Events 25 May 2016

XI Mediterranean Diet Conference Report

This edition is dedicated to the XI Mediterranean Diet Conference that took place in Barcelona from April 27-28, 2016 and was organised by the Mediterranean Diet Foundation and FIVIN.

The conference was a great opportunity to learn more about the latest scientific evidence on the Mediterranean diet (MD) including responsible wine consumption and it also became evident that other lifestyle factors contribute to a healthy lifestyle and wellbeing.

With many interesting presentations of researchers from all over the world about different aspects of the Mediterranean lifestyle. In this newsletter, we can only provide a small insight into the vast multitude of topics.


The Mediterranean Diet Foundation and FIVIN under the supervision of Domingo Valiente and his team organised a well-rounded conference.

The mission of the Mediterranean Diet Foundation (MDF) is to promote the values of the Mediterranean Diet, its products, the healthy lifestyle it represents, which is both viable and socially respectful with the environment instead. It aims to safeguard the ancient heritage common to the Mediterranean populations whose lifestyles and habits – including farming practices, cooking, nutrition and regularly practiced physical activity – has attracted interest in recent decades from eminent scientists around the world for its contribution to the prevention of many diseases. The MDF disseminates the results of studies and promotes the Mediterranean Diet among different population groups.

FIVIN, the Foundation for Wine Research and Nutrition created in 1992, focuses on assessing possible protective effects of moderate wine consumption on the human body and health from a medical standpoint. FIVIN undertakes continuous research and data collection on wine and health, with the support of a scientific committee consisting of doctors, health professionals and nutrition specialists of international prestige.

Conference President

Prof. Ramon Estruch, president of the Mediterranean Diet Conference, professor of the University of Barcelona and leading researcher of the PREDIMEDThe PREDIMED study is one of the few randomized controlled trials about the Mediterranean Diet. More... study.

In his opening speech, Prof. Estruch welcomed the participants to two days of sessions focusing on the Mediterranean Diet (MD) and how to move forward to an even healthier lifestyle. He emphasised that the MD is one of the healthiest dietary patterns in the world and has been included – among others – in the nutritional guidelines of the US Department of Agriculture.

The aim of this conference was to disseminate the latest scientific evidence supporting the Mediterranean Diet and its main food components as the backbone of physical and mental health as well as preventing many chronic diseases.

Day 1 – Mediterranean Diet Pattern

Key note Speaker – Beneficial effects of moderate wine consumption

Prof. Iris Shai The keynote speaker of the conference was Prof. Iris Shai, Ben-Gurion University of the Negev, Israel. As the leading investigator of the first randomised controlled CASCADEThe CASCADE study (CArdiovaSCulAr D trial, she reported about results of this study where type-2 diabetes patients were randomly assigned to consume 150 ml of mineral water, white or red wine with dinner for 2 years.
All participants followed a Mediterranean diet without caloric restriction. Her motivation for initiating the CASCADEThe CASCADE study (CArdiovaSCulAr D study was the controversy about the recommendations regarding moderate alcohol consumption particularly for diabetic patients because of the lack of long-term randomized controlled trials.

The results showed that there are slow and fast alcohol metabolizers depending on the genetic make up (alcohol dehydrogenase allele variants) and that slow alcohol metabolizers significantly benefited from the effect of both wines on the glycemic control compared to fast alcohol metabolizers. In addition, across all three groups, no differences were identified in blood pressure, adiposity, liver function, drug therapy, symptoms or quality of life.

At the end, she summarized that initiating moderate wine consumption among well-controlled diabetics as part of a healthy diet slightly decreased the cardio-metabolic risk and seems to be safe.

This research was published in 2015 in the Annals of Internal Medicine: Effects of Initiating Moderate Alcohol Intake on Cardiometabolic Risk in Adults With Type 2 Diabetes: A 2-Year Randomized, Controlled Trial.

Wine in Moderation and Mediterranean lifestyle – From science to consumers

In the following session the Wine Information Council scientific coordinator, Ursula Fradera, had the opportunity to present Wine in Moderation and Mediterranean lifestyle – From science to consumers.

She introduced Wine in Moderation as the international programme of the wine sector that aims to inspire healthy lifestyles and contribute to the reduction of alcohol-related harm. The Programme builds on scientific evidence, education and self-regulation and aims to organise and empower the entire international wine value chain, raise awareness and knowledge about responsible drinking patterns and moderate wine consumption. Ursula Fradera
In a digital era with fast moving information, translating the latest research results into easily understandable language and communicating in an objective and responsibly manner is challenging and difficult.

For this purpose, one of the pillars of Wine in Moderation Programme is the scientific documentation to make available objective, unbiased evidence-based scientific data.

This pillar is supported by the Wine Information Council (WIC), an independent scientific advisory group that assesses and advises on current scientific issues related to wine, health and social aspects.

Using the recent updates of the drinking guidelines in some countries and the potential health consequences, Ms. Fradera illustrated one of the issues that WIC is dealing with.

She presented an overview of the drinking guidelines and reviewed the scientific evidence behind them with a special focus on the recent revision of the UK drinking guidelines.

These proposed guidelines do not consider the overall disease/mortality risk but are just based on the risk of injuries/accidents in the case of men and the cancer risk in the case of women. With such an approach, the known benefits of moderate wine consumption, with regards to cardiovascular disease and diabetes and the fact that the total mortality risk follows a J-curve, are completely ignored. Considering the global epidemic of obesity and inactivity, the risk of developing cardio-metabolic diseases has increased steadily in recent years: approximately two thirds of the obese population, 50% of the overweight and 25% of the normal weight population in Western societies are regarded as metabolically unhealthy. These individuals with a high prevalence of cardio-metabolic risk factors represent the population group who might benefit from moderate drinking.

Ms Fradera emphasized that moderate wine consumption should always be regarded in context. Unfortunately, the new drinking guidelines do not seem to adequately account for the complex interactions of wine/alcohol with other dietary factors.

Moderate wine intake is an integral part of the Mediterranean eating pattern and is not only associated with reduced cardiovascular but also with reduced cancer and total mortality.

She concluded with a citation of Hoffman RM & Gerber M. (BMJ 2016;352:i580) that “failing to adequately emphasise the importance of the context of alcohol consumption, risks unnecessarily to stigmatise responsible drinking with a healthy meal…”.

Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered ... – Why drinking patterns matter

Prof. Mladen Boban The next speaker, Prof. Mladen Boban, University of Split, and member of the Wine Information Council, focused on the importance of the Mediterranean drinking patternThe Mediterranean diet, which includes moderate consumption of wine, is considered ... – Why the drinking pattern matters.
He explained that drinking patterns in terms of frequency and the amount of wine consumed as well as drinking with or without a meal are important influencing factors for the biological effects of wine. Prof. Boban addressed the potential underlying mechanisms where the beneficial effects of wine are more evident, if consumed as an integral part of a meal, a typical drinking habit in the Mediterranean. These mechanisms include:

– wine polyphenols act locally in the gastrointestinal tract by preventing generation and absorption of products of lipid oxidation and counteracting effects of postprandial oxidative stress systematically;

– a specific metabolic response of our body and role of uric acid in increasing plasma antioxidant capacity after wine consumption;

– reduced rate and absorption of alcohol and a related lower metabolic load of alcohol and production of its toxic metabolites;

– a potent antibacterial activity of wine and its capacity to act as a digestive aid and to improve microbial food safety.

As a practical recommendation, he proposed to enjoy wine slowly and moderately with the meal and alternate with water to promote a healthy lifestyle and to minimize the risks of alcohol-related harm.

Day 2 – Mediterranean Lifestyle Factors

2016 Mediterranean Diet Congress While during the first day of the conference the focus was on the Mediterranean eating and drinking patterns, the theme of the second day was “Lifestyle and Health: Beyond diet”, where it became obvious that diet is not the only important factor but that other lifestyle factors also play an important role in the health and well-being.

How does sleep affect our eating pattern?

Dr. Marie-Pierre St. Onge, College of Physicians and Surgeons, Columbia University, New York Obesity Nutrition Research Center, illustrated how a healthy sleep is influenced by eating patterns. She described how sleep duration has been associated with food intake: short sleepers have poorer dietary habits than normal sleepers.

It is increasingly documented that sleep restriction not only increases overall caloric intake but favours consumption of high fat, and high carbohydrate foods that are energy dense.

In her studies, she has shown that dietary intake can also influence sleep and that sleep patterns change as diet changes. For example, when participants of her in-patient sleep study went from a lower saturated fat diet to one higher in saturated fat, sleep onset latency almost doubled and time spent in slow wave sleep was reduced. In addition, greater fiber intakes during a day of self-selected unrestricted food intake predicted less sleep time in stage 1 sleep and more time in slow wave sleep. On the contrary, energy intake from saturated fat predicted less slow wave sleep. Finally, higher energy intake from sugar was associated with more arousals during sleep.

Other epidemiological studies also suggest that diet is related to sleep. Patients suffering from insomnia report greater intakes of sugar-sweetened beverages and energy drinks, confectionaries, irregular eating patterns and less frequent breakfast consumption.

Why happiness is linked to health, well-being and a long life

Prof. Carol Ryff, Psychologist at the University of Wisconsin-Madison, demonstrated how happiness is linked to health and well-being and a long life.

There is growing evidence that those with higher levels of well-being, particularly purposeful life engagement, self-realisation and positive ties with others, have a reduced risk of multiple disease outcomes, and live longer.

She explained that the biological and brain-based mechanisms for this phenomenon have been investigated and it was observed that well-being predicts lower levels of inflammation and cardiovascular risk factors, along with a sustained positive response to positive stimuli and faster neural recovery from negative stimuli. Interventions in both clinical and community contexts are underway to promote experiences of well-being.

One key direction for future research is to better understand the role of psychological well-being in promoting good health behaviours, including the Mediterranean Diet.