mediterranean diet and h eart health
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Mediterranean diet and h eart health. Dr Claire McEvoy and Sarah Moore. Overview. Does a Mediterranean diet reduce risk of heart disease and diabetes? What is the Mediterranean diet? TEAM-MED research study. Heart disease. - PowerPoint PPT PresentationTRANSCRIPT
Mediterranean diet andheart health
Dr Claire McEvoy and Sarah Moore
Overview
• Does a Mediterranean diet reduce risk of heart disease and diabetes?
• What is the Mediterranean diet?
• TEAM-MED research study
Heart disease • In NI, over 75,000 people with heart disease
and 1 in 4 people die each year due to heart disease
• Diabetes is a major risk factor for heart disease
• Most deaths could be prevented by making lifestyle changes such as eating a healthy diet…
BHF, 2013 & NHS, 2012
• Seven Countries Study (1968)
• Disease rates and dietary patterns differed across countries
• Mediterranean diet responsible?
Mediterranean Diet and Heart Disease
RESEARCH
Keys et al., 1986
Does a Mediterranean diet reduce risk of heart disease and diabetes?
• People: 7447 adults at risk of heart disease
• Groups: Med diet and olive oil Med diet and nuts Low fat diet
• Outcome: Heart related death, heart attack, stroke or diabetes
• Duration: 5 years
Predimed Study
PREDIMED Study
Year 0 1 2 3 4 5
60
40
30
20
10
0
50
Low fat diet
Med diet + nuts
Med diet + olive oil
% people had heart event
Estruch et al., 2013
Heart events over 5 years
PREDIMED Study
Med diet + olive oil
Low fat diet
Salas-Salvadó et al., 2011
Med diet + nuts
Survival without diabetes over 5 years (non-diabetic individuals)
Cum
ulati
ve su
rviv
al f
rom
dia
bete
s
30% reduction in risk of heart disease 52% reduction in risk of diabetes
PREDIMED Results
(Taylor et al, 2013; (Knowler et al, 2002)
27% reduction in risk of heart disease with statin treatment
30% reduction in risk of diabetes with metformin treatment
Greater adherence to a Mediterranean diet is more effective than current drug treatments to reduce the risk of heart disease and diabetes.
What these results tell us…
Mediterranean Diet: How it reduces risk
Blood pressure
Cholesterol
Blood glucose
Weight gain
Other health benefits of a Mediterranean diet
Following a Mediterranean diet can:
• reduce the risk of Alzheimer's and Parkinson's disease
• reduce the risk of death from or occurrence of Cancer
Sofi F et al., 2010
Summary
• Heart disease remains a major cause of death
• Good evidence that following a Mediterranean diet can reduce risk of heart disease and diabetes
• Further research needed on how to support people to change their diet
What is the Mediterranean diet?
The Mediterranean diet
• High in fruits, vegetables, wholegrain bread, rice and pasta, potatoes, beans, nuts, and seeds
• Olive oil as an important fat source and dairy products, fish, and poultry (consumed low- moderate amounts)
• Eggs (moderate amounts), and red meat (low amounts)
• Wine is consumed in low to moderate amounts.
• Dietary pattern based on food patterns of many Mediterranean regions in 1960s
Kris-Etherton, 2001
Mediterranean Diet Pyramid
Mediterranean Diet guidelinesEvery main meal• 1-2 portions fruits, 2+ portions vegetables• 1-2 servings wholegrain bread/ rice/ pasta• Use olive oil as main cooking fat or as a dressingEvery day• 2 servings dairy• 1-2 servings nuts Weekly • 2 servings poultry, 2+ servings oily fish, 2+ servings legumes • Less than 2 servings red meat, 1 or less serving processed meat• 0-4 servings Eggs• Less than 2 servings sweet foods • Optional: 1 glass wine/day(women), 2 glasses/day(men) most days
Bach-Faig et al., 2011
Eat more fruit & vegetables
Include oily fish (e.g. salmon, herring, sardines) 2-3 times/ week Eat wholegrain bread and cereals instead of white/ low fibre
Use olive or rapeseed oils & spreads
Add more natural nuts into your diet (e.g. walnuts, almonds or hazelnuts)
Reduce red meat intake and eat poultry more often
Alcohol in moderation (optional)
Guidelines: key foods & advice
BreakfastFruit or small glass of unsweetened fruit juiceWholegrain breakfast cereal/ porridge/ muesliWholemeal bread/ toast with olive oil spread Lunch Soup and wholemeal breadSmall portion of chicken/ fish/ egg/ cheeseSaladWholemeal breadFruit and yoghurt Evening mealSmall portion meat/ chicken/ fish/ eggPlenty of salad/ vegetablesPotatoes, rice, pasta, other grains or wholemeal breadFruit for dessertGlass of wine (optional)
Mediterranean diet meal plan
MENU
Wholegrain bagel with olive oil spread +fresh fruit
Lentil soup + wholegrain bread
Mediterranean-style marinated fish or chicken
Snacks: Fruit/ nuts
2 tbsp olive oil 1 clove garlic, thinly sliced1 carrot, diced1 large onion, sliced1 celery stick, sliced 1 medium potato, diced1-2 slices of turnip, diced 100g (4oz) red lentils 1L (1 ¾ pt) chicken or vegetable stock (serves 4)
Heat the olive oil in a saucepan and add the onion and garlic.
Sauté gently for 5 minutes until softening Add the rest of the vegetables and cook for a further 4-5 minutes. Add the lentils and stock and bring to the boil. Simmer for 15-20 minutes. Season with pepper, blend until smooth. Pour the mixture back into the pan, reheat gently.
Serve with wholemeal bread
Mediterranean diet recipes
LENTIL SOUP
2 (100g/4oz) fish fillets (or chicken breasts)2 tbsp olive oil 2 tsp red wine vinegar½ tsp ground black pepper½ dried basil or thyme ¼ tsp garlic granules2 bay leaves(serves 2)
In a bowl, mix olive oil, vinegar, pepper, basil, thyme and garlic. Coat both sides of the fish/ chicken fillets. Break the bay leaves into 3-4 pieces, press onto both sides of fillets. Cover and refrigerate for at least an hour. Remove the bay leaves. Cook in a non-stick pan over a medium-high heat.
Serve with potatoes, pasta, rice or another ‘grain’ such as couscous and vegetables
Mediterranean diet recipes
MED-STYLE MARINATED FISH (or chicken)
Encouraging adoption of a Mediterranean diet
75 peopleat risk
of heart disease
Peer support (25)
Time 0 12 (months)
Written Mediterranean diet advice (25)
Sessions with Dietitian and provided olive oil
and nuts (25)
TEAM-MED Study
LOOKING FOR VOLUNTEERS!
Nutrition and Metabolism GroupCentre for Public Health, QUB
Thank you for your attention
Any questions?