In the traditional Mediterranean diet, many healthy lifestyle factors such as fresh staple foods, enjoyable meals and moderate regular consumption of wine are combined. Worldwide, the Mediterranean diet is regarded as a healthy and enjoyable way of eating. In Barcelona, early April, researchers from all over the world gathered to present and discuss the latest scientific evidence.
The presentations and discussions focused mostly on cardiovascular disease, diabetes, Alzheimer and other chronic diseases, in particular on the advantages of the Mediterranean diet. The renowned speakers belong to the scientific elite when it comes to research about the Mediterranean diet during the last decades.
In his inaugural keynote speech, Prof. Ramon Estruch, President of the “10th International Conference Mediterranean Diet” and principal investigator of the PREDIMED study, emphasized the health benefits of the Mediterranean food pattern. A high adherence to the Mediterranean diet (MeDiet) is associated with a strong protection against cardiovascular disease as seen in the results of his PREDIMED study, where the markers of cardiovascular risk such as blood pressure, lipid profiles, inflammation, oxidative stress and atherosclerosis improved significantly. The PREDIMED results further demonstrate that a high-unsaturated fat and antioxidant-rich dietary pattern is a useful tool in the prevention of cardiovascular disease. Thus, the protective benefits of the traditional MeDiet may be even greater, if it is upgraded with extra virgin olive oil (instead of common olive oil), a higher amount of nuts, fatty fish and whole grain cereals and maintaining a moderate consumption of wine with the meals.
What happened to the French Paradox?
The cardiologist Prof. Michel de Lorgeril, currently at the Faculty of Medicine in Grenoble and one of the initiators of the famous “Lyon Study”, spoke about the “French Paradox – 20 years later”.
The “French Paradox” is the fact that, despite similar risk factor patterns as other Western countries, the mortality rate from cardiovascular disease in the 1960’s-1980’s was about 50% lower in France compared to similar developed countries. In 1992, de Lorgeril and other French scientists like Serge Renaud, proposed a theoretical explanation of the “French Paradox”: the lifestyle of French people, in particular their dietary habits, could be protective. More specifically, the French way of drinking alcoholic beverages – wine in moderation – could be the main explanation because regular low dose alcohol does have anti blood clotting properties and wine polyphenols could also provide some health benefits. Twenty years later, when the mortality rate from cardiovascular disease (CVD) has decreased in most Western countries, the French Paradox still persists; mortality from CVD in France is still lower than in UK and USA and even lower than in most Mediterranean countries. De Lorgeril attributes it to the fact that the French have maintained their lifestyle and drinking patterns.
Communicating the Mediterranean drinking patterns
The scientific work of the Vice president of the Hellenic Health Foundation, Prof. Antonia Trichopoulou, focused on public health nutrition and nutrition epidemiology, with emphasis on the health effects of the Mediterranean diet and traditional foods. She explained in her presentation that moderate wine drinking during meals is associated with health benefits. It appears that this is due to the gradual and lower elevation of ethanol in the circulating blood or because it may modulate the health effects of other food components (such as vegetables, fruit, olives and nuts) in the stomach. In addition, the drinking patterns of wine drinkers are different from those consuming beer or spirits. Moderate wine drinking during the meals may maximize the health benefits without substantially increasing the risk of excessive ethanol consumption. Prof. Trichopoulou emphasized that it is necessary to balance the risks and benefits and prevent alcohol misuse and its negative consequences. However, those who like to enjoy 2 – 3 glasses of wine per day during the meals can continue to do so and combine pleasure and enjoyment with good health.
The French Paradox also in China and the US
Prof. Eric Rimm, director of the Programme in Cardiovascular Epidemiology at the Harvard School of Public Health, also travelled to Barcelona. The focus of his talk were alcoholic beverages and in particular, wine. He described that during the last four decades, over a hundred large prospective studies have examined the association between alcoholic beverages and CVD from countries as far reaching as Thailand, China, Japan in the East and England, Spain, France and the US in the West. Almost without exception, every study finds that men and women who drink moderately have a 30% lower risk of coronary heart disease and a 10-15% reduction in ischemic stroke. Rimm pointed out that the challenges may be less about the science of the benefits and more about the best way to communicate the health messages around healthy vs. unhealthy drinking patterns. From long-term prospective studies with data on drinking pattern, it is known that the healthiest drinking is at modest levels more frequently during the week as opposed to infrequent binge drinking. Rimm advised to eat a balanced diet and drink moderately with the meals. He cautioned, however, that without exception, there is no benefit from consuming more than 4-5 drinks per day because at these levels, the risk for all diseases is increased.