The Mediterranean Diet and Metabolic Syndrome X.
June 3, 2014 Admin 4
Anyone interested in the field of Nutrition and health may already know that metabolic syndrome is a cluster of conditions associated with a greatly increased risk of developing cardiovascular disease, diabetes and other potentially debilitating conditions. Studies which have examined the root and cause of metabolic syndrome have generally presented different results and ideas on how to tackle the issue with the only general concensus being the need for an implementation of intense lifestyle modification. In this article we look closely at the Mediterranean Diet and Metabolic Syndrome X.
Metabolic syndrome was first described by the French physician Jean Vague shortly after the end of World War II. Vague discovered the connection between abdominal obesity and a set of metabolic abnormalities of which he based his findings. It was not until 1988 though that major progressions were made in the area when Gerald Reaven, an Endocrinologist, suggested insulin resistance and not obesity as previously thought was the major contributory factor to developing metabolic syndrome. Reaven referred to his findings as ‘Syndrome X’.
In recent years the most widely used definition of Metabolic Syndrome X was one established by the World Health Organisation who regard the condition as a significant cardiovascular risk factor with a set of attributes such as elevated LDL cholesterol, atherogenic dyslipidemia, insulin resistance, abdominal obesity, hypertension and several other inflammatory markers. Reaven has since noted that the WHO definition may not be wholly accurate in predicting the condition due to certain diagnostic aims and institutional goals when compared to other organisations using the same terms but different methodology in diagnosis. In 2005 the Internation Diabetes Federation Epidemiology Task Force created a new definition for metabolic syndrome which focussed on central obesity.
The role of therapeutic lifestyle changes (TLC’s) in order to stifle the growth of metabolic syndrome have been the cornerstone of most studies, guidelines and recommendations. One such recommendation is for those at risk to follow the Mediterranean Diet. Although there is no single Mediterranean diet, with regional variations spread from Spain the the Middle East, the changes are largely created by the availablity of foods, preparation and cultural differences. Similarities though are the general reliance on fresh vegetables, fruits, beans and legumes, olives and olive oil, nuts and seeds and on the animal product side, cheese, yoghurt, chicken, eggs and fish.
The consumption of wine is also firmly integrated into the diet. A closer look at the diet reveals its ability to provide high levels of fibre, essential fats, phytochemicals, vitamins, minerals and antioxidants. Besides fresh produce and an abundance of whole grains there is nearly no processing of foods at least not in the modern sense, no deep frying and very little saturated fat, sugar or concentrated fructose sources (i.e fruit juices or corn syrups).
Olive Oil, which features heavily on the diet is perhaps one of the most interesting. The oil must be Extra Virgin and not refined and is used to garnish salads, to make sauces and as an alternative to butter for the accompaniment to bread. Studies analyzed gene responses in patients with metabolic syndrome that demonstrated extra virgin olive oil significantly reduced the expression of inflammatory genes. Study data also revealed the the mechanism by which Extra Virgin Olive Oil and its phenolic constituents exert their anti-inflammatory effect, involving pathways related to to NF-κB/AP-1, cytokine-cytokine receptor interaction, arachidonic acid metabolism, and mitogen-activated protein kinase (MAPK).
Red Wine has long been documented for its ability to promote cardiovascular health and is rich in polypheolic compounds. One such compound is resveratrol. Resveratrol is noted for its ability to mimic calorific restriction and act as a an activator of the NAD(+)-dependent deacetylases sirtuins. Sirtuins may also regulate the circadian clock of cells in response to inflammation and sirtuins inhibited by nicotinamide are activated by resveratrol. Fresh fruits and vegetables provide nutrients in the form of vitamins and phytochemicals, notably tomatoes which are rich in the carotenoid, lycopene.
Dutch scientists, writing in the Journal of Nutrition presented findings that in middle aged and elderly males, those with a higher than average intake of carotenoids like lycopene, experienced a 58% lower incidence of metabolicsyndrome. The highest intake of lycopene itseld was directly associated with a 45% lower incidence compared to males with lower than average intakes. Green leafy vegetables, peppers and whole olives provide similar levels of phytochemicals and antioxidants.
High fibre content of the Mediterranean Diet comes in the consumption of beans, fruit, vegetables and whole grains. Controlled studies have found that the consumption of whole grains on a regular basis have a positive effect on insulin sensitivity and lipid metabolism. Other studies have found studies discovered diets rich in whole grains protect against cardiovascular disease and associated conditions, type 2 diabetes and obesity itself.
Whilst presenting the Mediterranean diet as a cornerstone of a healthy lifestyle and eating regime, research also continues to demonstrate the diets strong role in prevention of metabolic syndrome. Originally gathering interest for its effect in longevity, the diet also takes the role of preventing debilitating conditions which can occur in middle age. To implement the diet, there is no need to live in the Mediterranean itself, but simply to source the common ingredients and foodstuffs in your local store or market. Using organic produce over conventionally farmed products is an additional recommendation as it obtaining fresh rather than frozen, canned or dried foods. Only Extra Virgin oil should be used, also organic if available.
The highest currently recognised resveratrol content found is grapes is from the Muscadine Vine (Vitus Rotundifolia) at around 40mg/litre. Although not a Mediterranean native, Muscadine grapes are rich sources of polyphenols with gallic acid and epicatechin being the major phenolics present. Their skin is are rich in ellagic acid, myricetin, quercetin, trans-resveratrol and kaempferol, which would suggest consumption of the grapes themselves when available as well as wine will be beneficial. Such wines and possibly the grapes also may be available in stores around the world, if not, other grapes and red wines would contain similar phenolic compounds but in somewhat lesser amounts. Grape Juice is not recommended because of the high fructose content and fruit juices in general are not consumed in preference to fresh whole fruits on the diet.