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The mediterranean diet: Rationale and evidence for its benefit

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Abstract

There is now a consensus about recommending the Mediterranean diet pattern for the prevention of coronary heart disease (CHD) and cancer. The most important aspect of this treatment decision, in contrast with the pharmacologic prevention of CHD (including cholesterol lowering), is that the Mediterranean diet has a striking effect on survival. The main explanation for this is that the Mediterranean diet is protective not only against CHD and cancers but also against other various chronic diseases. Furthermore, the Mediterranean diet appears to be effective at reducing atherosclerosis and the risk of fatal complications (ie, sudden cardiac death and heart failure) of atherosclerosis. Finally, unlike drug therapies, no harmful side effect has been reported following the adoption of this dietary pattern. Many micro-and macronutrients characteristic of the Mediterranean diet interact in a synergistic way to induce states of resistance to chronic diseases. More research is required to understand these complex interplays.

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References and Recommended Reading

  1. Sans S, Kesteloot H, Kromhout D: Dynamics of cardiovascular and all-cause mortality in Western and Eastern Europe between 1970 and 2000. Eur Heart J 2006, 27:107–113.

    PubMed  Google Scholar 

  2. Willett WC, Sacks F, Trichopoulou A, et al.: Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995, 61(Suppl):1402S–1406S.

    PubMed  CAS  Google Scholar 

  3. de Lorgeril M, Salen P: Modified Cretan Mediterranean diet in the prevention of coronary heart disease and cancer: an update. World Rev Nutr Diet 2007, 97:1–32.

    PubMed  Google Scholar 

  4. Hjermann I, Holme I, Leren P: Oslo Study Diet and Antismoking Trial. Results after 102 months. Am J Med 1986, 80:7–11.

    Article  PubMed  CAS  Google Scholar 

  5. de Lorgeril M, Renaud S, Mamelle N, et al.: Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994, 343:1454–1459.

    Article  PubMed  Google Scholar 

  6. Burr ML, Fehily AM, Gilbert JF, et al.: Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet And Reinfarction Trial. Lancet 1989, 334:757–761.

    Article  Google Scholar 

  7. de Lorgeril M, Salen P, Monjaud I, Delaye J: The diet heart hypothesis in secondary prevention of coronary heart disease. Eur Heart J 1997, 18:14–18.

    Article  Google Scholar 

  8. GISSI-Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999, 354:447–455.

    Article  Google Scholar 

  9. Gilman MW, Cupples LA, Gagnon D, et al.: Protective effect of fruits and vegetables on development of stroke in men. JAMA 1995, 273:1113–1117.

    Article  Google Scholar 

  10. Rimm EB, Ascherio A, Giovannucci E, et al.: Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996, 275:447–451.

    Article  PubMed  CAS  Google Scholar 

  11. Key TJ, Thorogood M, Appleby PN, Burr ML: Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17-year follow-up. BMJ 1996, 313:775–779.

    PubMed  CAS  Google Scholar 

  12. Albert CM, Hennekens CH, O’Donnell CJ, et al.: Fish consumption and risk of sudden death. JAMA 1998, 279:23–28.

    Article  PubMed  CAS  Google Scholar 

  13. Daviglus ML, Stamler J, Orencia AJ, et al.: Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997, 336:1046–1053.

    Article  PubMed  CAS  Google Scholar 

  14. Robinson K, Arheart K, Refsum H, et al.: Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease and coronary heart disease. Circulation 1998, 97:437–443.

    PubMed  CAS  Google Scholar 

  15. Stampfer MJ, Rimm EB: Folate and cardiovascular disease: why we need a trial now. JAMA 1996, 275:1929–1930.

    Article  PubMed  CAS  Google Scholar 

  16. Wever RM, Lüscher TF, Cosentino F, Rabelink TJ: Atherosclerosis and the two faces of endothelial nitric oxide synthase. Circulation 1998, 97:108–112.

    PubMed  CAS  Google Scholar 

  17. de Lorgeril M, Salen P, Martin JL, et al.: Effect of a Mediterranean-type of diet on the rate of cardiovascular complications in coronary patients. Insights into the cardioprotective effect of certain nutriments. J Am Coll Cardiol 1996, 28:1103–1108.

    Article  PubMed  Google Scholar 

  18. de Lorgeril M, Salen P, Martin JL, et al.: Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study. Circulation 1999, 99:779–785.

    PubMed  Google Scholar 

  19. de Lorgeril M, Salen P, Caillat-Vallet E, et al.: Control of bias in dietary trial to prevent coronary recurrences. The Lyon Diet Heart Study. Eur J Clin Nutr 1997, 51:116–122.

    Article  PubMed  Google Scholar 

  20. de Lorgeril M, Salen P, Martin JL: Mediterranean dietary pattern in a randomized trial: Prolonged survival and possible reduced cancer rate. Arch Intern Med 1998, 158:1181–1187.

    Article  PubMed  Google Scholar 

  21. Cummings JH, Bingham SA: Diet and the prevention of cancer. BMJ 1998, 317:1636–1640.

    PubMed  CAS  Google Scholar 

  22. The Women’s Healthy Eating and Living (WHEL) randomized trial. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer. JAMA 2007, 298:289–298.

  23. Clark LC, Combs GF, Turnbull BW, et al.: Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin: a randomized controlled trial. JAMA 1996, 276:1957–1963.

    Article  PubMed  CAS  Google Scholar 

  24. Menendez JA, Papadimitropoulou A, Vellon R, et al.: A genomic explanation connecting “Mediterranean diet”, olive oil and cancer: oleic acid, the main monounsaturated fatty acid of olive oil, induces formation of inhibitory “PEA3 transcription factor-PEA3 DNA binding site” complexes at the Her-2/neu (erbB-2) oncogene promoter in breast, ovarian and stomach cancer cells. Eur J Cancer 2006, 42:2425–2432.

    Article  PubMed  CAS  Google Scholar 

  25. Hashim YZ, Eng M, Gill CI, et al.: Components of olive oil and chemoprevention of colorectal cancer. Nutr Rev 2005, 63:374–386.

    Article  PubMed  Google Scholar 

  26. MacLean CH, Newberry SJ, Mojica WA, et al.: Effects of omega-3 fatty acids on cancer risk. A systematic review. JAMA 2006, 295:403–415.

    Article  PubMed  CAS  Google Scholar 

  27. Larsson SC, Kumlin M, Ingelman-Sundberg M, et al.: Dietary long-chain n-3 fatty acids for the prevention of cancer: a review of potential mechanisms. Am J Clin Nutr 2004, 79:935–945.

    PubMed  CAS  Google Scholar 

  28. Mitrou PN, Kipnis V, Thiebaut AC, et al.: Mediterranean dietary pattern and prediction of all-cause mortality in a US population. Arch Intern Med 2007, 167:2461–2468.

    Article  PubMed  Google Scholar 

  29. Trichopoulou A, Costacou T, Barnia C, Trichopoulos D: Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003, 348:2599–2608.

    Article  PubMed  Google Scholar 

  30. Knoops KT, de Groot L, Kromhout D, et al.: Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women. The HALE Project. JAMA 2004, 292:1433–1439.

    Article  PubMed  Google Scholar 

  31. Kris-Etherton P, Eckel RH, Howard BV, et al.: AHA Science Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I dietary pattern on cardiovascular disease. Circulation 2001, 103:1823–1825.

    PubMed  CAS  Google Scholar 

  32. Zeghichi S, Kallithraka S, Simopoulos AP, Kypriotakis Z: Nutritional composition of selected wild plants in the diet of Crete. World Rev Nutr Diet 2003, 91:22–40.

    Article  PubMed  CAS  Google Scholar 

  33. de Lorgeril M, Salen P, Martin JL, et al.: Interactions of wine drinking with omega-3 fatty acids in coronary heart disease patients. A fish-like effect of moderate wine drinking. Am Heart J 2008, 155:175–181.

    Article  PubMed  Google Scholar 

  34. Simopoulos A: Importance of the ratio of omega-6/omega-3 essential fatty acids: evolutionary aspects. World Rev Nutr Diet 2003, 92:1–22.

    Article  PubMed  CAS  Google Scholar 

  35. Toufektsian MC, de Lorgeril M, Nagy N, Salen P, et al.: Chronic dietary intake of plant-derived anthocyanins protects the rat heart against ischemia-reperfusion injury. J Nutr 2008, 138:747–752.

    PubMed  CAS  Google Scholar 

  36. Di Castelnuovo A, Costanzo, S, Bagnardi V, et al.: Alcohol dosing and total mortality in men and women. An updated meta-analysis of 34 prospective studies. Arch Intern Med 2006, 166:2437–2445.

    Article  PubMed  Google Scholar 

  37. de Lorgeril M, Salen P, Martin JL, et al.: Wine drinking and risks of cardiovascular complications after recent acute myocardial infarction. Circulation 2002, 106:1465–1469.

    Article  PubMed  Google Scholar 

  38. Mukamal KJ, Maclure M, Muller JE, et al.: Prior alcohol consumption and mortality following acute myocardial infarction. JAMA 2001, 285:1965–1970.

    Article  PubMed  CAS  Google Scholar 

  39. Janszky I, Ljung R, Ahnve S, et al.: Alcohol and long-term prognosis after acute myocardial infarction. The SHEEP study. Eur Heart J 2008, 29:45–53.

    Article  PubMed  CAS  Google Scholar 

  40. Guiraud A, de Lorgeril M, Boucher F, et al.: Cardioprotective effect of chronic low dose ethanol drinking: insights into the concept of ethanol preconditioning. J Mol Cell Cardiol 2004, 36:561–566.

    Article  PubMed  CAS  Google Scholar 

  41. Albert CM, Manson JE, Cook NR, et al.: Moderate alcohol consumption and the risk of sudden cardiac death among US male physicians. Circulation 1999, 100:944–950.

    PubMed  CAS  Google Scholar 

  42. Zheng ZJ, Croft JB, Giles WH, Mensah GA: Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001, 104:2158–2163.

    Article  PubMed  CAS  Google Scholar 

  43. Bero L, Oostvogel F, Bacchetti P, Lee K: Factors associated with findings of published trials of drug-drug comparisons: why some statins appear more efficacious than others. PLoS Med 2007, 4:e184.

    Article  PubMed  Google Scholar 

  44. de Lorgeril M, Salen P: Cholesterol lowering and mortality: time for a new paradigm? Nutr Metab Cardiovasc Dis 2006, 6:387–390.

    Article  Google Scholar 

  45. Strandberg TE, Strandberg AY, Salomaa VV, et al.: Alcoholic beverage preference, 29-year mortality, and quality of life in men in old age. J Gerontology 2007, 62:213–218.

    Google Scholar 

  46. Di Castelnuovo A, Rotondo S, Iacoviello L, et al.: Metaanalysis of wine and beer consumption in relation to vascular risk. Circulation 2002, 105:2836–2844.

    Article  PubMed  Google Scholar 

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Correspondence to Michel de Lorgeril.

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de Lorgeril, M., Salen, P. The mediterranean diet: Rationale and evidence for its benefit. Curr Atheroscler Rep 10, 518–522 (2008). https://doi.org/10.1007/s11883-008-0080-5

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