Mediterranean Diet and cardiovascular health: an historical perspective

Abstract

The first investigation of dietary intake in the Mediterranean region was undertaken at the initiative of the government of Greece in 1948. Plant foods (cereals, pulses, nuts, potatoes, vegetables and fruits) accounted for 61% of total energy intake (TEI), animal foods (meat, eggs, fish, and dairy products) for 7% of TEI, and olive oil was the main oil used. In 1950s, Ancel Keys undertook studies in USA, Italy, Spain, England, Japan, Australia, Canada leading him to hypothesize that a link could exist between diet, plasma cholesterol and coronary heart disease (CHD). Between 1958 and 1964, Keys and co-workers carried out the Seven Countries Study, which enrolled men aged 40-59 years in one of 16 cohorts from seven countries (Finland, Greece, Italy, Yugoslavia, Japan, USA and Italy), After 15-y, 25-y and 50-y follow up, a strong positive relation was observed between saturated fat intake and CHD mortality, and a negative one with Mediterranean Dietary Index. In 1975, Keys and his wife published a book intitled: “How to eat well and stay well. The Mediterranean way”, which popularized Mediterranean Diet (MedDiet). After 45-y follow-up longevity without CHD death was 12.9 years higher in Crete than in Finland. Protecting effect of MedDiet towards CHD incidence and risk is now confirmed by PREDIMED Study and by cohorts’ studies gathered in several recent meta-analysis. MedDiet is sustainable and recognized by UNESCO as an Intangible Cultural Heritage, which is the most beautiful homage that can be paid to Ancel Keys and all his co-workers.

Energy-Adjusted Dietary Inflammatory Index in pregnancy and maternal cardiometabolic health: findings from the ROLO study

“… 52 A Mediterranean diet that consists mainly of plant foods, animal foods, and olive oil has been shown to minimize inflammation and benefit maternal and offspring cardiovascular health. 53 , 54 , 55 A prospective cohort study reported a significant inverse relationship between Mediterranean diets and risk of hypertension among women with a history of GDM. 56 In another study, Mediterranean diet score was moderately negatively correlated (ie, r≈−0.50 to −0.70) with the DII.…”

The health benefits and practical considerations for the adoption of a Mediterranean-style dietary pattern

“…The seminal Seven Countries Study of Ancel Keys (1958Keys ( -1964 and colleagues, which included a number of Mediterranean cohorts first highlighted the health benefits of this dietary pattern (1) . Although at times criticised for its design limitations (it has an ecological design which means that only data from average populations, not individual data is used to establish correlations), this work which included 12 763 healthy men aged 40-59 years has highlighted over the decades the strong positive and negative association between saturated fat intake and the MDP index, respectively, and CHD mortality.…”

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The term Mediterranean diet first appeared in the late 1940s (1) . It is described by UNESCO as 'a set of skills, knowledge, practices and traditions ranging from the landscape to the table, including the crops, harvesting, fishing, conservation, processing, preparation and, particularly, consumption of food'.

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Lipids in Pathophysiology and Development of the Membrane Lipid Therapy: New Bioactive Lipids

“…There is clear epidemiological evidence of a correlation between dietary lipids and human health, suggesting that melitherapy interventions could have valuable therapeutic consequences. In this context, high saturated fatty acid (SFA) intake has been associated with a risk of cardiovascular disease [99], whereas high mono- [100,101] and polyunsaturated [102,103] fatty acid intake is associated with a much lower risk of developing such problems. Moreover, unsaturated fatty acids (mainly eicosapentaenoic acid [EPA], DHA, and oleic acid [OA]) have been associated with a lower risk or incidence of cancer, metabolic syndrome, neurodegenerative pathologies, etc.…”