Mediterranean Diet, Heart Health and Cycling

The world has been abuzz of findings from a diet based on oil rich foods from the Mediterranean, such as

Healthy nuts–eat plenty according to this new study

olive oil and nuts that made participants healthier than if they had been on low-fat diets.

The study found that an energy-unrestricted Mediterranean diet supplemented with either extra-virgin olive oil or nuts resulted in an absolute risk reduction of approximately 3 major cardiovascular events per 1000 person-years, or a relative risk reduction of about 30%, among high-risk persons who were initially free of cardiovascular disease. In simple language–less chance of getting a heart attack for people with or without previous risk of one.

The results are important because often cyclists think because of their activity level they can throw anything down their gullet and still be healthy.

But exercise is only one part of the picture, especially when it comes to heart health. Cyclists International interviewed the chefs for Alberto Contador’s then Saxobank team in 2011, and their diet also was heavily weighted towards healthy oils in abundance, fish, white meat, vegetables, and only minimal red meat—lamb.

But cyclists are often unaware of how their diets might be hurting their hearts because they burn so many calories. You probably know a healthy athlete who had a heart attack while running, cycling or swimming in the last year alone.

The results of the research were published in the New England Journal of Medicine this month and

Contador posing on rest day at Hotel Chateau Rochegude in 2011: He only ate food prepared by Team Chef Henna Grant (c) Benepe

aimed to test participants in key health factors such as heart disease, stroke, diabetes, and metabolic functions affecting health.

“The results of our trial might explain, in part, the lower cardiovascular mortality in Mediterranean countries than in northern European countries or the United States,” wrote the authors of the PREDIMED trial (Prevención con Dieta Mediterránea).

The trial used three parallel-groups of men and women over the age of 40, and gave one group a diet consisting of extra virgin olive oil, and the other nuts. Both Mediterranean diet groups were also instructed to eat fruits, vegetables, cereals, minimal low-fat dairy products, fish, chicken, and no red meat.

The third group was given a low fat diet with no emphasis on olive oil or nuts.

In their summary the scientists conclude, “A systematic review ranked the Mediterranean diet as the most likely dietary model to provide protection against coronary heart disease.”

In addition, the study concluded that there were “plausible biologic mechanisms to explain the salutary effects of this food pattern.”

The participants in the study were allowed to eat as much virgin olive oil and nuts such as walnuts, hazelnuts and almonds, as they wanted, were not advised to restrict calories, and did not have to change their exercise level.

The study took six years, from 2003 to 2009, and 7447 people were randomly assigned to one of the three study groups.

A general medical questionnaire, a 137-item validated food-frequency questionnaire, and the Minnesota Leisure-Time Physical Activity Questionnaire were administered on a yearly basis.

Biomarkers of compliance, including urinary hydroxytyrosol levels (to confirm compliance in the group receiving extra-virgin olive oil) and plasma alpha-linolenic acid levels (to confirm compliance in the group receiving mixed nuts), were measured in random subsamples of participants at 1, 3, and 5 years.

Participants in the two Mediterranean-diet groups significantly increased weekly servings of fish (by 0.3 servings) and legumes (by 0.4 servings) in comparison with those in the control group.  In addition, participants assigned to a Mediterranean diet with extra-virgin olive oil and those assigned to a Mediterranean diet with nuts significantly increased their consumption of extra-virgin olive oil (to 50 and 32 g per day, respectively) and nuts (to 0.9 and 6 servings per week, respectively).

But also of importance, the two Mediterranean diet groups ate three portions of fruit, vegetables and beans a day each, ate no red meat, had fish and chicken each up to 3 times a week, and drank one glass of wine a day (if they were drinkers at all.) No hard liquor was allowed, and participants had to make salad one of their vegetable servings per day. Participants were also required to eat only low fat dairy products such as milk and cheese.

The consumption of baked goods especially those made with sugar, refined flours, dairy and trigliceride fats was not allowed.  In other words, no cookies, cakes, muffins, brioches, croissants, banana breads, corn breads, and all of the tasty extras cyclists love to consume at rest stops.

The authors admitted the results of the study might not apply to the world population outside of the Mediterranean. They write, “the generalizability of our findings is limited because all the study participants lived in a Mediterranean country and were at high cardiovascular risk; whether the results can be generalized to persons at lower risk or to other settings requires further research.”


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