Heart disease risk-factor status and dietary changes in the Cretan population over the past 30 y: the Seven Countries Study

Kafatos, Anthony; Diacatou, A; Voukiklaris, G; Nikolakakis, Nikolaos; Vlachonikolis, John; Kounali, Daphne‐Zacharenia; Mamalakis, George; Dontas, A. S.

doi:10.1093/ajcn/65.6.1882

Cited by 159 publications

(129 citation statements)

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“…Subsequently, the Lion Diet Heart study revealed a smaller incidence in the number of re-infarction and death in 50-70% of subjects who, after a first infarction, followed the MD enriched in a-linolenic acid, in addition to standard diet. Such a result was seen after 27 months, but was also confirmed after 46 months [21][22][23]. Confirmations have subsequently been obtained from many investigations about the MD, highlighting a low frequency in several pathologies (hypercholesterolaemia, hypertension, atherosclerosis, diabetes, and obesity).…”

Section: Towards Evidence-based Medicinesupporting

confidence: 57%

“…In fact, it was found that the MD, in which the lipidic component is somewhat high (>25-30% of total calories, and is represented almost entirely by EVOO, rich in MUFA oleic acid, reduced some risk factors, such as hypercholesterolaemia, atherosclerosis and hypertension, and mortality for cardiovascular diseases. Moreover, a decrease of 56% in total mortality and 61% in cancer risk was seen [14][15][16]21]. In the Seven Countries study (Italy, Greece, Ex-Yugoslavia, Holland, Finland, USA, and Japan, a study on human subjects between 40 and 59 years old), atherosclerotic cardiovascular disease fluctuated between 2 and 10% in southern Europe, where the MD is widespread and the use of EVOO is high (Turkey: 1 kg/year; Italy and Spain: 10-12 kg/year), while it was 10-18% in Northern Europe and USA (USA: 0.45 kg/year).…”

Section: Towards Evidence-based Medicinementioning

confidence: 99%

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Virgin olive oil in preventive medicine: From legend to epigenetics

Caramia¹,

Gori

Valli

et al. 2012

Euro J Lipid Sci & Tech

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Among vegetable oils, extra virgin olive oil (EVOO) has nutritional and sensory characteristics that make it unique and a basic component of the Mediterranean diet. EVOO has always been used over the centuries for its preventive and therapeutic properties, as well as precious and valuable dietary lipidic condiment. Benefic effects of a diet rich in EVOO on the human health, especially in prevention and/or reduction of hypercholesterolaemia, serum lipoprotein levels and atherosclerosis, hypertension, cardiovascular diseases and thrombotic risk, oxidation and oxidative stress, obesity and type 2 diabetes, inflammatory processes and cancer are discussed in these review. Recent studies suggest also its role in regulating the sense of satiety. The chemical compounds of EVOO that may contribute to its overall therapeutic characteristics, the epigenetic and physiological mechanisms involved are focused, taking into account the most important studies in the literature of the last years.Practical applications: Many studies on various aspects of nutrition indicated that many human diseases are influenced by lifestyle, in which the diet has an important aspect. The use of extra virgin olive oil is especially important from early childhood and throughout adult life to contribute to hinder the aging process. The importance of preventive and sometimes curative action, carried out by its various components in several pathological conditions has emerged from clinical, experimental, and epidemiological studies which, in many cases, are accompanied by indisputable scientific evidences. Taking into account the most important studies in the literature of the last years, the chemical compounds of extra virgin olive oil and the physiological mechanisms involved in their curative/health effects are the focus of this article.

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Section: Towards Evidence-based Medicinesupporting

confidence: 57%

Section: Towards Evidence-based Medicinementioning

confidence: 99%

Virgin olive oil in preventive medicine: From legend to epigenetics

Caramia¹,

Gori

Valli

et al. 2012

Euro J Lipid Sci & Tech

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“…More detailed studies, however, also show that Greek men and women have high fasting triglyceride levels and high postprandial lipaemic changes. Katan and ourselves have therefore expressed surprise that the IHD morbidity and mortality rate are not higher (Aravanis et al, 1988;Kafatos et al, 1997). A lag time might be the confounding factor, this lag probably being greater for disease development than disease remission.…”

Section: Lipid Changesmentioning

confidence: 97%

The high-fat Greek diet: a recipe for all?

2002

Self Cite

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Objective: To examine critically the published results of dietary surveys on the fat content of the Greek diet, and to assess its evolution and its relationship to the health of the Greeks. To consider the implications of these findings for current views on the nature and health implications of the traditional Mediterranean diet and how best to define it for use in modern policy making. Design: A systematic review of the literature on food consumption in Greece. Setting: Greece. Results: The first fully published data on the fat content of the Greek diet -the Seven Countries Survey -relates only to a small number of adult males in Crete and Corfu; the legitimacy of extrapolating these results to the rest of Greece is questioned. Earlier studies and chemical validation of intakes point to a lower fat content of the traditional diet than that inferred for Crete. Nearly all later surveys relate only to urban groups in Athens (mostly case -control hospital-based samples) and a variety of nonrepresentative Cretan groups. Only two studies are larger and more representative, but one uses FAO food balance-sheets to reflect the national diet, and the other surveyed school-age children in three out of the 52 Greek counties. Unfortunately recent dietary studies have proved unreliable, given the continuing lack of national food composition tables with survey methods which proved inaccurate for dietary fat content. A progressive upward trend in total and saturated fat intake appears to have occurred with all health indicators in relation to fat indicating remarkable increases in adult and childhood obesity with attendant progressive deterioration in cardiovascular mortality and its risk factors, ie hypertension and diabetes. These data emphasise the need to alter current nutritional advice in Greece, particularly when it focuses on the promotion of olive oil and a high-fat diet. Conclusions: The findings reaffirm low -moderate fat policies for optimum health, within which olive oil can be an important component of the diet.

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“…Evidence from subsequent surveys, however, suggests that the prevalence of CVD among Cretans has been increasing rapidly during the past two-three decades (Voukiklaris et al, 1996), and CVD now constitutes the primary cause of morbidity and mortality nationally (Chimonas, 2001). This trend comes at odds to what is observed in most developed countries, and has been attributed mainly to overall lifestyle modifications, such as adverse dietary practices (Kafatos & Mamalakis, 1993;Kafatos et al, 1997), diminished physical activity , and limited health awareness of contemporary Greeks. At the same time, a number of conventional risk factors, and especially obesity (Mamalakis & Kafatos, 1996;Pitsavos et al, 2003) and dyslipidaemia Voukiklaris et al, 1996;Pitsavos et al, 2003), are very common nowadays and, undoubtedly, confer increased CVD risk to Greek subjects.…”

Section: Introductionmentioning

confidence: 96%