Tuesday, November 6, 2012

The Popularity of the Mediterranean Diet

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Entire books have been written advocating the benefits of the Med­ iterranean diet. One such book, for those interested in this line of thinking,  is  Low-Fat Lies, High-Fat Frauds,  by  Kevin  Vigilante  and
Mary Flynn. They accurately point out that calories
do matter and explain that the main reason such carbohydrate-restricting, high-fat diets as Atkins and Sugar Busters work is that most people can't eat too many calories from  high-fat  food because they can eat only so much rich,  fatty food — so they wind up eating fewer calories.
This is only partially true. However, research has shown that weight loss is about the same from any type of food eaten when caloric intake is equally low. Their main message is threefold: first, eat mostly phytochemical-rich plant foods to maximize health and disease prevention; second, caloric re­ striction and exercise must be maintained  for positive results; and
third, healthy fats, especially olive oil, should not be restricted, be­
cause a diet without these fats is both unhealthy and unpalatable. The diet they recommend, which watches saturated fat intake and avoids trans fats, is a nice improvement over the diet most Americans eat. Certainly it is better to use olive oil than butter or margarine. I have only a few bones to pick with those advocating this diet style. First, they claim that cooking food in olive oil increases phyto-chemical absorption and that  eating vegetables without a  high-fat topping is not as nutritious since the phytochemicals are not ab­ sorbed. This is not accurate. When vegetables are cooked, or eaten with fat,  some  nutrients  are  more  efficiently absorbed  and  other heat-sensitive nutrients are lost or rendered less absorbable. Many studies show that raw fruits and vegetables offer the highest blood levels of cancer-protective nutrients and the most protection against cancer of any other foods, including cooked vegetation. Any advice
not recognizing that raw vegetables and fresh fruits are the two most
powerful anti-cancer categories of foods is off the mark.
Paul Talalay, M.D., of the Brassica Chemoprotection Laboratory at theJohns Hopkins School of Medicine is involved with research­ ing the effect of cooking on phytochemicals. He reports "widely dif­ ferent effects on  the compounds in vegetables that protect against cancer." These  compounds  are  both  activated  and  destroyed  by various cooking methods. Vigilante and Flynn have championed the position that cooking foods in olive oil is the centerpiece of a healthy diet, without adequate scientific evidence. Their interpretation of the scientific literature perpetuates this fallacy. The result is more people unable to lose weight successfully. My advice is extremely different. I recognize that raw, uncooked vegetables and fruits offer the most powerful protection against dis­ ease and I encourage my patients to eat huge salads and at least four fresh fruits per day. Diets with little raw foods are not ideal. As the amount of raw fruits and vegetables are increased in a person's diet, weight loss and blood pressure are lowered effortlessly. Additionally,  raw  foods  contain  enzymes,  some  of which  can survive the digestive process in the stomach and pass into the small intestines. These heat-sensitive elements may offer significant nutri­ tional advantages to protect against disease, according to investiga­ tors from the Department of Biochemistry at Wright State University School of Medicine.31 These researchers concluded that "most foods undergo a decrease in nutritive value in addition to the well-known loss of vitamins when cooked and/or processed." Most vitamins are heat-sensitive, for example 20-60 percent of vitamin C is lost, de­
pending on the cooking method.Thirty to forty percent of miner­ als are lost in cooking vegetables as well. Consuming a significant quantity of raw foods is essential for superior health. For the best results, your diet should contain a huge amount of raw foods, a large amount of the less calorically dense cooked vege­ tation, and a lesser amount of the more calorically rich cooked starchyvegetables and grains. Cooking your food in oil will make your diet less effective and you  will not lose weight as easily. You may not even lose any weight at all. Vigilante and Flynn tested their diet on  120 people, and the av­ erage person lost eight pounds in eight weeks. In the same amount of tune on my diet, you will lose at least three times that, if you have that much extra  weight  to lose.  Keep in mind,  weight  loss slows down over time. Most people starting almost any diet after eating haphazardly lose some weight initially. It is easy to drop a few pounds by merely counting calories, but many overweight individuals with a
strong genetic tendency to obesity and slow metabolism who need to
lose lots of weight may lose very little or none at all. Some may lose an initial five to fifteen pounds, but then when further weight loss becomes even more difficult, they give up. Another problem with Mediterranean diets is the preponderance of pasta  and  Italian  bread,  which  not  only  causes  difficulty with weight control but is also an  important  factor in increasing colon cancer risk in populations with this eating style. For the very overweight individual, this Mediterranean diet, like other conventional weight-loss programs, is neither restrictive enough nor filling enough to achieve the results desired. Because olive oil adds so many extra calories to their diet, the dieters still have to care­ fully count calories and eat tiny portions. All those calories supplied by olive oil, almost one-third of the total caloric intake, make the diet significantly lower in nutrients and fiber. You can always lose weight by exercising more, and I am all for it. However, many very overweight patients are too ill and too heavy
to exercise much. As a former athlete, and today as a physician, I am
an exercise nut and a fanatic about recommending exercise to my patients, but many patients cannot comply with a substantial exer­ cise program until they are in better health or lose some more weight first. So many people need a diet that will drop weight effectively, even if they can't do lots of exercise. I have tested my recommendation on more than two thousand patients. The average patient loses the most weight in the first four to six weeks, with the average being about twenty pounds. The weight loss continues nicely — those following this program continue to lose about ten pounds the second month and about a pound and a half per week thereafter. The weight loss continues at this comparatively quick rate until they reach their ideal weight. The bottom line about healthy fats is that raw nuts and seeds, av­ ocados, and unsalted olives (if you can find t h e m ) co n tain h e a l t h y fats. However, you should consume a limited amount of these foods, especially if you wish to lose weight. Also remember that oil, includ­ ing olive oil, does not contain the nutrients and phytonutrients that were in the original olive. The oil has little nutrients (except a little
vitamin E) and a negligible amount of phytochemical compounds. If you eat the quantities of oil permitted on the typical Mediterranean diet, where all the vegetables are cooked in oil, you will have diffi­ culty taking off the weight you need to lose. You can add a little bit of olive oil to your diet if you are thin and exercise a lot. However, the more oil you add, the more you are low­ ering the nutrient-per-calorie density of your diet —and that is not your objective, as it does not promote health.
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