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They’re Still Doing It Wrong: Is the Mediterranean Diet the Healthiest Way to Eat? Versus Robb Wolf in Reno, Nevada.

March 4, 2013
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Last weekend the New York Times published the results of the first major clinical trial to measure the health benefits of the Mediterranean Diet in the article Mediterranean Diet Shown to Ward Off Heart Attack and Stroke, saying this: “The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.”

I’m not surprised by their positive results.  The diets participants ate were good, if not great, and perhaps most importantly, participants were those who needed intervention.  The participants were almost all already taking statins, and every person required intervention in some regard: participants were 7,447 randomly assigned people in Spain who were overweight, were smokers, or had diabetes or other risk factors for heart disease.  Importantly, there was no statistically significant weight loss while on the program.  The two things the researchers saw were decreased heart disease and stroke.

Participants were originally intended to test two different diets relative to controls, a “low fat” diet, and a “high fat” diet — versus the reserachers’ version of the Mediterranean Diet.   The results ended up shoddy, however: participants had a hard time with the low fat approach.  Few of them were able to stick to it.  Instructions were to stay on each individual’s current diet but eliminate the fat–a poor model of health by a wide variety of standards–and the program was so hard to follow that nearly no one adhered to the guidelines.   Apparently low fat diets are not much of a party.  Thank you, researchers, you kind-of almost got it this time.

But sincerely, that’s good news, that researchers are coming around to fat at all.

So participants in reality fell into two categories.  They either continued to eat “as is” — whatever that was for the participant before starting the study, or they ate one of two variants on the Mediterranean Diet.  The Mediterranean Diet was then partitioned into two categories: one with the fat source as four tablespoons of olive oil each day, and one with the fat source as nuts such as walnuts:

 

One group assigned to a Mediterranean diet was given extra-virgin olive oil each week and was instructed to use at least 4 four tablespoons a day. The other group got a combination of walnuts, almonds and hazelnuts and was instructed to eat about an ounce of the mix each day. An ounce of walnuts, for example, is about a quarter cup — a generous handful. The mainstays of the diet consisted of at least three servings a day of fruits and at least two servings of vegetables. Participants were to eat fish at least three times a week and legumes, which include beans, peas and lentils, at least three times a week. They were to eat white meat instead of red, and, for those accustomed to drinking, to have at least seven glasses of wine a week with meals.

They were encouraged to avoid commercially made cookies, cakes and pastries and to limit their consumption of dairy products and processed meats.

 

So it comes as no surprise to me that these participants saw a reduction in herat disease risk.  You’ll notice also that grains were not in the instructions at all.  Because they weren’t forbidden, it is almost certain that all participants ate grains.  But participants were not explicitly instructed to eat grains — another encouraging fact and positive contribution to the results of this study.

The diet described above sans legumes is a “paleo” diet.  No processed foods with fresh vegetables, healthy oils, and animal products–even if emphasizing white meat over red– they’re on the right track.  No, the diet isn’t perfect.  Nuts are not necessarily the best form of fat because of their high phytate and omega 6 content.  Animal fats can be uniquely healthful and do not need to be avoided.  Red meats have better mineral profiles than white meats.  All of which is to say, it’s not perfect, but there’s no surprise that people switching over to this diet from a life of processed foods and statins find relief.

Why few people hail the elimination of processed foods as the common denominator between all of the success is completely beyond me.  Every time a study is conducted in which participants eliminate processed foods — even if moving to a vegetarian diet — demonstrates that diseased states are significantly correlated with processed foods.  This leaves a group of superior diets all hovering over the Standard American Diet.   This explains why doctors can ardently stand by diets as — in my opinion — dangerous as a low fat vegetarian diet such as Dean Ornish.  No, it’s not ideal– but it is a diet that resides among those more natural and less processed than most of contemporary toxins.

What needs to happen now is a distillation of that pool.  What is the optimal diet within those that eliminate processed goods?  A diet that is satisfying, that uniquely meets nutritional needs and replenishes nutrient stores, that is rich in savory and fulfilling meals, and that is free of toxins found in foods such as grains– this is likely the cream of the crop.

Some of this work is already being done.  Robb Wolf is front-runner in this movement, actually studying and implementing paleo / natural food principles in real life.  Read about his work revamping public health in Reno, Nevada here.   In his work there, millions of dollars are being saved and hundreds of lives resuscitated as paleo-type interventions radically decrease insulin resistance and heart disease risk.

From the Reno police chief, we see two case studies of improved health across a wide spectrum of specific and crucial markers for cardiovascular and metabolic health.  These people are not just decreasing their risk of heart disease and stroke, but actively losing weight as well (no statistical weight loss occurred on the Mediterranean Diets in the study).  I have copied them here:

 

RPD Case Studies

As mentioned earlier, the program in Reno impacted approximately 80 personnel in both the police and fire departments. To date, the program has involved approximately 60 police officers, and the number of participants is increasing. Chief of Police Steven Pitts works closely with officers following annual physicals to identify those who are at risk in a variety of areas and then introduces the officers to the RPD Program. Voluntary participation is at approximately 90 percent. Following are two case studies that demonstrate the effectiveness of the program and its sustainability. Case studies and graphs are the property of SpecialtyHealth’s Wellness and Prevention Program (all rights reserved, June 2012).

Case one. This case involves a highly motivated 33-year-old police officer who, over a four-month period, has had a spectacular reversal of insulin resistance. This was accomplished with a low-carbohydrate diet, exercise, a weight loss of 12 pounds, and medication—in this case, a generic statin costing $10 every three months. The officer’s LDL dropped more than 1,200 points to ideal levels.

SPECIALTY HEALTH 2/1/11 6/6/11 4-MO. RESULT
Weight 219 207
5.4%
LDL-P 2231 1026
1205
HDL-P 23.6 28.7
5.1
LDL-C 117 61
56
HDL-C 31 35
4
Triglycerides 362 119
243
Insulin Resistance Score 73 51
16

Case two. This case is a six-year follow-up on a 52-year-old police officer. He lost 40 pounds (including five inches from his waist) and corrected almost all of his numbers including four of the markers that diagnose him with metabolic syndrome. He went from having five out of five metabolic markers to one out of five. His overall risk dropped precipitously, and his triglycerides went from 270 to 38. These results were achieved by the same basic approach that was used in case one but with more pharmaceuticals. The corrections are sustainable. ♦

SPECIALTY HEALTH 2/1/06 2/10/12 6-YEAR RESULT
Weight 235 195
40
Waist (inches) 43 38
5
LDL-P 1393 1096
297
LDL-C 106 83
23
HDL-C 38 55
17
Triglycerides 270 38
232
Insulin Resistance Ration 7.1 .7
6.4
Metabolic Syndrome
Markers
5/5 1/5
4

So it’s important and remarkable to note that the elimination of processed foods a la the Mediterranean Diet above is a big deal.  It’s enormously helpful, and I’ll support anyone who’s undertaking a move towards natural health such as the Mediterranean Diet always, period.

But if we want optimality, and we want weight loss, and we want radiance, and we want to save us from health care implosion, and we want health improvements across the board, distilling the pool of natural diets down to which ones best optimize health and minimize toxicity is the next step.

Paleo ho!

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Want to advance healthful eating, talk about stuff like this, and have a wicked good time doing so?  Check out Paleo Fx, coming to us in Austin in just three weeks!

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Managing director of Paleo for Women and author of Sexy by Nature.

2 Comments

  1. Although I agree that processed foods are never good I don’t think this should become the new’ answer’ to weight loss. Simply because it isn’t. Gary Taubes shows in his book how populations were still obese and were not eating processed foods. So I think this is an important element, but it certainly isn’t the answer to all our problems.

    • Dan, which population is/was obese without processed foods? I have Taubes’ book but I can’t remember which group that was. Thank you!

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