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Jordi Salas-Salvadó, M.D., Ph.D.
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A traditional Mediterranean diet with an additional daily serving of
mixed nuts appears to be useful for managing some metabolic
abnormalities in older adults at high risk for heart disease, according
to a report in the December 8/22 issue of Archives of Internal Medicine,
one of the JAMA/Archives journals. The metabolic syndrome is a set of
metabolic abnormalities that includes abdominal obesity and high
cholesterol, high blood pressure and high blood glucose levels, all of
which are risk factors for cardiovascular disease, according to
background information in the article. "Development of the metabolic
syndrome depends on a complex interaction between still largely unknown
genetic determinants and environmental factors, including dietary
patterns," the authors write. A traditional Mediterranean
diet—characterized by a high intake of cereals, vegetables, fruits and
olive oil, a moderate intake of fish and alcohol and a low intake of
dairy, meats and sweets—has been associated with a lower risk for
metabolic abnormalities.
Jordi Salas-Salvadó, M.D., Ph.D., of the University of Rovira i
Virgili, Spain, and colleagues assessed 1,224 participants in the
PREDIMED (Prevencion con Dieta Mediterranea) study who were age 55 to
80 and at high risk for cardiovascular disease. Participants were
randomly assigned to one of three groups: one group received advice on
a low-fat diet while two received quarterly education about the
Mediterranean diet. One of the Mediterranean diet groups was provided
with 1 liter per week of virgin olive oil and the other received 30
grams per day of mixed nuts.
At the beginning of the study, 61.4 percent of the participants met
criteria for the metabolic syndrome. After one year, 409 participants
in the Mediterranean diet plus olive oil group, 411 in the
Mediterranean diet plus nuts group and 404 in the control group of
low-fat diet advice were available for evaluation. The prevalence of
metabolic syndrome decreased by 13.7 percent among those in the nut
group, 6.7 percent in the olive oil group and 2 percent in the control
group.
Participants' weight did not change over the one-year period.
However, the number of individuals with large waist circumference, high
triglycerides or high blood pressure significantly decreased in the
Mediterranean diet plus nuts group compared with the control group.
This suggests that components of the diet, principally the nuts, may
have beneficial effects on pathophysiological characteristics of
metabolic syndrome, such as oxygen-related cell damage, resistance to
the effects of insulin or chronic inflammation. The Mediterranean diet
is high in unsaturated fatty acids; in addition, nuts also contain
beneficial nutrients such as fiber, arginine, potassium, calcium and
magnesium.
"Traditionally, dietary patterns recommended for health have been
low-fat, high-carbohydrate diets, which generally are not palatable,"
the authors conclude. "The results of the present study show that a
non–energy-restricted traditional Mediterranean diet enriched with
nuts, which is high in fat, high in unsaturated fat and palatable, is a
useful tool in managing the metabolic syndrome." A longer follow-up of
the PREDIMED study participants may provide stronger evidence of the
cardiovascular benefits that could result, they note.
Source: JAMA and Archives Journals
Original article: Jordi Salas-Salvadó et al. Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status. Arch Intern Med. 2008;168(22):2449-2458.
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