The Mediterranean Lifestyle Improves Heart Health

 

Experts agree that the combination of diet, social life and physical activity can make a generous impact on an individual’s heart health. In fact, new research has found that a Mediterranean lifestyle may boost heart health.

While the Mediterranean diet, with its focus on fruit, vegetables, olive oil, whole grains, fish and lean meats, is helpful for a myriad of health reasons, researchers found that the lifestyle surrounding the diet was worth emphasizing. 

They found that the more people followed a Mediterranean lifestyle, the less likely they were to die of cancer or cardiovascular disease. Those with the closest adherence were about 30% less likely to die of cancer or heart disease than those with the lowest adherence.

“It’s not just the diet, it is the other environmental factors also that benefit us,” said John P. Higgins, professor of cardiovascular medicine at the UTHealth Houston McGovern Medical School. 

Dr. Higgins continued, “Things like setting up your environment so that walking is the healthy choice, being happy and smiling, having sociable interactions, as well as good sleep, appear to work in concert with the Mediterranean diet to improve health and wellness.” 

Adhering to a certain lifestyle may sound overwhelming, but the Mediterranean lifestyle is fairly simple to follow. Sustainable shifts in nutrition, physical activity and social life are all that are needed for these heart-healthy habits.

Research has shown isolation and loneliness both increase a person’s risk of cardiovascular disease, highlighting the importance of the social aspects of a Mediterranean lifestyle.

“Meals are something that happen around the family and friends,” Mercedes Sotos-Prieto, an adjunct assistant professor of environmental health at the Harvard School of Public Health said. She noted a concept called conviviality, one of the key factors evaluated in the study. The concept relates to how individuals eat, rather than what they eat. In the study, this was measured as sharing meals. 

“This is something very characteristic of the traditional Mediterranean lifestyle, the pleasure of sharing meals that fosters the sense of community,” Sotos-Prieto explained. “That moment where we chat in a relaxed way while savoring the food.” 

Social habits were also tied to doing physical activity with others, such as taking a walk, or how often people attended different social events that applied to their lives, such as going to church. 

At their core, social interactions like these foster opportunities for hospitality and social support systems, according to Sotos-Prieto. This support can reduce the stress that puts strain on the cardiovascular system. When paired with exercise—like taking a walk with a friend—this can make a big difference on an individual’s overall health. 

Eating meals in a social setting may also impact what an individual is likely to eat. 

“I have a lot of patients who are single and they are eating by themselves and I find they are less likely to plan and prepare a healthy balanced meal for themselves, and then their nutrition is being compromised,” explained Jenifer Bowman, a registered dietitian in the department of cardiology at UCHealth in Fort Collins, Colorado. 

By simply sharing a meal with someone—family, friends, a roommate—individuals may naturally make more nutritious (and heart-healthy) decisions.

According to Dr. Higgins, the way of eating also boosts levels of nitric oxide, a gas that regulates blood vessel dilation, and therefore blood flow, which boosts heart function. 

Meanwhile, the Mediterranean eating style’s prioritization of fruits and vegetables provides both fiber and antioxidants. It also encourages whole grains, as well as beans—more high-fiber foods.

“Fiber takes some work for your digestive system to break down, so you have a more gradual raise in your blood sugar with higher fiber food,” explained Bowman. “Fiber also has the ability to bind to cholesterol and help remove that cholesterol from our digestive tract, which helps manage cholesterol overall.”

The Mediterranean diet also emphasizes healthy fats, especially olive oil, nuts, seeds, and lean meat, especially fish. These foods have antioxidant and anti-inflammatory properties, including Omega-3 fatty acids, that boost heart health by reducing triglycerides, a type of fat in the blood, reducing the risk of irregular heartbeats, and slowing the build-up of plaque that hardens and blocks the arteries.

 “It does not have to be only fresh fruits and vegetables, that’s a huge myth. Frozen is fine.” Bowman said.

If fatty fish is not accessible, lean meat such as skinless chicken breasts provides healthy protein without adding saturated fat. The important thing is to avoid processed, prepackaged meals when possible, she said. 

“People in this [Mediterranean] region are not eating macaroni and cheese and frozen pizza,” she said, adding that it can be helpful to keep in mind that three-quarters of your plate should be plant-based. 

“Half of the plate should be vegetables, a quarter of it is lean protein, then the other quarter high fiber plant foods like beans or whole grains.”

Learn from the “Blue Zones” to Live Longer

 

In a few, unique communities around the globe, some people live long and have heathy lives. Dubbed as “Blue Zones”, residents of these areas share a common environment and lifestyle that scientists believe contribute to their longevity. 

Dan Buettner, an explorer, National Geographic Fellow, award-winning journalist and producer, first brought "Blue Zones" into the public consciousness. He believes anyone can copy and apply lessons from the Blue Zones, no matter where they live and eat — even in highly processed, food-obsessed cultures such as the United States. 

People in Blue Zones walk, garden and bike as part of their daily lives. They are close to friends and family, have a purpose in life, handle stress well and are often members of a social or religious group. They eat a plant-based diet and stop eating before they are full. 

“The Blue Zone eating pattern is 98% plant-based foods — whole food-based and high carbohydrate. But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop,” Buettner said.

Complex carbohydrates, such as beans, peas, vegetables and whole grains provide vitamins, minerals and fiber that can go missing in processed and refined foods. In addition, they are digested more slowly, and the fiber helps them feel full longer, according to the American Heart Association. 

 “The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts and beans. In fact, I argue the cornerstone of a longevity diet is beans,” Buettner said. 

Blue Zone eating is similar to that of the Mediterranean style. But there are also differences between a Blue Zone eating pattern and that of the Mediterranean, Buettner said. 

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only 3 ounces,” he said. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.” 

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino.

Purple sweet potatoes have contributed to the longevity of people in Okinawa, Japan, Dan Buettner said. “I would argue it produced the longest-lived population in the history of humankind.” 

Blue Zone recipes were also found in Gullah Geechee cuisine, a method of cooking developed by descendants of enslaved Africans who settled in the Sea Islands of Georgia, Florida, North Carolina and South Carolina. Stews and soups may be thickened with benne seeds, an heirloom version of sesame seeds brought over on slave ships. Meanwhile, traditional Vietnamese pho is part of the "Blue Zone" pattern of eating.

Chronic Pain raises Dementia risk

 

Chronic pain, such as arthritis, cancer or back pain, lasting for over three months, raises the risk of cognitive decline and dementia, a new study found. Living with chronic pain can lead to more rapid cognitive decline and later dementia.

The hippocampus, a brain structure highly associated with learning and memory, aged by about a year in a 60-year-old person who had one site of chronic pain compared with people with no pain. 

When pain was felt in two places in the body, the hippocampus shrank even more — the equivalent of just over two years of aging. 

The risk rose as the number of pain sites in the body increased. Hippocampal volume was nearly four times smaller in people with pain in five or more body sites compared with those with only two — the equivalent of up to eight years of aging. 

People with higher levels of pain were also more likely to have reduced gray matter in other brain areas that impact cognition, such as the prefrontal cortex and frontal lobe — the same areas attacked by Alzhemier’s disease. In fact, over 45% of Alzheimer’s patients live with chronic pain, according to a 2016 study. 

Equally important is a link between chronic pain and inflammation. A 2019 review of studies found pain triggers immune cells called microglia to create neuroinflammation that may lead to changes in brain connectivity and function. 

In addition, chronic pain often makes getting a good night’s sleep difficult. Sleeping less in turn raises the risk of cognitive decline.  A 2021 study found sleeping less than six hours a night in midlife raises the risk of dementia by 30%. 

“Exercise is the #1 the most powerful tool in the fight against cognitive decline,” Alzheimer’s disease researcher Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases of Florida, said. People who walked with "purpose" -- at a pace over 40 steps a minute -- were able to cut their risk of dementia by 57% with just 6,315 steps a day.

“Asking people about any chronic pain conditions, and advocating for their care by a pain specialist, may be a modifiable risk factor against cognitive decline that we can proactively address,” Dr. Isaacson said.

The treating programs on chronic pain typically involve a number of specialists to find the best relief for symptoms while providing support for the emotional and mental burden of pain. 

Psychologists who specialize in rehabilitation may recommend cognitive and relaxation techniques such as meditation, tai chi and yoga that can take the mind off fixating on pain. Cognitive behavioral therapy is a key psychological treatment for pain.

Going on an anti-inflammatory diet may be suggested, such as cutting back on trans fats, sugars and other processed foods.

Weight loss may be helpful as well, especially for back and knee pain, according to Johns Hopkins Medicine.

Use food to boost your immune system

 

A plant-based diet underpins the health of those who live longest. Beans, legumes and pulses (such as lentils and chickpeas) are the most important dietary predictor of longevity. From another study, it was found that those who ate a handful of nuts at least five times a week lived two to three years longer than those who did not eat any nuts.

 “What we eat is very important in terms of how our immune system responds to pathogens and how well it can defend itself against a pathogen,” said Dr. Simin Meydani, senior scientist and leader of the nutritional immunology team at Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging. 

 “There isn’t any one food or nutrient to rely on here, but rather it is the interplay of ‘harmonious interactions’ between the various micronutrients,” said Stanford School of Medicine nutrition scientist Christopher Gardner.

Thus a large variety of foods are needed to provide the micronutrients the body needs to mount a robust cellular immune response. Micronutrients such as vitamin C, vitamin D, vitamin B complex, zinc and selenium can help “pump up” the body’s defenses against colds, flu and even Covid-19, Meydani said.

Hence, we need to plan our daily menus around a large variety of fresh and colorful red, yellow, orange, blue and green fruits and vegetables, along with some high-quality whole grains and nuts, a bit of lean protein and a splash of healthy oils.

If you want to maximize the impact of food on your immune system, you will need to dramatically increase the amount of fruits and vegetables you eat each day, Meydani says.

On the other hand, eating a lot of unhealthy, “ultraprocessed”, fat-laden foods, sugary drinks and red and processed meats may shorten your life – just a 10% increase in such foods was significantly associated with a 14% higher risk of death from all causes, studies have shown.

A 2017 study found a significant reduction in the risk of heart attack, stroke, cancer and early death by eating 10 portions of fruit and vegetables each day. Meanwhile, the study found that one in five deaths globally – that is about 11 million people –occurred because of too much sodium and a lack of whole grains, fruit, nuts and seeds.

In fact, chronic inflammation has been linked in studies to cancer, heart disease, diabetes, arthritis, depression, Alzheimer’s and many other diseases.  A certain amount of inflammatory response is needed to get rid of the pathogens and to help the body’s immune system perform its function. In this aspect, you can choose leafy greens, tomatoes, fruits, nuts, fatty fish and olive oil – foods that can support a healthy inflammatory response. Studies are also finding that fermented foods such as kimchi, sauerkraut or kombucha may also help battle some types of inflammation by improving the microbiome in the digestive system. In addition, tea brewed from local rosemary, wild sage and dandelion are known to have anti-inflammatory properties.

Mushrooms, particularly shiitake, contain more than 100 compounds with immune-protecting properties. Selenium in seafood, meat, poultry, eggs, dairy products, breads, cereals, and nuts, especially Brazil nuts, also plays an important role in inflammation and immunity while ginger's golden cousin is a powerful anticancer, antioxidant and anti-inflammatory agent.

Meanwhile, vitamin E plays a dual role in boosting the body’s immune response. It acts as an antioxidant in the body, helping to protect cells from the damage caused by free radicals and also can have an anti-inflammatory effect. Some of the best sources for vitamin E are vegetable oils like sunflower and safflower; peanuts, hazelnuts and almonds; seeds; and wheat germ. 

Peppers are rich in vitamins, especially vitamin C.

In addition to eating well, it is important to stay at a healthy weight, reduce your stress, get quality sleep and regular exercise to keep those natural defenses in fighting shape.