Tuesday, September 01, 2009

Mediterranean diet fights type 2 diabetes better than low-fat diets....

Today's Post: Tuesday, 9-1-2009


A story from Reuters Health online they published yesterday late in the day was titled.:

“Mediterranean diet tops low-fat diet for diabetics”

The study, from the Annals of Internal Medicine, September 1, 2009 was of two groups of people with type 2 diabetes who followed either a low carbohydrate Mediterranean diet or a lowfat & calorie restricted diet -- for four years.

I found the results quite convincing and one part of the results very useful to people trying to lose excess fat or to lose weight.

The bottom line was that only 44% of the people eating the Mediterranean diet wound up needing drugs for their type 2 diabetes to lower their blood sugar while 70% of the people eating the lowfat diet did.

The people eating the Mediterranean diet had their HDL go up and their triglycerides fall and maintained those improved readings as long as they were in the study eating a Mediterranean diet. As readers of my blog know, it’s been discovered that this means their small particle LDL, that is literally so tiny it sinks into the molecular chinks in your artery walls causing heart disease, dropped significantly.

And, that, combined with the better blood sugar control, meant that they dropped their heart disease risk by a lot!

The interesting part was that despite the fact that the lowfat diet emphasized to avoid all fats and restrict calories more, the people who ate the low carb version of the Mediterranean diet lost a bit more weight, about 2 pounds; but of most importance, they lost more inches from their waists.

Bottom line, that means that the less psychologically restrictive and more enjoyable Mediterranean diet not only got better health results, it got better fat loss results also.

Here are the key parts of a Mediterranean diet compared with what many people eat.

Meat tends to be eaten once or twice a week instead of much more often. Wild caught fish and some grains and nuts are much more emphasized. Some chicken is included. Some cheese is included but in small quantities.

Grain foods tend to be whole grain pasta or bread and virtually no snack foods or refined grain foods are eaten. Since the version of the Mediterranean diet in this study was low carb, the amount of even whole grain foods was low moderate or moderate instead of a lot.

Even less dairy fat and butter is eaten than in the lowfat diet. Even less oils high in omega 6 such as corn oil and soy oil are eaten than in the lowfat diet. Almost exclusively, olive oil or extra virgin olive oil is used instead -- along with eating nuts.

No soft drinks are included at all. But moderate amounts of red wine are.

Fresh garlic is often used as a spice in salads and in savory foods.

Whole fresh fruit is included.

And, one of the most important keys is that a wide variety of salad vegetables, other vegetables, and both fresh & cooked tomatoes are included.

A. Here’s why this seems to work so well.

1. While it was somewhat calorie restricted, the lowfat diet apparently did have some sugars and refined grain foods. Those tend to make eating less food or calories harder and to spike blood sugar and lead to insulin resistance. They also tend to increase triglyceride levels and lower HDL.

2. In addition, the oils that are high in olive oil and nuts are mostly monosaturated oils which have been separately found to lower insulin levels! That helps to keep off excess fat and may result from improved insulin effectiveness meaning that insulin resistance is better prevented or improved by such oils.

3. The saturated fats and omega 6 oils NOT eaten in the Mediterranean diet by avoiding most fatty and grain fed meat and heavy use of dairy fat – and vegetable oils high in omega 6 tend to increase LDL and lower HDL while olive oil and nuts tend to increase HDL and lower LDL.

4. Garlic may help prevent or reverse plaque build up and blood clotting in the blood and help keep the surface of your blood vessels, the endothelium, healthy -- even though it doesn’t lower LDL cholesterol very much. It also helps by making food taste good without needing to add salt or as much salt.

5. And, red wine in moderation makes the Mediterranean diet more enjoyable for most people and increases HDL plus containing other heart protecting substances such as resveratrol.

6. The emphasis on lots of vegetables and a wide variety of vegetables also helps make people feel full and not hungry despite having very few calories. And the nutrients in vegetables, particularly organically grown vegetables, have been found to help prevent cancer and promote good health and longevity in other ways. In fact, this greater amount of vegetables is one explanation for the greater fat and weight loss than the officially calorie restricted lowfat diet produced.

B. The last point is that this study did not even look at exercise levels. And since regular exercise, particularly vigorous exercise such as strength training or interval cardio, helps lower high blood sugar and prevents or sharply improves insulin resistance, adding that kind of exercise program to the low carbohydrate Mediterranean diet would have dropped the number of type 2 diabetics who needed blood sugar reducing drugs well below 44%.

Weds, 9-2-2009 Correction:

After I wrote this post, I found that the TIME magazine coverage of this study reported that both groups of people, the lowfat diet people AND the Mediterranean diet people WERE recommended to exercise regularly.

There was no reporting though to indicate how well the two groups followed this advice while the study researchers did seem to be more careful to ensure the groups followed the diets they were supposed to follow.

So, I still suspect that a study of people who actually exercised instead of just had it suggested, would find fewer than 44% of the people needed to take drugs who both actually exercised and ate a Mediterranean diet.

And, since studies HAVE found that even brief bursts of vigorous exercise DO lower high blood sugar, I think that if people followed the Mediterranean diet AND got some quite vigorous exercise once or twice each day, they would do even better.

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