Adopt a Mediterranean diet now for better health later

Millions of American men and women have served in the Armed Forces, protecting and defending our nation. Although many died, most returned home to “pick up their lives.” That isn’t always easy. For some veterans, the trauma of war changes the brain in ways that can cause long-term problems.

War-related mental health problems have been with us for centuries. They probably afflicted Achilles, the Greek warrior at the center of Homer’s Iliad. During the Civil War, such problems were called “nostalgia” or “soldier’s heart.” In World War I, the term was “shell shock.” “Combat neurosis” and “battle fatigue” were the preferred descriptions during World War II and the Korean War. By the late 1970s, the condition had evolved into post-traumatic stress disorder (PTSD).

According to the American Psychiatric Association, more than 300,000 veterans of the wars in Iraq and Afghanistan have been diagnosed with PTSD. Countless others probably suffer from this condition but have never sought help for it. Even sadder, in 2012 more military deaths were caused by suicide than by combat. You can see other compelling statistics in the infographic below.


Many veterans don’t seek help because they feel there’s a stigma attached to these invisible wounds. That’s a shame, because help is available. “Seeking help for a mental health issue is a sign of strength, not weakness,” says former U.S. Rep. Patrick Kennedy, in a video encouraging the American family to “embrace our veterans so they stop suffering in silence.”

If you know a veteran, thank him or her for having served our nation. And if you think he or she is having trouble, bolster your courage and ask. Beginning the conversation may open the door to healing. Trans fats, once seen as harmless additives that ended up in everything from Twinkies to French fries, are finally getting the reputation they deserve—bad for health.

For years, the FDA has labeled trans fats as “generally recognized as safe.” That term applies to substances added to foods that experts consider safe, and so can be used without testing or approval. Yesterday the FDA proposed removing trans fats from the generally recognized as safe list, a step that would eliminate artificial trans fats from the American food supply.

The move comes as a victory for Dr. Walter Willett and his colleagues at the Harvard School of Public Health, who have long highlighted the health harms of trans fats. Research on the health hazards of trans fats goes back four decades. In our 2001 book, Eat, Drink, and Be Healthy, Dr. Willett and I wrote that “Only one type of dietary fat is worse for you than saturated fat—the increasingly common trans fats.”

Since then, communities from Tiburon, California to New York City banned the use of trans fats as evidence continued to mount against them. Many companies have already removed trans fats from their products. The FDA’s proposal, if finalized, would speed that process.

You can see an interview with Dr. Willett about the FDA’s proposal on the Harvard Gazette website.
Why the ruckus?

Trans fats are a type of unsaturated fat. Think of them as the evil cousins of the healthy omega-3 fats in fish, flaxseeds, and walnuts.

Once upon a time, the only sources of trans fats were bacteria living in the forestomach of ruminants. As a result, beef, lamb, buffalo, deer, and dairy products have small amounts of trans fats. By the end of the 20th century, though, they were everywhere, thanks to the ingenuity of early 20th-century chemists who discovered that they could turn a liquid vegetable oil into a solid or semi-solid by bubbling hydrogen gas through it. Partially hydrogenated oils don’t spoil or turn rancid as readily as non-hydrogenated fats and can withstand repeated heating without breaking down.

Those characteristics made trans fats a workhorse of the food industry. The FDA has estimated that in the late 1990s, 95% of prepared cookies, 100% of crackers, and 80% of frozen breakfast products contained trans fats. Frying oils used in restaurants were also rich in them.

The problem for us is that trans fats are bad for the heart and the rest of the body. Eating trans fats boosts LDL (bad) cholesterol, especially the small, dense LDL particles that are most damaging to arteries. It depresses protective HDL, which trucks LDL to the liver for disposal. Trans fats have unhealthy effects on triglycerides; make blood platelets stickier than usual and so more likely to form artery-blocking clots in the heart, brain, and elsewhere; and feed inflammation, which plays key roles in the development of heart disease, stroke, and diabetes.

Writing in the New England Journal of Medicine, Harvard School of Public Health researchers once estimated that removing trans fats from the U.S. food supply would prevent between 72,000 and 228,000 heart attacks each year.

The FDA’s proposal to reclassify trans fats is a move that should have little impact on what we eat, as food companies have been finding successful—and healthier—alternatives. But it could have a beneficial impact on our health. It’s been a big year for the Mediterranean diet. Convincing evidence published in 2013 has shown that this kind of eating pattern is effective at warding off heart attack, stroke, and premature death. While you probably get the biggest payoff by adopting such a diet early in life, a new study shows that doing it during midlife is good, too.

Researchers looked at the dietary habits of more than 10,000 women in their 50s and 60s and compared them to how the women fared health-wise 15 years later. Women who followed a healthy diet during middle age were about 40% more likely to live past the age of 70 without chronic illness and without physical or mental problems than those with less-healthy diets. The healthiest women were those who ate more plant foods, whole grains, and fish; ate less red and processed meats; and had limited alcohol intake. That’s typical of a Mediterranean-type diet, which is also rich in olive oil and nuts. The report appeared yesterday in the Annals of Internal Medicine.

Why would your menu in middle age protect your health later in life? “Several mechanisms may be involved, including lowering inflammation and oxidative stress, both systemically and within the central nervous system. These are two general pathways underlying many age-related chronic diseases and health conditions, such as age-related brain diseases and mental health. Other potential mechanisms include notably improving glucose metabolism and insulin sensitivity,” explains lead author Cécilia Samieri, a researcher at Université Bordeaux in France, who conducted the study while a postdoctoral fellow at Harvard Medical School.

Good food is a pretty powerful health booster. Whole grains, legumes, fruit, and vegetables are packed with fiber, which slows digestion and helps control blood sugar. Monounsaturated fats in olive oil, nuts, and fish can have anti-inflammatory effects, which may help stave off heart disease and many other conditions.

That Mediterranean-style diets have health benefits isn’t necessarily new. Past research has shown that this type of eating pattern can help lower cholesterol, help with weight loss, improve rheumatoid arthritis, and reduce the risk for developing Alzheimer’s disease, diabetes, and various types of cancer.

What is new is that the fast-growing mountain of scientific evidence about the diet’s benefits is now at Swiss Alps level, and many health experts are hoping you’ll be inspired to start the journey to better health Mediterranean-style. Just do it slowly, cautions Stacey Nelson, a dietitian from Harvard-affiliated Massachusetts General Hospital. “It’s not realistic to make the changes overnight, but you can start with small changes,” she explains.

First, it’s important to understand the elements of a Mediterranean-type diet:

    Base every meal on fruits, vegetables, whole grains (whole wheat bread, brown rice, quinoa and bulgur), olive oil, beans, nuts, legumes (lentils, dried peas and beans), seeds, herbs and spices.
    Eat fish at least twice a week.
    Eat moderate portions of cheese and yogurt daily to weekly.
    Eat moderate portions of poultry and eggs every two days or weekly.
    Eat red meat sparingly or limit to three-ounce portions.
    Drink plenty of water each day, and drink wine in moderation—no more than one (5-ounce) glass a day for women, two glasses per day for men.

To jump-start your effort, here are five tips:

    Sauté food in olive oil, not butter.
    Eat more fruits and vegetables by having them as a snack or adding them to other recipes
    Choose whole grains instead of refined breads and pastas
    Substitute a fish meal for red meat at least twice per week
    Limit high-fat dairy by switching to skim or 1% milk from 2% or whole.

It also helps to make small swaps for foods you’re already eating. For example, instead of using mayonnaise on your sandwich, try a hummus spread. Here are some more suggestions:

Instead of this:

Try this Mediterranean diet option:
Crackers, chips, pretzels and ranch dip     Celery, carrot or pepper strips and salsa
White rice     Quinoa
Sandwiches with white bread or rolls     Sandwich fillings in whole wheat tortillas
Hamburgers     Salmon croquettes
Full-fat ice cream     Pudding made with skim or 1% milk
Eggs with Hollandaise sauce     Eggs with salsa

Suggestions courtesy of Stacey Nelson, Massachusetts General Hospital

You can eventually work up to swapping entire meals, such as ditching beef burgundy over white rice in favor of sautéed scallops over whole grain penne pasta.

Make the transition gradually over weeks or months so your new eating style becomes a habit and not a fad. Permanent lifestyle change in midlife is what will help get you to the goal of good health in old age.


Popular posts from this blog

ways to spring-clean your iPad and iPhone

What is the magic sleep number

Turning to drugs and treatments for better health