29 Mar Want 30% Reduction in Heart Attacks, Strokes, and Deaths? Try this Drug
Ayurveda, Self-Reformation, & The Mediterranean Diet Study.
[Warning: I hope this article isn’t too preachy…not my intention]
Remember the Mediterranean Diet? Lots of veggies and fruits and whole grains and beans and olive oil, nuts, fish, some wine (if you already drink) with some meals, etc? Well, in February, 2013, the New England Journal of Medicine reported the results of a study titled, Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. Participants were overweight, smokers, had diabetes, high cholesterol, high blood or other risk factors associated with heart disease. Many were already on medications for their conditions. They were encouraged to eat the Mediterranean diet and to avoid highly processed foods like packaged cookies, cakes and pastries, and to limit consumption of dairy products and processed meats.
The results? The army of researchers found a 30% reduction in heart attacks, strokes, and deaths. That’s a pharmacological effect. In other words, if a pharmaceutical drug could get those kinds of numbers in people at high risk for heart disease, that would be considered an effective drug. And everybody would want it. And its only side effects were positive, whereas pharmaceutical drugs come with unwanted negative side effects. The study was considered so successful that it was stopped before the scheduled five years, as it was considered unethical to continue, as then the people in the control group would not have the opportunity to change their diets as well.
This is all good news, (if it is, indeed, still news to us that eliminating processed food and eating a whole foods diet is good for the health), but I do want to point out a few things about it:
- It might be tempting to think that there is one part of this diet that is the magic bullet. It is not that olive oil is a miracle cure or that nuts are the medicine. It may simply be the whole package: a diet that consists of whole foods.
- This study looked at a diet that included many foods. There may be some foods that contributed more than others towards the outcome of this study. There may be other regimens or diets that have even better results. For example, Dr. Dean Ornish has treated heart disease with lifestyle, diet and meditation for…for just about ever…well, since the mid ‘70’s, and achieved remarkable results. He believes that cardiovascular disease, obesity and diabetes are “completely preventable in at least 95 percent of people just by changing diet and lifestyle.” His regimen is very anti-fat –including olive oil–in the diets he recommends to reverse heart disease. It is possible that the participants in this study may have done better on Dr. Ornish’s diet. We don’t know. It could just be that the Mediterranean diet was a significant improvement over the group’s previous diet, which included more processed foods.
- The olive oil used was extra-virgin, “polyphenol-rich olive oil instead of refined variety, which is low in polyphenols.” This is important. If you consume crappy oil, the results may not be as good. To complicate matters, there was a study showing that 69% of olive oils marked as “extra virgin” were not. It seems most olive oils may be adulterated. If you are interested in how to test to see if your olive oil is really extra virgin, here’s a good article.
- Also worth noting is that, in the actual study guidelines (Table 1. Summary of Dietary Recommendations to participants in the Mediterranean-Diet groups and the control group diet group.”) the dietary guideline was, “wine with meals (optionally, only for habitual drinkers)[italics mine].” That means, if you were already a habitual drinker, then drink wine (instead of whatever else you may have been drinking), and consume it with your meals. It did not mean that everybody in the study had to drink wine. It would be a shame if people came away with the message that they should be drinking wine. That part may not have come across in the media’s reports. I guess it just sounds too prudish? The point is, we know (read the alcohol parts in Balance Your Hormones, Balance Your Life the risks (especially cancer) associated with drinking alcohol. There is no need to trade one disorder for another.
So, sorry. There isn’t a drug. There is a lifestyle change–in this case a change in diet–that can help us.
Some years ago a thoughtful man, who had reason to want the answer, asked me what I thought the position and future of Ayurveda is and will be in the West.
I’ve been feeling lately the answer is clearer and gaining momentum. Ayurveda is the most elegant, inspiring, practical vehicle I know for self-reformation. My teacher once said, “Wanted: Reformers of self, not of others.” While I recognize that very statement perhaps aims to reform others—by inspiring them to be involved in their own reformation, the spirit is true.
If we aim to reduce the ridiculous spending on healthcare, its absurd cost, and reduce the incidences of obesity, heart disease, diabetes, cancer and other lifestyle-and-diet-related epidemics, there is no alternative outside of mass self-reformation.
Only through self-reformation can we really achieve preventative healthcare. Early detection is not preventative medicine. The simple fact that there is something to detect proves that the problem was not prevented. In many cases, real prevention lies in diet and lifestyle. And that is on each one of us.
We each need to practice what we know is good for our health. It’s not brain surgery. But stuff can be simple and still be hard. It’s hard to make healthy lifestyle changes. It’s hard to know what to do in a sea of information and misinformation. And it’s hard to then do it.
We generally need a health care practitioner or consultant to point us in the right direction. And we often need cheerleaders (our healthcare person or a community of good company) to keep us going in that direction.
Although there are many indigenous traditions that treat ailments with herbal or other “natural” remedies, it has been my experience that Ayurveda is the most elegant at explaining and addressing health through lifestyle and dietary considerations and practices. While there is a need for health care practitioners trained in Ayurveda, ultimately we all need to be practitioners, in the sense that we each need to practice what we preach, learn or know—health care practitioners and patients alike.
And, I think if we are going to try to follow Ayurvedic principles, the first book we might want to read re. diet doesn’t even use the word, “Ayurveda” in it. It is Michael Pollan’s In Defense of Food. It is a quick and friendly read and outlines what real food is and how we got so far away from it. Starting with real food is a good place to start, and one that has been shown time and again to be a good starting place for health.
So, to self reform, one way we can start is simply eating whole foods. Once we’ve got that down, many of our ailments may drop away. From there Ayurveda or other Indigenous medical traditions, can help us refine our diets further if necessary, and possibly add recommendations for exercise, meditations or remedies.
Thank you for being there.
 Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Ramón Estruch, M.D., Ph.D., Emilio Ros, M.D., Ph.D., Jordi Salas-Salvadó, M.D., Ph.D., Maria-Isabel Covas, D.Pharm., Ph.D., Dolores Corella, D.Pharm., Ph.D., Fernando Arós, M.D., Ph.D., Enrique Gómez-Gracia, M.D., Ph.D., Valentina Ruiz-Gutiérrez, Ph.D., Miquel Fiol, M.D., Ph.D., José Lapetra, M.D., Ph.D., Rosa Maria Lamuela-Raventos, D.Pharm., Ph.D., Lluís Serra-Majem, M.D., Ph.D., Xavier Pintó, M.D., Ph.D., Josep Basora, M.D., Ph.D., Miguel Angel Muñoz, M.D., Ph.D., José V. Sorlí, M.D., Ph.D., José Alfredo Martínez, D.Pharm, M.D., Ph.D., and Miguel Angel Martínez-González, M.D., Ph.D. for the PREDIMED Study Investigators
February 25, 2013DOI: 10.1056/NEJMoa1200303
By Dr. Claudia Welch adapted from a 2013 newsletter
 Dr. Dean Ornish presentation at the TED conference, Monterey, CA. Feb 2006.