Mediterranean diet obesity - cancer - alcohol

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FYI

American Journal of MedicineVolume 113 • Number Suppl 9B • December 30, 2002Dietary fat consensus statementsThe Mediterranean diet of the early 1960s is characterized by the following:

1.

An abundance of plant food (fruit, vegetables, breads, other forms of cereals, potatoes, beans, nuts, and seeds);

2.

Minimally processed, seasonally fresh, and locally grown foods;

3.

Fresh fruit as the typical daily dessert, with sweets containing concentrated sugars or honey consumed a few times per week;

4.

Olive oil as the principal source of fat;

5.

Dairy products (principally cheese and yogurt) consumed daily in low to moderate amounts;

6.

Fish and poultry consumed in low to moderate amounts;

7.

0 to 4 eggs consumed weekly;

8.

Red meat consumed in low amounts; and

9.

Wine consumed in low to moderate amounts, normally with meals.

As much as can be determined, this diet was low in saturated fat (7% to 8% of energy), with total fat ranging from <25% to >35% of energy from 1 area to another. Data also indicate that work in the field or kitchen resulted in a lifestyle that included regular physical activity and was associated with far less obesity than exists in the United States and Northern Europe.

Obesity

1.

Obesity is primarily a disorder of energy balance.

2.

Obesity increases the risk of many diseases including diabetes, heart disease, hypertension, dyslipidemias and certain cancers.

3.

Obesity is a common and increasing public health problem in both developed and developing countries.

4.

Although data are limited in population studies, no strong association has been demonstrated between dietary fat and body fatness.

5.

Obesity can be prevented and controlled by balancing energy intake and energy expenditure through a healthy diet and regular physical activity.

6.

The Mediterranean diet, although not a low-fat diet, may contribute to the prevention and treatment of obesity because of its variety and palatability, provided it is controlled in calories.

Cancer There is substantial and consistent evidence that diets rich in vegetables and fruit reduce risk of cancer. The folic acid content may be a reason. Concerning fat and related foods, the following may be said:

Colon cancer:

1.

Total fat is probably unrelated.

2.

There is disagreement on the strength of the association of red meat with increased risk.

Breast cancer:

1.

Total fat intakes in the range of 20% to 40% of energy are not related.

2.

Monounsaturated fats and olive oil may decrease risk.

Prostate cancer:

1.

There is some evidence of an association between intake of red meat and risk of prostate cancer.

Alcohol

1.

Wine is part of the traditional diet in much of the Mediterranean region, where it is the usual mealtime beverage. It is well established that the light-to-moderate intake of wine and other alcoholic beverages reduces the risk of coronary heart disease and ischemic stroke by =30% and is usually associated with a reduction in all-cause mortality.

2.

Clearly, alcohol itself is a major reason for the benefits of wine and other alcoholic beverages, which are increases in HDL and possibly an antithrombotic effect. There is less consensus on whether wine has advantages over other types of alcoholic beverages in the prevention of cardiovascular disease, because wine drinkers often have other healthy lifestyle habits that may contribute to the added protection against heart disease. On the other hand, phenolics and other nonalcoholic substances in wine have been well demonstrated to be powerful antioxidants and have many potentially important health effects, although it is unclear whether the amounts of them in wine are sufficient to produce benefits.

3.

The beneficial health effects of alcohol are primarily on the risk of chronic diseases of middle-aged and elderly people.

4.

General recommendations to the public regarding the consumption of any type of alcohol consumption must always take into account the adverse health and societal effects of excessive or irresponsible alcohol consumption. Excessive intake of alcohol increases the risk of many cancers, especially upper respiratory and digestive tract cancers, and many studies indicate a slight increase in breast cancer risk even for small amounts of alcohol. Alcohol consumption is not rec-ommended for individuals with a past history of alcohol abuse, with liver disease or certain other medical conditions, or for those who choose not to drink because of religious, ethical, or other reasons.