fat from olive oil and nuts. We can’t ignore the results just because there wasn’t a group that ate even worse!
Mediterranean Diet vs. Low Fat
Next, the Center takes issue with the fact that the “low-fat control” Mediterranean diet doesn’t fit the American standard of “low-fat”. (Still not all about America). In fact the “low-fat control” group ate 37% of their calories from fat, while the average American eats 33% of their calories from fat. Oh, and the USDA (United States Department of Agriculture) recommends a diet of 20-35% of calories from fat.
Let’s break it down again. What the researchers considered “low-fat” was still higher than the Standard American Diet and was found to be the least healthy. The reduction in heart attacks, strokes, and deaths from heart disease were found in the people who increased their fat intake by adding olive oil and nuts (good fats!). But, this goes against the current barrage of (mis)information about the benefits of a low-fat diet! A Mediterranean diet isn’t necessarily low-fat, but the Mediterranean diet is rich in healthy fats.
Mediterranean Diet, Olive Oil & Nuts
The next piece the Center complains about is that the only real change in the Mediterranean diet was the addition of extra olive oil and nuts. “None of the three groups changed much of what they ate, with one key exception: people who got free deliveries of olive oil or nuts ate somewhat more of them”. And, they had a 30% lower risk of major cardiovascular problems (that part isn’t in contention). Again, this flies in the face of the current USDA doctrine so it’s being called into question. Seriously?! You’re not willing to consider that maybe this fake low-fat food thing isn’t a good idea and real, nutrient-dense whole foods might be better for the body? Guess not.
Mediterranean Diet & Calorie Counting
After a whole page of trying to show how none of the three Mediterranean diets were really that much different, we get to the surprise of calories, where the article now tries to show the diets are different in order to prove their argument (“the study’s two Mediterranean diets didn’t limit olive oil, nuts, or dark chocolate . . . the control group-which had no limits on bread, pasta, rice, and potatoes”). The current American dogma states you have to watch all your calories to lose weight. I’ve written about the problems with this concept before here. (If it was that easy it wouldn’t matter what the food was – one cookie or two cups of broccoli = same calories, but not the same nutrition.) Low and behold, “people who ate all the nuts they wanted and just poured on the olive oil; they didn’t gain weight”. The research authors suggested that as part of the Mediterranean diet, eating oil and nuts made participants more full so they ate less of other foods. One of the benefits of fat is that it satiates the body and slows absorption of foods so you stay fuller longer. But amazingly the Center writes “there’s no good evidence that something about nuts and olive oil kept people from overeating”. Nope, probably nothing that specific but the results speak for themselves and basic bio-chemistry explains the digestion of fats.
Mediterranean Diet Final Take
I won’t continue with the last page and a half. You probably get the idea. The Center complains about the press reports misleading people by taking apart the Mediterranean diet study to validate the current government recommendations. Finally, they recommend the DASH and OmniHeart diets both co-authored by Lawrence Appel and Frank Sacks who were interviewed for the Center’s article. At least Sacks did finally state “PREDIMED is a landmark study that should encourage Americans to improve their diets to prevent cardiovascular disease.”
This part is true. The average American needs to improve their diets in order to obtain optimal health and the Mediterranean diet can be a great solution. It’s time to start paying attention to the big picture studies, like PREDIMED, rather than the industry sponsored and interest group supported studies that are constantly being reported and sanctioned by the American government.
Center for Science in the Public Interest. (2013). Mediterranean Mix-Up. Nutrition Action Healthletter. May.
New England Journal of Medicine. (2013). Vol. 368:1279-1353.