By Dr. Mercola
While there are many variations of the Mediterranean diet, its primary hallmark is whole, minimally processed foods.
Clearly, the emphasis on fresh vegetables, nuts and fats like olive oil makes it far more healthful than the standard American diet which is very high in processed foods.
Now, a study many consider to be a "landmark" trial provides compelling evidence that the type of fat you consume, not the amount, is what imparts the cardiovascular health benefits associated with the Mediterranean diet. As summarized by Dr. Dean Ornish:1
"...the most responsible conclusion from this study would be, 'We found a significant reduction in stroke in those consuming a Mediterranean diet high in omega-3 fatty acids, when compared to those who were not making significant changes in their diet.'"
Sadly, our government has been pushing a low-fat diet recommendation that has been causing death and disease for decades.
The Right Fats Can Cut Your Heart Disease Risk by Nearly One-Third
The Spanish trial, which included nearly 7,450 volunteers between the ages of 55 and 80, began in 2003 and was stopped early for ethical reasons, in 2011, as the control group was deemed to be at a dangerous disadvantage. The participants had all been diagnosed with high risk of cardiovascular disease, but were asymptomatic at the outset of the study. Participants were followed for a median of 4.8 years.
The volunteers were randomly divided into three groups (two intervention groups and one control):
- Mediterranean diet rich in fresh vegetables, seafood, mono-unsaturated fats, supplemented with 30 grams of nuts per day (15 grams walnuts, 7.5 grams almonds, and 7.5 grams hazelnuts)
- Mediterranean diet (as above) supplemented with 50 ml of virgin olive oil per day instead of nuts
- Low-fat diet (control)
There were no calorie restrictions for any of the groups, nor was physical activity promoted or required. Compliance with olive oil and nut consumption was tested via blood and urine analysis. The primary end point was a composite of myocardial infarction, stroke, and death from cardiovascular causes. Secondary end points were stroke, myocardial infarction, death from cardiovascular causes, and death from any cause.
Remarkably, in less than five years, the two intervention groups achieved a 30 percent relative risk reduction for cardiovascular disease, and stroke reduction was an impressive 49 percent.
No wonder they felt the trial had to be stopped for ethical reasons! Sadly, low-fat diets are among the most accepted diets in the medical community, both for weight management and cardiac health, and have been aggressively promoted for the past 60 years. Now the evidence is showing this is perhaps the worst type of diet one could consume. There's just no telling how many millions of people have prematurely died from this fatally flawed advice. According to the authors:2
"In observational cohort studies and a secondary prevention trial (the Lyon Diet Heart Study), increasing adherence to the Mediterranean diet has been consistently beneficial with respect to cardiovascular risk. A systematic review ranked the Mediterranean diet as the most likely dietary model to provide protection against coronary heart disease. Small clinical trials have uncovered plausible biologic mechanisms to explain the salutary effects of this food pattern.
We designed a randomized trial to test the efficacy of two Mediterranean diets (one supplemented with extra-virgin olive oil and another with nuts), as compared with a control diet (advice on a low-fat diet), on primary cardiovascular prevention...
Our findings are consistent with those of prior observational studies of the cardiovascular protective effects of the Mediterranean diet, olive oil, and nuts; smaller trials assessing effects on traditional cardiovascular risk factors and novel risk factors, such as markers of oxidation, inflammation, and endothelial dysfunction; and studies of conditions associated with high cardiovascular risk — namely, the metabolic syndrome and diabetes. Thus, a causal role of the Mediterranean diet in cardiovascular prevention has high biologic plausibility.
...The risk of stroke was reduced significantly in the two Mediterranean-diet groups. This is consistent with epidemiologic studies that showed an inverse association between the Mediterranean diet or olive-oil consumption and incident stroke."
When Will Government Alter its Dangerous Dietary Guidelines?
The single-blind, randomized clinical trial was published online at the end of February in the New England Journal of Medicine.3 It is perhaps one of the strongest validations of my optimized Nutritional Plan so far, which calls for high amounts of healthful raw fats, including omega-3, modest high-quality animal protein, and restriction of carbohydrates to high-fiber vegetables — all from fresh whole foods, as opposed to processed. During his presentation at the 6th International Congress on Vegetarian Nutrition at Loma Linda University in California, Mayo Professor David Jacobs, PhD, called for nutrition researchers to focus on food and dietary patterns instead of isolated nutrients.
"What this study gives us is A-level evidence," he said. "The US Dietary Guidelines Committee will notice that."4
Another interesting tidbit is the fact that calories per se did not account for the benefits. Those in the extra virgin olive oil group consumed an average of 2,172 calories a day and those supplementing with nuts ate 2,229 calories per day, whereas the control group consumed only 1,960 calories a day. Yet, despite consuming more calories, and far more fat, the intervention groups reduced cardiovascular disease and stroke risk by 30 and 49 percent respectively.
This is precisely what I've been telling my readers for years: Eating fat does NOT make you fat! Eating sugar and grains does... As explained by Dr. Robert Lustig, fructose in particular is "isocaloric but not isometabolic." This means you can have the same amount of calories from fructose or glucose, fructose and protein, or fructose and fat, but the metabolic effect will be entirely different despite the identical calorie count. Many governments around the world have been pushing low-fat diet recommendations5 that have been causing death and disease for decades. How quickly will they admit their error and failure and make the necessary changes? Only time will tell...
Healthy Fat Guidelines
Sources of healthy fats include:
Olives and Olive oil Coconuts and coconut oil Butter made from raw grass-fed organic milk Raw nuts, such as, almonds or pecans Organic pastured egg yolks Avocados Grass-fed meats Palm oil Unheated organic nut oils
Another healthful fat you want to be mindful of is animal-based omega-3. Deficiency in this essential fat can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3's and the best sources of this fat, please review this previous article. It will also be crucial to eliminate any trans fats, which are loaded in virtually all bakery goods and most processed foods. Trans fats embed themselves into your cell membranes and disrupt key metabolic functions. They are pernicious poisons and ideally your consumption of them should be zero.
Another Crazy Health Study in the News
While we're on the topic of flawed health recommendations, vitamin D has made headlines in the mainstream media lately. For example, the Los Angeles Times6 recently reported that calcium and vitamin D are not effective for preventing bone fractures — a surprising statement, to say the least. The US federal government's expert panel on preventive medicine came to this conclusion after reviewing six randomized trials studying the health effects of vitamin D and calcium supplements.
However, and this is a MASSIVE however, the dosages assessed were highly suspect: only 400 IU's of vitamin D3, combined with 1,000 mg of calcium per day. Two of the most obvious potential problems here are:
- The vitamin D3 dose was FAR too low to provide therapeutic benefit
- Both calcium and vitamin D supplementation requires vitamin K2 in order to function properly. Without K2, both calcium and vitamin D supplements can cause improper calcification and related health problems
First, let's look at the dosage. While there is no one-size-fits-all dosage level at which "magic" happens, based on the most recent research by GrassrootsHealth — an organization that has greatly contributed to the current knowledge on vitamin D through their D*Action Study — it appears as though most adults need about 8,000 IU's of vitamin D a day in order to get their serum levels above 40 ng/ml — a far cry from the 400 IU's studied. Secondly, the calcification problem... According to the LA Times:
"The analysis also made clear that this level of vitamin D and calcium supplementation increases the risk of kidney stones. The added risk is small, but considering the lack of demonstrated benefits, even a small risk can't be justified, the panel said."
This is a perfect example of how there's more to nutrition as medicine than taking any one individual nutrient to prevent or treat any given problem, and why getting the majority of your nutritional needs from whole food is always recommended.
As discussed in a recent interview with Dr. Kate Rheaume-Bleue, author of Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life, both calcium and vitamin D need vitamin K2 to function properly. Vitamin K2, also called menaquinone, is made by the bacteria that line your gastrointestinal tract. K2 goes straight to your blood vessel walls, bones, and tissues other than your liver, and is really critical for keeping your bones strong and arteries clear.
In fact, the biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn't be, such as in your arteries and soft tissues. Unfortunately, about 80 percent of Americans do not get enough vitamin K2 in their diet, which makes taking calcium and vitamin D supplements a riskier proposition.
If Taking a Vitamin D Supplement, Remember Vitamin K2
What's more, while vitamin D is a critical nutrient for optimal health, taking oral vitamin D could become problematic unless you're also getting sufficient amounts of vitamin K2. As explained by Dr. Rheaume-Bleue:
"When you take vitamin D, your body creates more of these vitamin K2-dependent proteins, the proteins that will move the calcium around. They have a lot of potential health benefits. But until the K2 comes in to activate those proteins, those benefits aren't realized. So, really, if you're taking vitamin D, you're creating an increased demand for K2. And vitamin D and K2 work together to strengthen your bones and improve your heart health.
...For so long, we've been told to take calcium for osteoporosis... and vitamin D, which we know is helpful. But then, more studies are coming out showing that increased calcium intake is causing more heart attacks and strokes. That created a lot of confusion around whether calcium is safe or not. But that's the wrong question to be asking, because we'll never properly understand the health benefits of calcium or vitamin D, unless we take into consideration K2. That's what keeps the calcium in its right place."
According to Dr. Rheaume-Bleue, vitamin K2 deficiency is also what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries. So, while the conclusion that taking vitamin D and calcium supplements may be bad for you is not false per se, it is incomplete, and therefore misleading...While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Rheume-Bleue suggests about 150-200 micrograms of K2 will meet the need for the "average" healthy person.
Reminder: The Best Form of Vitamin D Does Not Come in a Pill...
While many are interested in the guidelines for vitamin D supplementation, it's important to realize that the IDEAL way to optimize your vitamin D level is not by taking a pill, but rather allowing your body to do what it was designed to do — create vitamin D from sun exposure or a safe tanning bed. Sunlight is better for a number of reasons:
- It is natural. Our ancestors optimized their vitamin D levels by sun exposure, not by swallowing it in foods. Although vitamin D is in some animal foods, it is in relatively low quantities and to my knowledge there are no known ancestral populations that thrived on oral vitamin D sources.
- When you expose your skin to the sun, your skin also synthesizes high amounts of cholesterol sulfate, which is very important for cardiovascular health. In fact, Dr. Stephanie Seneff, believes that high LDL and associated heart disease may in fact be a symptom of cholesterol sulfate deficiency. Sulfur deficiency, in fact, also promotes obesity and related health problems like diabetes
- You cannot overdose when getting your vitamin D from sun exposure, as your body has the ability to self-regulate production and only make what it needs
- Sunlight has additional health benefits unrelated to vitamin D production
Also, while Norway,7 and Europe8 as a whole, are wisely increasing the recommended daily allowance for vitamin D, it's important to realize that the most important factor is your serum vitamin D level (the level in your blood), not the daily dose. The only way to determine whether you're within the therapeutic range is to regularly test your vitamin D levels. Again, according to the most recent research the ideal adult dose is closer to 8,000 IU's a day in order to achieve serum levels at or above 40 ng/ml.
That said, you really should be taking whatever dosage required to obtain a therapeutic level of vitamin D in your blood. For more information, including an in-depth explanation of everything you need to know before you get tested, please see Test Values and Treatment for Vitamin D Deficiency.
Measuring Vitamin D Performance is One of Your Most Cost Effective Health Strategies
Many families have seen a rise in the proportion of their income spent on healthcare expenses. For many, the costs now exceed what they spend on food. Measuring your vitamin D performance and taking steps to optimize your level is one of the easiest and least expensive things you can do for your health, and could help you with out-of-control health care expenses.
According to a January 17 press release by Orthomolecular Medicine,9 3,600 medical papers with vitamin D in the title or abstract were published in 2012 alone, bringing the grand total to 33,800. That's a lot of studies on vitamin D. The Top 16 vitamin D papers of 2012 selected by a panel of vitamin D experts focused on vitamin D's beneficial impact on:
Pregnancy outcomes (reduced risk of Cesarean section and pre-eclampsia) Autism Childhood language impairment Cardiovascular disease Type 1 diabetes Type 2 diabetes Bacterial and viral infections Cancer Falls and bone fractures All-cause mortality
A Return to Common Sense
All in all, what most well-performed research is ultimately showing is that the rules of health are actually fairly simple and straightforward. Your health is a direct reflection of your total lifestyle, with diet being the predominant factor.
The primary factor of "a healthy diet" is whole food, grown in a natural way, without genetic tinkering and toxic chemicals. Food that is sprayed with agricultural chemicals, genetically altered, processed, pasteurized and irradiated, and then reformulated with added synthetic nutrients, additives and fillers, simply cannot take the place of real food. You cannot eat trash and supplement your way to radiant health...
It's also inadvisable to get too hung up on individual nutrients, as virtually all nutrients are dependent on other dietary factors for optimal function. Aggressive supplementation can sometimes add to the problem by worsening nutritional deficiencies. This problem can largely be circumvented by eating a varied whole food diet, and in the case of vitamin D, living in a Mediterranean type climate where you can expose large amounts of your skin to sunshine regularly.
It's really not rocket science, and I would recommend placing a little less stock in those who insist that every single nutrient must be scientifically proven beneficial in order to validate a sensible whole food diet over processed alternatives. You cannot fool nature. And you can only fool your body for so long.