Health Benefits of a Mediterranean Diet: Miscellaneous Benefits

Mediterranean diet reduces risk for rheumatoid arthritis

Two studies, presented this week at the American College of Rheumatology Annual Meeting in San Francisco, show a person's diet can significantly affect his or her chance of developing rheumatoid arthritis.

Rheumatoid arthritis is the most common chronic autoimmune disease that affects the joints. RA has the potential for joint damage and deformity, with loss of function. The cause of RA is unknown. It affects people of all ages, and women more commonly than men. RA causes pain, stiffness and swelling, generally in multiple joints. RA may affect any joint, but the small joints in the hands and feet are most frequently involved. Rheumatoid inflammation may also develop in other organs such as the lungs.

The first study found that typical Western diets high in red meat, processed meat, refined grains, fried food, high-fat dairy, and sweets can increase a person's risk of developing RA in comparison to Prudent diets made mostly of fruit, vegetables, legumes, whole grains, poultry and fish.

"The evidence for diet having a role in the etiology of RA is inconsistent, sometimes conflicting. The prior studies based on individual nutrients and food groups may not have enough power to detect small effects," explains lead investigator in the study, Bing Lu, MD, DrPH; assistant professor of medicine; Brigham and Women's Hospital and Harvard Medical School.

"Instead, overall dietary pattern analysis examines the cumulative effects of multiple nutrients and foods, and may be more predictive of disease risk than individual foods or nutrients. The single-nutrient approach may be inadequate for taking into account complicated interactions among nutrients, and high levels of inter-correlation makes it difficult to examine their separate effects. Therefore, we proposed a prospective study examining the overall effect of dietary patterns to furnish novel information about diet and etiology of RA."

Through the Nurses' Health Study II, -- a study of 116,460 female registered nurses ranging in age from 25 to 42 -- Dr. Lu's team followed 93,859 women without RA who filled out dietary questionnaires every four years between 1991 and 2011. From these questionnaires, the researchers discovered two dietary patterns among the women: Western and Prudent.

Throughout the course of the study, 347 women developed RA at an average age of 49. After taking into consideration their age, smoking status, body mass index, total calories consumed each day, alcohol consumption, level of physical activity, and socioeconomic factors, the women on Prudent diets had less of a chance of developing RA, while those on the Western diet were at increased risk, but BMI weakened these findings.

"This indicates that the effects of the two dietary patterns on RA risk may be partially through BMI, and the clear mechanism is still unknown. Therefore, adherence to a healthy diet may be a way to prevent this debilitating disease, especially for high risk population," explains Dr. Lu of the findings.

The second study, showed that following the Dietary Guidelines for Americans can also lower one's chances of developing the disease. According to the United States Department of Agriculture, "the Dietary Guidelines for Americans … provide authoritative advice about consuming fewer calories, making informed food choices, and being physically active to attain and maintain a healthy weight, reduce risk of chronic disease, and promote overall health."

Little has been reported on how following these guidelines can impact one's risk of developing RA, so Dr. Lu's team again utilized the Nurses' Health Study II and food frequency questionnaires to determine if following these guidelines could lessen one's chance of developing RA.

In this study -- based on dietary intakes of various foods provided in the food frequency questionnaires, -- the Alternate Healthy Eating Index 2010 was created to measure how well the participants followed the Dietary Guidelines for Americans (2010), and the researchers observed associations of the diets of study participants and the likelihood of developing RA.

Looking at data from 1991 to 2011, 347 study participants self-reported a diagnosis of RA, which was later confirmed through their medical records. The researchers noted those who best adhered to the Dietary Guidelines for Americans (based on the Alternate Healthy Eating Index 2010) had a 33 percent reduced risk of developing RA when compared to those who did not follow the guidelines as closely. And, just as in the first study, the researchers noted that body mass index may be a modest intermediate factor linking diet and risk of RA.

Of those who developed RA, 215 had seropositive RA (diagnosed due to the presence of anti-cyclic citrullinated peptides or rheumatoid factor in blood work) and 132 had seronegative RA (an RA diagnosis, but one that is lacking definitive bloodwork). This led the researchers to further look into the difference between these two groups, and they found the association between following the dietary guidelines and the risk of developing RA was stronger among those with seronegative RA than those with seropositive.

"As we found with the first study, it is clear that a healthy diet may prevent RA development, and our team is interested in conducting further studies to look at why diet is associated with this risk," Dr. Lu concludes.

Mediterranean diet, fruits and vegetable, prevent depression

Eating a Mediterranean diet or other healthy dietary pattern, comprising of fruit, vegetables, legumes, and nuts and low in processed meats, is associated with preventing the onset of depression, according to research published in the open access journal BMC Medicine. A large study of 15,093 people suggests depression could be linked with nutrient deficits.

Following extensive research into diet and its effect on our physical health, researchers are now exploring the link between nutrition and mental health. This is the first time that several healthy dietary patterns and their association with the risk of depression have been analyzed together.
The researchers compared three diets; the Mediterranean diet, the Pro-vegetarian Dietary Pattern and Alternative Healthy Eating Index-2010. Participants used a scoring system to measure their adherence to the selected diet, i.e. the higher the dietary score indicated that the participant was eating a healthier diet.

Food items such as meat and sweets (sources of animal fats: saturated and trans fatty acids) were negatively scored, while nuts, fruits and vegetables (sources of omega-3 fatty acids, vitamins and minerals respectively) were positively scored.

Lead researcher, Almudena Sanchez-Villegas, University of Las Palmas de Gran Canaria, says "We wanted to understand what role nutrition plays in mental health, as we believe certain dietary patterns could protect our minds. These diets are all associated with physical health benefits and now we find that they could have a positive effect on our mental health."

"The protective role is ascribed to their nutritional properties, where nuts, legumes, fruits and vegetables (sources of omega-3 fatty acids, vitamins and minerals) could reduce the risk of depression."

The study included 15,093 participants free of depression at the beginning of the study. They are former students of the University of Navarra, Spain, registered professionals from some Spanish provinces and other university graduates. All are part of the SUN (Seguimiento Universidad de Navarra) Project, a cohort study started on 21st December 1999. The cohort has been used to identify dietary and lifestyle determinants of various conditions, including diabetes, obesity and depression.
Questionnaires to assess dietary intake were completed at the start of the project and again after 10 years. A total of 1,550 participants reported a clinical diagnosis of depression or had used antidepressant drugs after a median follow-up of 8.5 years.

The Alternative Healthy Eating Index-2010 was associated with the greatest reduction of risk of depression but most of the effect could be explained by its similarity with the Mediterranean Diet. Thus, common nutrients and food items such as omega-3 fatty acids, vegetables, fruits, legumes, nuts and moderate alcohol intake present in both patterns (Alternative Healthy Eating Index-2010 and Mediterranean diet) could be responsible for the observed reduced risk in depression associated with a good adherence to the Alternative Healthy Eating Index-2010.

Almudena Sanchez-Villegas says, "A threshold effect may exist. The noticeable difference occurs when participants start to follow a healthier diet. Even a moderate adherence to these healthy dietary patterns was associated with an important reduction in the risk of developing depression. However, we saw no extra benefit when participants showed high or very high adherence to the diets.

So, once the threshold is achieved, the reduced risk plateaus even if participants were stricter with their diets and eating more healthily. This dose-response pattern is compatible with the hypothesis that suboptimal intake of some nutrients (mainly located in low adherence levels) may represent a risk factor for future depression."

A limitation of this study was that the results are based on self-reported dietary intake and a self-reported clinical diagnosis of depression. More research is needed to predict the role of nutrient intake for neurophysiological requirements and identify whether it is minerals and vitamins or proteins and carbohydrates that cause depression.

Fruit-Rich Mediterranean Diet s May Cut Age-related Macular Degeneration Risk by More than a Third

People who closely follow the Mediterranean diet - -especially by eating fruit -- may be more than a third less likely to develop age-related macular degeneration, a leading cause of blindness, according to a study presented today at AAO 2016, the 120th annual meeting of the American Academy of Ophthalmology. The study is the first to identify that caffeine may be especially protective against AMD.

Many studies have confirmed the health benefits of the Mediterranean diet, which emphasizes eating fruits, vegetables, whole grains, legumes, nuts, healthy fats and fish, and limiting red meat and butter. The diet has been shown to improve heart health and reduced risk of cancer, but there has been little research on whether its benefits can extend to eye disease. To determine this, researchers studied a Portuguese population to see whether adherence to the diet impacted people's risk of AMD. Their findings revealed a significant reduction in risk in those who ate a Mediterranean diet most frequently, and particularly among those who consumed more fruit and caffeine.

Researchers at the University of Coimbra in Portugal studied 883 people age 55 or older in the central region of the country between 2013 and 2015. Of those, 449 had AMD in its early stages before vision loss, and 434 did not have AMD. Researchers assessed their diets based on a questionnaire asking how often they ate foods associated with the Mediterranean diet. The more they ate foods associated with the diet, the higher the score, from 0-9. Those who closely followed the diet scored a 6 or greater. Their findings were as follows:

Higher diet adherence scores meant lower AMD risk. Of those who did not closely follow the diet (scored below a 6), 50 percent had AMD. Of those who did closely follow the diet (scored 6 or above), only 39 percent had AMD. This represents a 35 percent lower risk compared to those who did not adhere to the diet.

Fruits were especially beneficial. Researchers analyzed consumption of foods and found that people who consumed higher levels of fruit were significantly less likely to have AMD. Of those who consumed 150 grams (about five ounces) or more of fruit a day: 54.5 percent did not have AMD and 45.5 percent had AMD. Overall, people who ate that much fruit or more each day were almost 15 percent less likely to have AMD, based on an odds ratio calculation.

Caffeine and antioxidants also were protective. Researchers used a computer program to analyze the participants' consumption of micronutrients, according to their answers on the questionnaire. They found higher consumption of antioxidants such as caffeine, beta-carotene and vitamins C and E was protective against AMD. Of those who consumed high levels of caffeine (about 78 mg a day, or the equivalent of one shot of espresso): 54.4 percent did not have AMD and 45.1 percent had AMD.
While caffeine is not considered part of the Mediterranean diet per se, consumption of caffeine-containing foods such as coffee and tea is common in Mediterranean countries. The researchers opted to look at caffeine because it is a powerful antioxidant that is known to be protective against other conditions, such as Alzheimer's disease.

"This research adds to the evidence that a healthy, fruit-rich diet is important to health, including helping to protect against macular degeneration," said Rufino Silva, M.D., Ph.D., lead author of the study and professor of ophthalmology at the University of Coimbra, Portugal; ophthalmologist working at the Centro Hospitalar e Universitário de Coimbra; and investigator at the Association for Innovation and Biomedical Research on Light and Image. "We also think this work is a stepping stone towards effective preventive medicine in AMD.

Mediterranean diet may help protect kidney health

Every one-point increase in a Mediterranean diet score was associated with a 17% decreased likelihood of developing chronic kidney disease.

·       Dietary patterns that closely resembled the Mediterranean diet were linked with a 50% reduced risk of developing chronic kidney disease and a 42% reduced risk of experiencing rapid kidney function decline.

·      More than 20 million US adults have chronic kidney disease.

Adhering to a Mediterranean-style diet may significantly reduce the risk of developing chronic kidney disease, according to a study appearing in the Clinical Journal of the American Society of Nephrology (CJASN).

Chronic kidney disease is a growing epidemic, and while there has been significant progress in protecting against kidney disease and its progression through aggressive treatment of risk factors such as hypertension and diabetes, many people still experience declining kidney function as they age. Minesh Khatri, MD (Columbia University Medical Center) and his colleagues wondered whether an improved diet might provide additional benefits.

"Many studies have found a favorable association between the Mediterranean diet and a variety of health outcomes, including those related to cardiovascular disease, Alzheimer's disease, diabetes, and cancer, among others," said Dr. Khatri. "There is increasing evidence that poor diet is associated with kidney disease, but it is unknown whether the benefits of a Mediterranean diet could extend to kidney health as well." The Mediterranean diet includes higher consumption of fruits, vegetables, fish, legumes, and heart-healthy fats, while minimizing red meats, processed foods, and sweets.

The researchers examined the associations of varying degrees of the Mediterranean diet on long-term kidney function in an observational, community-based, prospective study. In their analysis of 900 participants who were followed for nearly 7 years, every one-point higher in a Mediterranean diet score, indicating better adherence to the diet, was associated with a 17% lower likelihood of developing chronic kidney disease. Dietary patterns that closely resembled the Mediterranean diet (with a score of ≥5) were linked with a 50% lower risk of developing chronic kidney disease and a 42% lower risk of experiencing rapid kidney function decline.

In an accompanying editorial, Julie Lin, MD, MPH, FASN (Brigham and Women's Hospital) noted that a Mediterranean-style diet is only one component of an overall healthy lifestyle, which also needs to incorporate regular physical activity. "Although a seemingly simple goal, achieving this is challenging. We need to begin by embracing the reality that there is no magic pill or miracle food, only vigilance and discipline with diet and regular exercise, and the rare indulgence in cake for very special occasions," she wrote.

Mediterranean diet wards off childhood respiratory allergies

A "Mediterranean" diet rich in fruits, vegetables and nuts protects against allergic rhinitis and asthma symptoms, suggests research published in Thorax.

The researchers assessed the dietary habits, respiratory symptoms, and allergic reactions of almost 700 children living in four rural areas on the Greek island of Crete.

The children were all aged between 7 and 18 years of age.

Skin allergies are relatively common in Crete, but respiratory allergies, such as asthma and allergic rhinitis are relatively rare.

Parents completed detailed questionnaires on their children's allergic and respiratory symptoms and dietary habits.

Whether the children ate a "Mediterranean" diet was measured against a set of 12 foodstuffs, including fruits, vegetables, whole-grains, legumes, nuts, and olive oil.

Eight out of 10 children ate fresh fruit, and over two thirds of them ate fresh vegetables, at least twice a day.

The effect of diet was strongest on allergic rhinitis, but it also afforded protection against asthma symptoms and skin allergy.

Children who ate nuts at least three times a week were less likely to wheeze.

Nuts are a rich source of vitamin E, the body's primary defence against cellular damage caused by free radicals. And they contain high levels of magnesium, which other research suggests, may protect against asthma and boost lung power.

And a daily diet of oranges, apples, and tomatoes also protected against wheezing and allergic rhinitis.

Grapes in particular seemed to protect against current and previous wheezing and allergic rhinitis, even after adjusting for other potentially influential factors.

Red grape skin contains high levels of antioxidants as well as resveratrol, a potent polyphenol, known to curb inflammatory activity, say the authors.

But high consumption of margarine doubled the chances of asthma and allergic rhinitis, the findings showed. Mediterranean diet wards off childhood respiratory allergies.

Virgin Olive Oil & Fish Fatty Acids Help Prevent Acute Pancreatitis

Scientists at the University of Granada have shown that oleic acid and hydroxytyrosol –present in a particularly high concentration in virgin olive oil– and n-3 polyunsaturated fatty acids –found in fish– relieve the symptoms of pancreatitis.

The researchers evaluated the role of Mediterranean diet ingredients in the prevention and mitigation of cell damage.

Oleic acid and hydroxytyrosol –present in a particularly high concentration in virgin olive oil– and n-3 polyunsaturated fatty acids –found in fish– affect the cellular mechanisms involved in the development of acute pancreatitis, a disease of oxidative-inflammatory etiology. Therefore, oleic acid and hydroxytyrosol can be considered potential functional ingredients, as they may prevent or mitigate this disease.

Such was the conclusion drawn in a study conducted by a research group at the University of Granada Physiology Department, where the researchers examined the role of the Mediterranean diet ingredients in the prevention and mitigation of cell damage.

These scientists developed an in vitro experimental model that allows scientist to evaluate how changes in the membrane fatty acid composition in vivo –caused by a change in the type of fat ingested– affect the ability of cells to respond to induced oxidative-inflammatory damage with cerulein (acute pancreatitis).

This is the first study to examine how fatty acids and antioxidants affect the cellular mechanisms that respond to local inflammation in the pancreas. The University of Granada scientists have evaluated the role of antioxidants from a preventive approach, that is, by using an experimental model in mice in which cell damage is induced after pretreatment with these nutritional components.

The author of this study, María Belén López Millán affirms that "there is increasing evidence that there are oxidative-inflammatory processes involved in the origin of chronic diseases and that diet plays an important role in such processes. The antioxidant (phenolic compounds) and antiinflammatory (omega-3 fatty acids) effects of diet components (nutrients and bioactive compounds) prevent/mitigate the pathological incidence of oxidative-inflammatory processes".

The author reminds us that the Mediterranean diet has been recognized by the UNESCO as Intangible Cultural Heritage “and it is important to provide scientific evidence that explains its beneficial effects on health”.

The results of this study –which has been coordinated by professors Mariano Mañas Almendros, María Dolores Yago Torregrosa and María Dolores Mesa García– have been partially published in the journal Proceedings of the Nutrition Society.

Mediterranean diet and exercise can reduce sleep apnea symptoms

Eating a Mediterranean diet combined with physical activity can help to improve some of the symptoms of sleep apnoea, according to new research.

The study, which is published online in the European Respiratory Journal, looked at the impact a Mediterranean diet can have on obese people with sleep apnea, compared to those on a prudent diet.

Obstructive sleep apnoea syndrome (OSAS) causes frequent pauses of breathing to occur during sleep, which disrupts a person’s normal sleeping pattern. It is one of the most prevalent sleep-related breathing disorders with approximately 2-4% of the adult population experiencing the condition. This percentage increases up to 20-40% with obesity, and weight loss is often an essential part of the recommended treatment plan.

The researchers, from the University of Crete in Greece, examined 40 obese patients suffering from OSAS. Twenty patients were given a prudent diet to follow, while the other 20 followed a Mediterranean diet*. Both groups were also encouraged to increase their physical activity, mainly involving walking for at least 30 minutes each day.

In both groups, the patients also received continuous positive airway pressure (CPAP) therapy which involves wearing a mask that generates an air stream, keeping the upper airway open during sleep.

The researchers monitored the patients during a sleep study, known as polysomnography. This involved monitoring several markers for OSAS, including electrical activity in the brain, eye movements and snoring. The patients were examined at the start of the study and again 6 months later.

The results showed that people following the Mediterranean diet had a reduced number of disturbances, known as apnoeas, during the rapid eye movement (REM) stage of sleep, which usually accounts for approximately 25% of total sleep during the night.

The findings also revealed that people following the Mediterranean diet also showed a greater adherence to the calorie restricted diet, an increase in physical activity and a greater decrease in abdominal fat.

The results of this small sample did show an improvement during one stage of sleep for people with sleep apnoea, however it did not show an overall improvement in severity of the condition. The authors suggest that further studies in a larger sample are required to fully understand the benefits of this diet.

Christopher Papandreou, lead author for the research, said: “This is the first study examining the impact of the Mediterranean diet in combination with physical activity on OSAS via changes in the human body. Our results showed that the number of disturbances during REM sleep was reduced more in the Mediterranean diet group than the other group. Recent reports have related an increase in disturbances during REM sleep with the risk of developing significant systemic consequences like diabetes type II. However, its clinical significance remains unclear. Finally, more studies are needed to examine the effect of the above diet on this sleep-related breathing disorder taking into account its anti-inflammatory and antioxidant properties.”

Mediterranean Diet Halves Risk of Lung Disease

A Mediterranean diet halves the chances of developing progressive inflammatory lung disease (COPD), reveals a large study, published  in Thorax.

COPD (chronic obstructive pulmonary disease) is an umbrella term for chronic progressive lung disease, such as emphysema and bronchitis. It is expected to become the third leading cause of death worldwide by 2020, with cigarette smoking the primary factor in its development.

The researchers tracked the health of almost 43,000 men, who were already part of the US Health Professionals Follow up Study. This began in 1986 and involved more than 50,000 US health care professionals aged between 40 and 75, who were surveyed every two years.

They were asked questions about lifestyle, including smoking and exercise, diet and medical history. Dietary intake was assessed in detail every four years.

Eating patterns fell into two distinct categories: those who ate a diet rich in fruit, vegetables, whole grains and fish (Mediterranean diet); and those who ate a diet rich in processed foods, refined sugars, and cured and red meats (Western diet).

Between 1986 and 1998, 111 cases of COPD were newly diagnosed.

The Mediterranean diet was associated with a 50% lower risk of developing COPD than the Western diet, even after adjusting for age, smoking, and other risk factors.

And men who ate a predominantly Western diet were more than four times as likely to develop COPD, even after taking account of other influential factors.

The higher the compliance with a Mediterranean diet, the lower was the risk of developing COPD over the 12 year period.

Conversely, the higher the compliance with the Western diet, the higher was the risk of developing COPD.

Mediterranean diet has proven beneficial effects regarding metabolic syndrome

The Mediterranean diet has proven beneficial effects not only regarding metabolic syndrome, but also on its individual components including waist circumference, HDL-cholesterol levels, triglycerides levels, blood pressure levels and glucose metabolism, according to a new study published in the March 15, 2011, issue of the Journal of the American College of Cardiology. The study is a meta-analysis, including results of 50 studies on the Mediterranean diet, with an overall studied population of about half a million subjects.

"The prevalence of the metabolic syndrome is increasing rapidly throughout the world, in parallel with the increasing incidence of diabetes and obesity, and is now considered a major public health problem," said lead investigator Demosthenes Panagiotakos, Ph.D., associate professor in Biostatistics-Epidemiology of Nutrition, Department of Science of Dietetics - Nutrition, Harokopio University of Athens. "Additionally, the metabolic syndrome is one of the main causes of cardiovascular disease (directly or indirectly), associated with personal and socio-economic burdens. As a result, prevention of this condition is of considerable importance."

The Mediterranean diet is a dietary pattern characterized by high consumption of monounsaturated fatty acids, primarily from olives and olive oils; daily consumption of fruits, vegetables, whole grain cereals, and low-fat dairy products; weekly consumption of fish, poultry, tree nuts, and legumes; a relatively low consumption of red meat; and a moderate daily consumption of alcohol, normally with meals.

The Mediterranean diet, according to Dr. Panagiotakos and Christina-Maria Kastorini, MSc, Ph.D. cand., is one of the best-known and well-studied dietary patterns, which has been shown to be associated with decreased mortality from all causes, lower risk for cardiovascular disease, type 2 diabetes, obesity and some types of cancer. Additionally, it has a beneficial effect on abdominal obesity, lipids levels, glucose metabolism and blood pressure levels, which are also risk factors for the development of cardiovascular disease and diabetes. The antioxidant and anti-inflammatory effects of the Mediterranean diet as a whole, as well as the effects of the individual components of the diet, and especially olive oil, fruits and vegetables, whole grains and fish, also confer to the beneficial role of this pattern.

"To the best of our knowledge, our study is the first work that has systematically assessed, through a large meta-analysis, the role of the Mediterranean diet on metabolic syndrome and its components," he said. "Our results add to the existing knowledge, and further demonstrate the protective role and the significance that lifestyle factors, and mainly dietary habits, have when it comes to the development and progression of the metabolic syndrome."

Encouraging adherence to a healthy dietary pattern like the Mediterranean diet, as well as the adoption of an active lifestyle, seems to be a cornerstone in developing public health strategies for the prevention of the metabolic syndrome, Dr. Panagiotakos suggested. Taking into account the limited financial resources many countries face in the 21st century, better eating seems to be an effective and affordable means for preventing cardiovascular diseases, at the population level, he suggested. In addition to its various health benefits, this dietary pattern can be easily adopted by all populations and various cultures.

Mediterranean Diet and Risk of Hyperuricemia

According to a study, “Mediterranean Diet and Risk of Hyperuricemia in Elderly Participants at High Cardiovascular Risk,” published in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences, a baseline adherence to a Mediterranean diet (MeDiet) is associated with a lower risk of hyperuricemia, defined as a serum uric acid (SUA) concentration higher than 7mg/dl in men and higher than 6mg/dl in women.

Hyperuricemia has been associated with metabolic syndrome, hypertension, type 2 diabetes mellitus, chronic kidney disease, gout, and cardiovascular morbidity and mortality. The MeDiet is characterized by a high consumption of fruits, vegetables, legumes, olive oil, nuts, and whole grain; a moderate consumption of wine, dairy products, and poultry, and a low consumption of red meat, sweet beverages, creams, and pastries. Due to its antioxidant and anti-inflammatory properties, the MeDiet might play a role in decreasing SUA concentrations.

Conducted by Marta Guasch-Ferré and 11 others, this study is the first to analyze the relationship between adherence to a MeDiet in older adults and the risk of hyperuricemia. The five-year study looks at 7,447 participants assigned to one of three intervention diets (two MeDiets enriched with extra virgin olive oil or mixed nuts, or a control low-fat diet). Participants were men aged 55 to 80 years and women aged 60 to 80 years who were free of cardiovascular disease but who had either type 2 diabetes mellitus or were at risk of coronary heart disease.

The findings below demonstrate the positive health effects of a MeDiet in older adults:

- Rates of reversion were higher among hyperuricemic participants at baseline who had greater adherence to the MeDiet.

- Consuming less than one serving a day of red meat compared with higher intake is associated with 23 percent reduced risk of hyperuricemia.

- Consuming fish and seafood increased the prevalence of hyperuricemia.

- Drinking more than seven glasses of wine per week increased the prevalence of hyperuricemia.

- Consuming legumes and sofrito sauce reduced the prevalence of hyperuricemia.

Reversion of hyperuricemia was achieved by adherence to the MeDiet alone, without weight loss or changes to physical activity.

Mediterranean-style Diet Boosts Fertility

Women who watch their weight and closely follow a Mediterranean-style diet high in vegetables, vegetable oils, fish and beans may increase their chance of becoming pregnant, according to dietitians at Loyola University Health System (LUHS).

"Establishing a healthy eating pattern and weight is a good first step for women who are looking to conceive," said Brooke Schantz, MS, RD, CSSD, LDN, LUHS. "Not only will a healthy diet and lifestyle potentially help with fertility, but it also may influence fetal well-being and reduce the risk of complications during pregnancy."

Thirty percent of infertility is due to either being overweight or underweight, according to the National Infertility Association. Both of these extremes in weight cause shifts in hormones, which can affect ovulation. Reducing weight by even 5 percent can enhance fertility.

Schantz recommends the following additional nutrition tips for women who are looking to conceive:

-Reduce intake of foods with trans and saturated fats while increasing intake of monounsaturated fats, such as avocados and olive oil

-Lower intake of animal protein and add more vegetable protein to your diet

-Add more fiber to your diet by consuming whole grains, vegetables and fruit

-Incorporate more vegetarian sources of iron such as legumes, tofu, nuts, seeds and whole grains

-Consume high-fat dairy instead of low-fat dairy

-Take a regular women's multivitamin

Approximately 40 percent of infertility issues are attributed to men, according to the American Society for Reproductive Medicine. Among them is low sperm count and poor sperm motility, which are common in overweight and obese men.

"Men who are looking to have a baby also have a responsibility to maintain a healthy body weight and consume a balanced diet, because male obesity may affect fertility by altering testosterone and other hormone levels," Schantz said.

The Mediterranean diet is definitively linked to quality of life

For years the Mediterranean diet has been associated with a lesser chance of illness and increased well-being. A new study has now linked it to mental and physical health too.

The Mediterranean diet, which is characterized by the consumption of fruit, vegetables, pulses, fish, olive oil and nuts, has been proven to be beneficial to the health in terms of a lesser chance of chronic illness and a lower mortality rate.

A new study headed by the University of Las Palmas de Gran Canaria and the University of Navarra took the next step and analyzed the influence of the Mediterranean diet on the quality of life of a sample of more than 11,000 university students over a period of four years.

"The progressive aging of the population in developed countries makes it even more interesting to find out those factors that can increase quality of life and the health of the population," as explained to SINC by Patricia Henríquez Sánchez, researcher at the centre in the Canary Islands and lead author of the study.

Dietary intake data was taken at the beginning of the study and self-perceived quality of life was measured after the four-year monitoring period. In order to ascertain whether the Mediterranean diet was followed, consumption of vegetables, pulses, fruit, nuts, cereals and fish was positively valued whereas consumption of meat, diary products and alcohol was negatively valued.

Published in the European Journal of Clinical Nutrition, the results reveal that those who stick more to the Mediterranean diet score higher on the quality of life questionnaire in terms of physical and mental well-being. This link is even stronger in terms of physical quality of life.

Mediterranean diet has long-lasting positive effects

Mediterranean and low-carbohydrate diets have lasting, healthy effects, even with partial weight regain, according to a follow-up study by researchers from Ben-Gurion University of the Negev (BGU) and Israel's Nuclear Research Center.

The results were published in a peer-reviewed letter in the October, 2012 New England Journal of Medicine (NEJM) as an update to the landmark study, the workplace-based Dietary Intervention Randomized Controlled Trial (DIRECT), a tightly controlled 24-month dietary intervention.

According to Dr. Dan Schwarzfuchs from the Nuclear Research Center Negev in Dimona, Israel, "Our follow-up subsequent data shows lasting, positive effects of Mediterranean and low-carbohydrate diets six years later." The results suggest that the lipid profile (lower cholesterol, triglycerides and arteriosclerosis) improved for the long term, regardless of partial regain. "Data from trials comparing the effectiveness of weight-loss diets are frequently limited to the intervention period," explains BGU Prof. Iris Shai.

Overall six-year weight loss was significantly lower from baseline for Mediterranean and low-carbohydrate diets, but not for the low-fat group. In the four-year post-intervention, participants regained nearly six pounds. Total weight change for the entire six-year period was approximately -7 lbs. for the Mediterranean diet and -3.7 lbs. for the low-carbohydrate diet.

After four years post-intervention, more than two-thirds (67 percent) of the DIRECT participants had continued with their original assigned diet, 11 percent switched to another diet and 22 percent were not dieting at all.

The researchers also found that after six years, the HDL/LDL ratio remained significantly lower only in the low-carbohydrate diet. Triglyceride levels remained significantly lower in the Mediterranean and low-carbohydrate diets. Overall, total cholesterol levels remained persistently and significantly lower in all diet groups as compared to baseline.

In the original study, 322 moderately obese subjects were randomly assigned to one of three diets: low-fat; restricted-calorie; Mediterranean; or low-carbohydrate, non-restricted-calorie, and were provided color-labeled food per diet daily in the workplace cafeteria. The two-year adherence rate was 85 percent. The results suggested beneficial metabolic effects to low-carb and Mediterranean diets. Moreover, the researchers found a significant diet-induced regression in the carotid vessel wall volume across all diet groups. This change was mainly dependent on diet-induced reduction of blood pressure.

"This breakthrough, even years later, continues to yield valuable information that can help every one of us make healthier diet choices," says Doron Krakow, executive vice president of American Associates, Ben-Gurion University of the Negev.

Mediterranean diet + olive oil protects bones

A study published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) shows consumption of a Mediterranean diet enriched with olive oil for two years is associated with increased serum osteocalcin concentrations, suggesting a protective effect on bone.

Age-related bone mass loss and decreased bone strength affects women and men alike are an important determinant of osteoporosis and fracture risk. Studies have shown that the incidence of osteoporosis in Europe is lower in the Mediterranean basin. The traditional Mediterranean diet, rich in fruits and vegetables, with a high intake of olives and olive oil could be one of the environmental factors underlying this difference.

"The intake of olive oil has been related to the prevention of osteoporosis in experimental and in vitro models," said José Manuel Fernández-Real, MD, PhD, of Hospital Dr. Josep Trueta in Girona, Spain and lead author of the study. "This is the first randomized study which demonstrates that olive oil preserves bone, at least as inferred by circulating bone markers, in humans."

The participants in this study were 127 community-dwelling men aged 55 to 80 years randomly selected from one of the Prevencion con Dieta Mediterranea (PREDIMED) study centers who had at least two years of follow-up. The PREDIMED study is a large, parallel group, randomized, controlled trial aimed to assess the effect of the Mediterranean diet on the prevention of cardiovascular diseases.

For this study, subjects were elderly without prior cardiovascular disease but having a diagnosis of type 2 diabetes or harboring at least three cardiovascular risk factors, namely hypertension, dyslipidemia, or a family history of premature cardiovascular disease. Participants were randomly assigned to three intervention groups: Mediterranean diet with mixed nuts, Mediterranean diet with virgin olive oil, and a low-fat diet.

Biochemical measurements of osteocalcin, glucose, total cholesterol, HDL-cholesterol and triglycerides were performed at baseline and after two year follow-up on fasting blood samples. Researchers found that only consumption of the Mediterranean diet with olive oil was associated with a significant increase in the concentrations of total osteocalcin and other bone formation markers. There were also no significant changes in serum calcium in subjects taking olive oil whereas serum calcium decreased significantly in the other two groups.

"It's important to note that circulating osteocalcin was associated with preserved insulin secretion in subjects taking olive oil," added Fernández-Real. "Osteocalcin has also been described to increase insulin secretion in experimental models."

Mediterranean diet has been shown to be an independent predictor of remission in patients rheumatoid arthritis

A new studies presented June 2014 at the European League Against Rheumatism Annual Congress (EULAR 2014) has helped clarify the relationship between the dietary intake of monounsaturated fatty acids with disease activity in rheumatoid arthritis (RA).

In the TOMORROW study, daily intake of monounsaturated fatty acids as a component of the Mediterranean diet has been shown to be an independent predictor of remission in patients with RA; monounsaturated fatty acids might therefore be suppressing disease activity.

Researchers have been exploring the link between diet and different types of arthritis since the 1930's.While the relationship between diet and arthritis is certainly complex, these two studies have highlighted the importance of addressing dietary intake of monounsaturated fatty acids and cholesterol when treating patients with RA and OA respectively.

Dietary intake of monounsaturated fatty acids independently predicts remission in RA Using the RA disease activity score calculator DAS28-ESR to categorise patients as having active disease or being in remission, dietary intake of monounsaturated fatty acids was shown to be an independent predictor of remission in patients with RA.

The intake of monounsaturated fatty acids and of Mediterranean diet components was significantly lower in the RA than in the control group.

The ratio of monounsaturated fatty acids to saturated fatty acids was significantly lower in patients with RA with high disease activity vs. those patients in remission and those with low disease activity.

"We now have a much better understanding of the relationship between disease activity in patients with RA and the Mediterranean diet based on the findings from our 10-year-prospective cohort study TOMORROW," said lead author Mr. Yoshinari Matsumoto of the Department of Medical Nutrition, Graduate School of Human Life Science, Osaka City University, Japan.

A previous study had shown that, by adjusting to a Mediterranean diet, patients with RA could obtain a reduction in inflammatory activity, an increase in physical function, and improved vitality. However, this is the first time the key elements within a Mediterranean diet involved in these beneficial effects have been assessed.

"Confirming that daily intake of monounsaturated fatty acids, as a component of the Mediterranean diet, is an independent predictor of remission in patients with RA suggests that monounsaturated fatty acids might actually be suppressing disease activity," Mr. Matsumoto concluded.

In this study, data was collected from 208 consecutive patients with RA and 205 age- and gender-matched healthy volunteers. Daily food and nutrient intake status were assessed using a brief, self-administered diet history questionnaire and Mediterranean diet scores were calculated from reference results from the control group.

Children consuming a Mediterranean Diet are 15% less likely to be overweight

A study of 8 European countries presented at this year’s European Congress on Obesity (ECO)in Sofia, Bulgaria, shows that children consuming a diet more in line with the rules of the Mediterranean one are 15% less likely to be overweight or obese than those children who do not.

The researchers used data from the IDEFICS study (Identification and Prevention of Dietary – and lifestyle – induced health effects in Children and infantS), funded by the European Commission. Weight, height, waist circumference, and percent body fat mass were measured in children from these eight countries.

Vegetables, fruit, nuts and fish

The parents of these children were interviewed by means of a questionnaire specifically designed for the IDEFICS study and enquiring about the consumption frequency of 43 foods. Additional dietary data have been complemented by a telephone interview performed on a sub-sample of parents.

The adherence to a Mediterranean-like diet was assessed by a score calculating by giving one point for high intakes of each food group which was considered typical of the Mediterranean diet (vegetables, fruit and nuts, fish and cereal grains), as well as one point for low intakes of foods untypical of the Mediterranean diet (such as dairy and meat products). High scoring children were then considered high-adherent and compared to the others.

Swedish children most Mediterranean

Interestingly, the prevalence of high adherence to a Mediterranean-like diet was found to be independent of the geographical distribution, with the Swedish children scoring the highest (followed by the Italians) and the children from Cyprus scoring the lowest.

The team found that children with a high adherence to a Mediterranean-like diet were 15% less likely to be overweight or obese than low-adherent children. The findings were independent of age, sex, socioeconomic status or country of residence.

The children with high adherence at baseline were 10-15% less likely to be among those who went through major increases in BMI, waist circumference and body fat.

“The promotion of a Mediterranean dietary pattern is no longer a feature of Mediterranean countries. Considering its potential beneficial effects on obesity prevention, this dietary pattern should be part of EU obesity prevention strategies and its promotion should be particularly intense in those countries where low levels of adherence are detected.” says Gianluca Tognon, researcher at the Sahlgrenska Academy.