Mediterranean diet reduces risk of heart attack and stroke

A new analysis of data from the Nurses’ Health Study has shown that women whose diets most closely resemble a traditional Mediterranean diet are significantly less likely to develop heart disease and stroke [1].

Lead researcher Dr Teresa T Fung (Harvard School of Public Health, Boston, MA) commented that many other studies have looked at the effects of this diet on cardiovascular mortality, but this is one of few with enough participants to look at nonfatal events and also is the first to examine stroke as a separate outcome. Fung and colleagues report their findings online February 16, 2009 in Circulation.

“What this adds to the existing literature is that it shows a reduced risk of nonfatal events as well,” she notes. “My take on this is that all the data from different studies with different types of dietary patterns are pointing in the same kind of direction: a minimally processed, mostly plant-based diet, with an abundance–not just in terms of quantity but in terms of variety–of different plant foods and fish. I will single out fish because we included fish in our score. Oily fish seem to have a very strong relation in terms of being beneficial.”

29% Reduced Risk of MI, 13% Reduction in Stroke Risk

Fung and colleagues used data on 74 886 women who participated in the Nurses’ Health Study, and the current analysis averaged data from six different dietary assessments self-reported between 1984 and 2002. Previous studies have shown an association between the Mediterranean diet and a reduced risk of cardiovascular death in both men and women, they note. 

They calculated the Alternate Mediterranean Diet (aMed) score, a measure constructed to assess US-based diets for their similarity to a traditional Mediterranean diet, for the women and divided them into quintiles. Relative risks for incident coronary heart disease, stroke, and combined fatal cardiovascular events were estimated and adjusted for cardiovascular risk factors.

During 20 years of follow-up, there were 2391 incident cases of CHD, 1763 incident cases of stroke, and 1077 cardiovascular disease deaths (fatal CHD and strokes combined).

Women in the top aMed quintile were at lower risk for both CHD and stroke compared with those in the bottom quintile (relative risk for CHD 0.71; p for trend <0.0001; relative risk for stroke 0.87; p for trend=0.03).

CVD mortality was also significantly lower among women in the top quintile of the aMed score (relative risk 0.61; p for trend <0.0001).

“These are dramatic results,” says Fung. “We found that women whose diets look like the Mediterranean diet are not only less likely to die from heart disease and stroke, but they are less likely to have those diseases.”

She stressed that these results–particularly the stroke finding–would need to be replicated in men, however.

An Easy-to-Follow Diet

Compared with a typical US diet, the Mediterranean-type diet requires a shift toward a more plant-based diet, which means eating less meat and getting more of the day’s protein from plant sources such as beans and nuts.  It also emphasises unprocessed whole grains and unsaturated oils, such as olive oil.

vegetables

The typical US dietary pattern of fast food and red meat high in saturated fats may be replacing the traditional Mediterranean diet even in Mediterranean countries.  Greece, for example, has one of the highest prevalences of obesity in Europe.  A recent study by researchers at the University of Michigan suggested a link between number of fast food restaurants in a neighbourhood and the risk of stroke.

You can learn how to cook delicious and heart-healthy food based on Mediterranean dietary principles at Cooking for Health courses, held throughout the year in Somerset, UK.

  1. Fung TT, Rexrode KM, Mantzoros CS, et al. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 2009; DOI:10.1161/CIRCULATIONAHA.108.816736. Available at: http://circ.ahajournals.org.

 

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Green and black tea may reduce stroke risk

Drinking at least three cups of green or black tea a day can significantly reduce the risk of stroke, a new University of California LA study has found. And the more you drink, the better your odds of staving off a stroke.

 

green-tea

 

The study results, published in the online edition of Stroke: Journal of the American Heart Association, were presented on 19 February at the American Heart Association’s annual International Stroke Conference in San Diego, California.

 

The UCLA researchers conducted an evidence-based review of all human observational studies on stroke and tea consumption found in the PubMed and Web of Science archives. They found nine studies describing 4,378 strokes among nearly 195,000 individuals, according to lead author Lenore Arab, a professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA.

 

“What we saw was that there was a consistency of effect of appreciable magnitude,” said Arab, who is also a professor of biological chemistry. “By drinking three cups of tea a day, the risk of a stroke was reduced by 21 percent. It didn’t matter if it was green or black tea.”

 

And extrapolating from the data, the effect appears to be linear, Arab said. For instance, if one drinks three cups a day, the risk falls by 21 percent; follow that with another three cups and the risk drops another 21 percent.

 

This effect was found in tea made from the plant Camellia sinensis, not from herbal teas.

 

There are very few known ways to reduce the risk of stroke, Arab said. And developing medications for stroke victims is particularly challenging, given that the drug has to get to the stroke-damaged site quickly because damage occurs so fast. Arab said that by the time a stroke victim gets medical care, it’s nearly too late to impede the damage.

 

“That’s why these findings are so exciting,” she said. “If we can find a way to prevent the stroke, or prevent the damage, that is simple and not toxic, that would be a great advance.”

 

Though no one is certain which compounds in tea are responsible for this effect, researchers have speculated that the antioxidant epigallocatechin gallate (EGCG) or the amino acid theanine may be what helps. Antioxidants are believed to help prevent coronary artery disease.

 

“And we do know that theanine is nearly 100-percent absorbed,” Arab said. “It gets across the blood-brain barrier and it looks a lot like a molecule that’s very similar to glutamate, and glutamate release is associated with stroke.

 

“It could be that theanine and glutamate compete for the glutamate receptor in the brain,” she added.

 

Although a randomized clinical trial is needed to confirm this effect, the findings suggest that drinking three cups of green or black tea a day could help prevent an ischaemic stroke.

 

Whilst drinking a moderate amount of green and black tea clearly has benefits, excessive consumption can upset blood sugar regulation due to the relatively high caffeine content of the leaves of Camellia sinensis.  If blood sugar is not well-regulated in the body, it can lead to symptoms of fatigue, cravings for sugar and a heightened stress response.  If you like regular hot drinks throughout the day, why not try some herbal teas which also contain powerful antioxidants.  Many people enjoy drinking Rooibos (or redbush) tea, made famous by the heroine of The No. 1 Ladies Detective Agency, Precious Ramotswe (Alexander McCall-Smith).  Rooibos is naturally caffeine free and contains high levels of the antioxidants aspalathin and nothofagin.  Aspalathin also has anti-mutagenic properties.

 

rooibos_aspalathus_linearispict2814_

 

To learn more about green tea and herbal teas and their health benefits, why not come to a Cooking for Health course, held throughout the year in Somerset, UK.

 

 

 

References

A. Von Gadow, E. Joubert and C. F. Hansmann.  Comparison of the antioxidant activity of rooibos tea (Aspalathus linearis) with green, oolong and black tea Food Chemistry, Volume 60, Issue 1, September 1997, Pages 73-77

 

 

 

Salt in popular restaurant meals twice the amount a child should have in a day

New research published on 2 February 2009 by Consensus Action on Salt and Health (CASH) shows that many popular meals eaten in UK high-street restaurants can contain large amounts of salt, in some cases more than twice the daily maximum limit for an adult in a single meal.

CASH worked with Trading Standards officers around the country to measure the salt content of 96 popular menu items from 16 high street restaurant chains.  Samples were purchased from the restaurants and analysed for their salt content by the Public Analyst.

Nearly three quarters (72%) of the main course dishes contained 3g of salt or more, the maximum daily limit for a six year-old and half the adult daily limit, and seven of these contained 6g of salt or more, the maximum daily limit for an adult.  The saltiest dishes were not confined to one or two restaurants – six out of the sixteen (over one third, 38%) restaurants surveyed served a popular main course dish containing 6g of salt or more.

The saltiest main course surveyed was Old Orleans Chicken Fajitas, with 8.8g of salt per serving.  Old Orleans also serves Wings and Ribs with 7.6g of salt per portion.  A Pizza Express American Hot Pizza contains 7.5g of salt per portion and a Wagamama Ramen contains 7.2g of salt per serving.  By comparison, a popular main meal at Beefeater of Sirloin Steak, grilled tomato, flat mushroom and chips contains only 0.4g of salt.

American Hot Pizza

American Hot Pizza

Starters and side dishes were also surveyed, with Old Orleans Chicken Wings with spicy BBQ sauce and blue cheese dressing containing almost 5g of salt per portion. Strada Aglio Garlic Bread contains 3.3g of salt per portion, over half the adult recommended daily limit.

Restaurant

Dish

Salt per Portion (g)

Old Orleans

Chicken Fajitas

8.84

Old Orleans

Wings and Ribs (with fries)

7.59

Pizza Express

American Hot Classic Pizza

7.5

Wagamamas

Wagamama ramen

7.2

Zizzi

Pizza Sofia

6.7

ASK

Fiesta Di Carne Pizza

6.55

Frankie and Benny’s

Chicken Penne Romana

6.0

 

Professor Graham MacGregor, Professor of Cardiovascular Medicine at St George’s Hospital in London said:

“Keeping our salt consumption below the recommended maximum levels is vital.  If we are to reduce the numbers of people needlessly dying from heart attacks and strokes, then we all need to keep a check on our salt intake.  The food industry in this country is leading the world in reducing the amount of salt it adds to the foods we buy in shops and supermarkets, and labelling those foods clearly so that we can make informed decisions about the products we buy.  Unfortunately the same cannot be said for foods we eat in restaurants.  It simply beggars belief that almost five years after the Food Standards Agency launched its salt reduction programme, and with all the publicity there has been about the 6g a day target, some high street restaurants have done nothing to reduce the amount of salt they add to their meals.  If they had even considered this issue then we wouldn’t be finding meals containing more than a day’s salt limit in a single course.  By comparison, ready meals sold in supermarkets have had their salt content reduced considerably over the last few years, and when we last surveyed them, we found only a very few with salt contents over 3g salt per serving.”

Raymond Blanc, Chef Patron of the Manoir Au Quat’ Saisons said,

“I believe that good food does not need more than the very lightest of seasoning – there is no reason for good chefs to mask the flavour of their ingredients by adding too much salt. Remember herby, sour, bitter and acid are also wonderful catalysts of flavour.”

For information about a two-day course in Somerset, UK, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population, please click here.