The thrive diet

The island of Crete is not just on the Mediterranean Sea; it’s in it. No wonder then that the people of that is­land lying off the coast of Greece en­joy what’s called “Mediterranean cui­sine”-tasty fare with little meat or rich foods but large amounts of veg­etables, fruits, grains and fish, along with fairly generous splashes of both olive oil and wine.

The people of Crete also enjoy an astonishingly low rate of heart dis­ease. One scientific project, called the Seven Countries Study, found that while 46 percent of deaths among middle-aged American men were due to heart disease, that number in Crete was a mere 4 percent-10 times less.

And it wasn’t because the men of Crete die instead from other causes. In fact, the death rate for any and all causes in Crete during the 15-year study was lower than in any other country studied.

Well, you say, perhaps it’s not the food they eat. Maybe it’s the aggrava­tion they don’t get. Or walking up and down the hills. The sea breeze. Family togetherness or the strong sense of community that abounds in most Mediterranean villages. Who knows?

PROBING THE DIET LINK

In France, they decided to find out. More than five years ago, medical re­searchers began working with about 600 men, each of whom had had a re­cent heart attack. Half the group was told to eat the “prudent” low-fat diet prescribed in many nations. The other half was told to follow a “Mediter­ranean diet” that strongly resembled the Cretan diet.

Here are the specific instructions the Mediterranean-diet group re­ceived during dietary counseling:

1.  Eat more vegetables of all kinds.

2.  Eat more fruit of any kind-”no day without fruit.”

3.  Eat more bread.

4. Eat more fish.

5.  Lay off meat-eat it no more than once a day, and replace beef, lamb and pork with poultry.

6.  No butter, cream or milk.

7.  Drink moderate amounts of wine with meals, if desired.

8.  For salads and cooking, use olive oil or canola oil exclusively.

9.  Replace butter and cream with a special margarine [provided to all the study's participants].

Now, this margarine really was special. Produced on an experimental basis by a private firm, it’s not com­mercially available. Yet. The mar­garine (similar chemically to olive oil) was made largely from canola oil and was not hydrogenated, unlike most margarines in the United States.

“It’s made solid by a completely dif­ferent process that doesn’t result in the formation of unhealthful trans-fatty acids,” explains J. Michael Gaziano, M.D., M.P.H., who is familiar with the French research. “Instead of hydrogenation, they use a process called esterification, so that after the mar­garine reaches the stomach, it winds up as a normal monounsaturate, as I understand it,” says the director of cardiovascular epidemiology at Brigham and Women’s Hospital and Harvard Medical School, Boston.

Or, as one of the French researchers told Prevention, “Margarine is some­thing you can do with as you please, so far as composition goes. The key is how it’s made,” says Serge Renaud, Ph.D., of France’s National Institute of Health and Medical Research. “It can be absolutely wonderful or it can be disastrous.”

Just how well did this diet perform, versus the “standard” diet given to most heart patients?

Spectacularly well, as a matter of fact. In the experimental group of pa­tients (those following the Mediter­ranean diet), there were nearly 70 per­cent fewer heart attacks and subsequent cardiac deaths. The con­trol group had more than twice as many cardiac deaths as the other group. The benefits kicked in early, too-in just a matter of months.

SUPREME EATING

So until evidence shows otherwise, maybe this is the ultimate diet.

Now, what’s also important is that these people were eating a diet not just featuring olive or canola oil in place of butter or other fats, but a diet that was overall low in saturated fats, as well. That’s the kind of fat that’s truly terri­ble for your ticker and found mostly in butter, cream, fatty meats, cold cuts and sausage, eggs and mayonnaise.

The fact is, it’s possible that the re­duction in saturated fats alone was largely responsible for the apparently good results, according to Margo Denke, M.D., associate professor of medicine at the University of Texas Southwestern Medical Center, Dallas. Dr. Denke also believes, she told us, that if the group getting the “stan­dard” low-fat diet had been given proper dietary counseling on how to eat the low-saturated-fat diet like the other group received, they might have done much better.

Perhaps that is true. Certainly, we have to say now that the best dietary change you can make is to steer clear of those saturated fats we mentioned above. The less bacon, liverwurst, but­ter and salami you eat, the longer you’ll probably live.

What really needs to be done, says Dr. Renaud, is for the Mediterranean diet to be tried in a country that’s nowhere near the Mediterranean, like the United States, or maybe England. Then we’d see if the “magic” of the Mediterranean is a universal law or just another island dream. -with Michele Toth, Research Associate.