Saturday, November 9, 2019

Retrospective #266: “Food Therapy for Metabolic Syndrome”

The banner on my smart phone read, “Food Therapy for Metabolic Syndrome,” but when I read it on my laptop, the title had morphed into “The Impact of Mediterranean Diets on Metabolic Syndrome.” Okay, I don’t shill for the Mediterranean Diet, or any other, but I do support the idea of “food therapy,” and I am very interested in how diet can affect Metabolic Syndrome, a dysfunctional metabolic state that is present and unrecognized in increasing numbers in the population. I have written about it numerous times starting with Retrospective #9.
The piece begins, “Metabolic Syndrome is characterized by risk factors that increase an individual’s chances for cardiovascular disease. These risk factors include obesity, hypertension, high cholesterol and uncontrolled blood glucose. In addition to cardiovascular disease, those with Metabolic Syndrome are at increased risk for type 2 diabetes.” One problem: The digest in Diabetes-in-Control incorrectly lists only 4 risk factors and mischaracterizes the definition of Metabolic Syndrome; the full medical journal paper referenced correctly describes its components as 5 risk factors and specifically includes high triglycerides and low HDL cholesterol, NOT “high cholesterol.” That’s a BIG difference. By definition, you have Metabolic Syndrome if you present with at least 3 of these 5 risk factors.
What I liked about this piece was the clear message the study design sends. The low-fat diet, that is the one our government and all our medical societies want us to eat, is the control diet; it is the one that the two different Mediterranean diets are being compared to. And guess what? Both Mediterranean diets fare better than low-fat. Another nail in the coffin of the low-fat diet, folks! Even a diet of “fruits, nuts and seeds,” and high in MUFAs, monounsaturated fat (from olive oil and nuts), and low in saturated fat, is BETTER THAN A LOW-FAT DIET.
The two Mediterranean diets being compared to the low-fat diet were supplemented with olive oil and nuts respectively, provided free by the Spanish producers. Each randomly selected sample of several thousand people consisted of “older participants at high risk of cardiovascular disease,” and each diet group regularly “completed a 14-item questionnaire to assess adherence to the intervention” – eating the free liter per week of olive oil or the 30 grams per day of free walnuts, hazelnuts and almonds, and other “fruits, nuts and seeds.”
“Participants were not advised on calorie restriction, and physical activity was not promoted for any intervention group.” They were just “community-dwelling men and women between 55 and 80” years of age with “no previously documented cardiovascular disease and… who had either type 2 diabetes or at least 3 cardiovascular risk factors,”
RESULTS: “Over 4.8 years of follow-up, Metabolic Syndrome developed in 960 (50%) of the 1919 participants who did not have the condition at baseline. The risk of developing Metabolic Syndrome did not differ between participants assigned to the control diet and those assigned to either of the Mediterranean diets.”
DISCUSSION: “The recognized protective effect of the Mediterranean diet was not enough to prevent Metabolic Syndrome in our study population.”
“A Mediterranean diet supplemented with extra-virgin olive oil was associated with a smaller increase in the prevalence of Metabolic Syndrome compared with advice on following a low-fat diet.” It conferred a benefit.
“We found the Mediterranean diet supplemented with extra virgin olive oil to have the most beneficial effect on central obesity and hyperglycemia.” And, “an isocaloric Mediterranean diet rich in extra-virgin olive oil prevented accumulation of central body fat compared with a low-fat diet, without affecting body weight.” Another benefit.
Of course, if they had eaten a Low Carb High Fat (LCHF) diet (including more saturated fat), they would similarly have reduced their truncal (central) obesity, and dramatically RAISED THEIR HDL (Retrospective #67) and LOWERED THEIR TRIGLYCERIDES (Retrospective #68) too, both additional risk factors for Metabolic Syndrome. And they’d surely have lost weight and had lower blood glucose, because Low-Carb High-Fat confers a benefit with ALL 5 RISK FACTORS!

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