Dr Hassan S Makki Phoenix Heart Center Mediterranean Diet

 American scientist, Ancel Keys pointed out the correlation between cardiovascular disease and diet in the 1950’s.  The poor population of small towns, of southern Italy was, much healthier than the wealthy citizens of New York, even compared to their own relatives who emigrated in earlier decades to the United States.  Keys suggested that this was diet dependant, by focusing his attention on foods that made up the diet of these populations.  Thus, he led the famous “Seven Countries Study” (conducted in Finland, Holland, Italy, United States, Greece, Japan and Yugoslavia), in order to document the relationship between lifestyles, nutrition and cardiovascular disease between different populations.

Mediterranean diet thought to be the cause!

 High in fruits, vegetables, wholegrain bread, rice and pasta, potatoes, beans, nuts, and seeds  Olive oil as an important fat source and dairy products, fish, and poultry (consumed low- moderate amounts)  Eggs in moderate amounts, and low amounts of red meat in low amounts  Wine is consumed in low to moderate amounts.

Every main meal  1-2 portions fruits, 2+ portions vegetables  1-2 servings wholegrain bread/ rice/ pasta  Use olive oil as main cooking fat or as a dressing Every day  2 servings dairy  1-2 servings nuts Weekly  2 servings poultry, 2+ servings oily fish, 2+ servings legumes  Less than 2 servings red meat, 1 or less serving processed meat  0-4 servings Eggs  Less than 2 servings sweet foods  Optional: 1 glass wine/day(women), 2 glasses/day(men) most days

 Eat more fruit & vegetables  Include oily fish (e.g. salmon, herring, sardines) 2-3 times/ week  Eat wholegrain bread and cereals instead of white/ low fibre  Use olive or rapeseed oils & spreads  Add more natural nuts into your diet (e.g. walnuts, almonds or hazelnuts)   Reduce red meat intake and eat poultry more often   Alcohol in moderation (optional)

 Breakfast  Fruit or small glass of unsweetened fruit juice  Wholegrain breakfast cereal/ oatmeal  Wholemeal bread/ toast with olive oil spread  Lunch  Soup and wholemeal bread  Small portion of chicken/ fish/ egg/ cheese  Salad  Wholemeal bread  Fruit and yoghurt  Evening meal  Small portion meat/ chicken/ fish/ egg  Plenty of salad/ vegetables  Potatoes, rice, pasta, other grains  Fruit for dessert  Glass of wine (optional) MENU Wholegrain bagel with olive oil spread +fresh fruit Lentil soup + wholegrain bread Mediterranean-style marinated fish or chicken Snacks: Fruit/ nuts

 2 tbsp olive oil  1 clove garlic, thinly sliced  1 carrot, diced  1 large onion, sliced  1 celery stick, sliced  1 medium potato, diced  1-2 slices of turnip, diced  100g (4oz) red lentils  1L (1 ¾ pt) chicken or vegetable stock  (serves 4) Heat the olive oil in a saucepan and add the onion and garlic. Sauté gently for 5 minutes until softening Add the rest of the vegetables and cook for a further 4-5 minutes. Add the lentils and stock and bring to the boil. Simmer for minutes. Season with pepper, blend until smooth. Pour the mixture back into the pan, reheat gently. Serve with wholemeal bread

 2 (100g/4oz) fish/chicken  2 tbsp olive oil  2 tsp red wine vinegar  ½ tsp ground black pepper  ½ dried basil or thyme  ¼ tsp garlic granules  2 bay leaves  (serves 2) In a bowl, mix olive oil, vinegar, pepper, basil, thyme and garlic. Coat both sides of the fish/ chicken fillets. Break the bay leaves into 3-4 pieces, press onto both sides of fillets. Cover and refrigerate for at least an hour. Remove the bay leaves. Cook in a non-stick pan over a medium- high heat. Serve with potatoes, pasta, rice or another ‘grain’ such as couscous and vegetables

 PREDIMED study (7500 pts)  30% reduction in risk of heart disease/stroke  52% reduction in risk of diabetes  Results comparable to statins and metformin respectively  reduce the risk of Alzheimer's and Parkinson's disease  reduce the risk of death from or occurrence of Cancer

PREDIMED Study-(wt loss, BP, BS control is better vs low fat diet) Stanford Study-(lowered CRP levels) Northwestern University-(Oleic acid blocked cancer genes) The Hale Project-(50% decreased mortality in Europeon elderly) Emory University Study Second University of Naples Federico II University- Maris Study/Wagening University University of Michigan Walter Reed Army Medical Center

 Better blood pressure control  Weight loss; less metabolic syndrome  More favorable lipid profile; lowers LDL and increases HDL  Better glycemic levels  More antioxidants from more vegetable sources.  Lower markers of inflammation, ie…CRP

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 Questions???  Answers !!??