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The Olive Oil Hunter News #131

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T. J.’s Mediterranean Salad Recipe, For Your Best Heart Health: The Mediterranean Diet and Reversing Metabolic Syndrome After Heart Disease

Research on the benefits of olive oil and the Mediterranean diet continues to support the role they play in good health. One of the longest and most wide-reaching studies comes from Spain, one of my favorite countries and of course, as Club members know, one of the leading producers of the most flavorful and polyphenol-rich extra virgin olive oils. This study’s scientific findings show that following the Mediterranean lifestyle, diet included, helps not only prevent many health conditions but also reverse some of them. And because it’s delicious as well as good for you, it doesn’t feel like “a diet,” but rather an enjoyable way of life. This week’s recipe also shows how easy it can be!

T. J.’s Mediterranean Salad

  • Mediterranean Salad with Watermelon T. J.’s Mediterranean Salad

    Every country around the Mediterranean has its own version of a national salad, usually created with tomatoes, cucumber, and onions with a smattering of fresh herbs. My version brings in the sweet surprise of watermelon—on its own a great pairing with the feta. Speaking of feta, always buy blocks or rounds of feta, not crumbles, which often get dried out in the package. This combination makes a satisfying lunch or dinner, especially on hot days when you want to enjoy a light meal with no cooking needed. It takes only a few minutes to prep, but if you have the time, let it sit on the counter for about 30 minutes before digging in so that the flavors can meld.

    Ingredients

    • 2 large cucumbers
    • 1 pound tomatoes, any variety
    • 1 pound watermelon chunks
    • 1 medium red onion 
    • 1/2 cup fresh parsley, minced
    • 1/4 cup fresh mint, minced
    • 4 tablespoons extra virgin olive oil
    • 2 tablespoons fresh lemon juice, plus more to taste
    • Freshly ground black pepper and sea salt to taste
    • 6-ounce slice feta cheese

    Directions

    Step 1

    Cut the cucumbers (leave the skins on), tomatoes, watermelon, and red onion into an even dice and place in a large glass bowl. Add the herbs, olive oil, and lemon juice, and toss gently. Taste and, if needed, add salt, pepper, and extra lemon juice to your liking.

    Step 2

    Just before serving, crumble the feta over the top.

    Yields 4 servings

Best Health: The Mediterranean Diet: Reversing Metabolic Syndrome After Heart Disease

For Your Best Heart Health

The Mediterranean Diet: Reversing Metabolic Syndrome After Heart Disease

The study: “Adherence to a Mediterranean lifestyle improves metabolic status in coronary heart disease patients: A prospective analysis from the CORDIOPREV study,” Journal of Internal Medicine, May 2023.

Study Abstract from the Research Team

Background and objectives: A Mediterranean lifestyle may prevent and mitigate cardiometabolic disorders. We explored whether adherence to a Mediterranean lifestyle (MEDLIFE) was prospectively associated with the risk of metabolic syndrome (MetS) among coronary heart disease (CHD) patients.

Methods: The Coronary Diet Intervention with Olive Oil and Cardiovascular Prevention (CORDIOPREV) study was an interventional diet study to compare a Mediterranean diet with a low-fat diet in 1,002 CHD patients. The Mediterranean lifestyle (MEDLIFE) index was used to assess adherence to MEDLIFE at baseline and, after five years, in 851 participants from the CORDIOPREV study. Subjects were classified as having high (13 points or more), moderate (12 to 13 points), and low (less than 12 points) adherence to MEDLIFE. 

Results: During the five-year follow-up, CORDIOPREV participants with high adherence to MEDLIFE had a lower risk of MetS development and a higher likelihood of reversing preexisting MetS compared with participants with low adherence to MEDLIFE. Each additional one-point increment in the MEDLIFE index was associated with a 24% lower risk of MetS development and a 21% higher likelihood of reversing preexisting MetS.

Conclusions: Our results showed that greater adherence to MEDLIFE reduced the risk of subsequent MetS development and increased the likelihood of reversing preexisting MetS among patients with CHD at baseline.

About Heart Disease and Metabolic Syndrome

In the US, you’re most likely to hear the term coronary artery disease, or CAD, though it is also referred to as coronary heart disease, according to the CDC. By either name, the condition is caused by the buildup of plaque (cholesterol and other substances) in the walls of the coronary arteries, those that supply blood to the heart and other parts of the body. This causes the arteries to narrow over time, partially or totally blocking blood flow. It’s especially dangerous because it can go undetected until it causes a heart attack.

The CDC estimates that about 1 in 20 adults age 20 and older have CAD. And CAD doesn’t discriminate: Heart disease is the leading causeof death for both men and women, including most racial and ethnic groups in the United States.

Metabolic syndrome is even more prevalent. About 1 in 3 American adults have it, according to the National Institutes of Health. It encompasses a constellation of factors: having a large waistline, high blood sugar, high blood pressure, high cholesterol, high triglycerides, and low HDL (or good) cholesterol. Having three or more of these factors leads to a metabolic syndrome diagnosis. 

Metabolic syndrome is a risk factor for heart disease. Since many people with heart disease also have metabolic syndrome, the ability to reverse it through the Mediterranean diet is extremely important.

An editorial published along with the study underlines the importance of the Mediterranean diet for everyone:

“Spain has a proud tradition of nutrition research in the cardiovascular field. The primary preventive PREDIMED study clearly shows the health benefits of professional dietary intervention for individuals with high cardiometabolic risk. The secondary preventive CORDIOPREV study also contributes with important new knowledge about the role of lifestyle, including nutrition, for the prognosis of coronary heart disease. The present study focuses on the role of an overall healthy lifestyle on the prevention and treatment of the metabolic syndrome. Still, the two studies provide complementary knowledge on the health benefits of traditional Mediterranean food. It is important to emphasize that this food pattern is a good model for healthy eating according to the current knowledge. 

“The results from the present CORDIOPREV study are indeed clinically relevant. In recent decades, lifestyle and risk factor patterns in the population as a whole, as well as in patients with coronary heart disease, have changed. The prevalence of the metabolic syndrome is increasing in all parts of the population, especially in at-risk individuals with coronary heart disease because such patients today are often sedentary and have abdominal obesity. The metabolic syndrome is—beyond an increased risk of cardiovascular diseases—also linked to an increased risk of cancer, cognitive impairment, and inflammatory diseases, as well as low quality of life.

“Perhaps, we are approaching the limit for what is achievable by pharmacological treatment alone. Instead, an increased investment in lifestyle might be required to further improve the prognosis for people with coronary heart disease. The important data from the Spanish CORDIOPREV study underline that lifestyle interventions, including dietary changes, are still underused in modern healthcare. This study indicates that much health remains to be gained.”

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The Olive Oil Hunter News #130

Posted on by The Olive Oil Hunter

Stone Fruit and Berry Buckle Recipe, Spotlight on Blueberries, Flavanols and Memory, Freezing Summer’s Bounty and Walking for Your Brain

With farmers’ markets brimming with all kinds of berries and ripe stone fruit like peaches, plums, and nectarines, there’s no better time to bake a buckle—a one-layer cake named for the dimpled look as the cake rises over chunks of fruit and a tempting crumble topping. This issue of the newsletter also has a boost-your-memory theme, with two important studies—one looks at the cognitive risks of flavanol deficiency and the other, at how walking boosts brain connectivity and thereby memory. 

Stone Fruit and Berry Buckle

  • Stone Fruit and Berry Buckle Recipe Stone Fruit and Berry Buckle

    This recipe is sized to feed a crowd—any leftovers make a terrific breakfast the next day. Choose fruit based on availability—it’s as delicious with just one variety as it is with four or more! Right out of the oven, the buckle is exceptional when topped with olive oil ice cream, a simple frozen treat you can make at home.

    Ingredients

    For the crumble topping:

    • 4 ounces unsalted butter, cubed and chilled
    • 1 cup sugar
    • 2/3 cup all-purpose flour
    • 1/2 teaspoon ground cinnamon 

    For the cake:

    • 1/2 cup extra virgin olive oil, plus more for the baking dish
    • 8 ounces unsalted butter at room temperature 
    • 2 cups sugar 
    • 8 large eggs
    • 3 cups all-purpose flour 
    • 1 teaspoon fine salt
    • 1-1/2 teaspoons baking powder
    • 6 cups assorted berries and stone fruit chunks (skin on) 
    • Optional toppings: fresh blueberries, confectioners’ sugar for dusting, lightly whipped cream, or ice cream

    Directions

    Step 1

    Preheat your oven to 350°F. Lightly coat a 13-inch by 9-inch baking dish with olive oil; set aside. 

    Step 2

    Make the topping: Use your hands or a pastry blender to turn the butter, sugar, flour, and cinnamon into small bits, ranging from the size of peas to the size of beans. Set aside.

    Step 3

    Make the batter: In a large bowl, cream butter and sugar with an electric mixer until fluffy. With the machine running on low, slowly pour in the olive oil and then add the eggs, one at a time, beating after each addition until combined. In a separate bowl, whisk together flour, salt, and baking powder. With your mixer on a low speed, gradually add flour mixture to the wet batter until incorporated.

    Step 4

    Transfer the batter to the baking dish and use a large offset spatula to smooth the surface. Arrange the fruit in a fun pattern over the top and then sprinkle on the crumble, being careful to get it into the corners of the dish so that every bite includes it. 

    Step 5

    Bake until the top of the cake is browns lightly and the tip of a sharp knife inserted in the center comes out clean, about an hour. Serve while still warm.

    Yields 12 servings

Healthy Ingredient Spotlight: Bountiful Blueberries

Healthy Ingredient Spotlight

Bountiful Blueberries

Blueberries are more than delicious—they pack amazing health benefits. Here are four great reasons why, according to Cleveland Clinic dietitian Julia Zumpano, RD, LD.

Blueberries pack an antioxidant wallop. Along with having vitamins C and K and the mineral manganese, they’re rich in anthocyanins, which give the berries their blue-purple color and protect our cells from damaging molecules called free radicals. To get the most antioxidants, enjoy some blueberries raw, and always choose organic when available.  

Blueberries’ soluble fiber helps manage blood cholesterol by sweeping cholesterol-laden bile out of the body, which, in turn, can lower the risk for heart disease. 

Blueberries help decrease blood sugar levels, thanks to the combination of their fiber and a lower amount of natural sugar than other fruits, according to some studies. 

Blueberries may also help with blood pressure, especially in people with metabolic syndrome. Eating them contributes to the body’s production of nitric oxide, which helps relax blood vessels.

Quick Kitchen Nugget: Freezing Fruits and Vegetables

Quick Kitchen Nugget

Freezing Fruits and Vegetables

Want to save some of summer’s bounty for the winter? Freeze pieces individually by spreading them in a single layer on a rimmed sheet pan. When frozen solid, transfer to airtight freezer-safe containers or bags, filling them up to minimize the amount of trapped air and avoid “snow” forming on the pieces. 

For Your Best Health: Flavanols and Memory

For Your Best Health

Flavanols and Memory

A large-scale study led by researchers at Columbia and Brigham and Women’s Hospital/Harvard is the first to establish that a diet deficient in flavanols, a specific type of phytonutrient within the flavonoid group, is linked to age-related memory loss.

The study found that flavanol intake among older adults tracks with scores on tests designed to detect memory loss due to normal aging and that replenishing these bioactive dietary components in mildly flavanol-deficient adults over age 60 improves their performance on these tests.

“The improvement among study participants with low-flavanol diets was substantial and raises the possibility of using flavanol-rich diets or supplements to improve cognitive function in older adults,” says Adam Brickman, PhD, professor of neuropsychology at Columbia University Vagelos College of Physicians and Surgeons and coleader of the study. The finding also supports the emerging idea that the aging brain requires specific nutrients for optimal health, just as a baby’s brain requires specific nutrients for proper development.

The current study builds on over 15 years of research done in the lab of the study’s senior author, Scott Small, MD, the Boris and Rose Katz Professor of Neurology at Vagelos. That work linked The current study builds on over 15 years of research done in the lab of the study’s senior author, Scott Small, MD, the Boris and Rose Katz Professor of Neurology at Vagelos. That work linked age-related memory loss to changes in the dentate gyrus, a specific area in the brain’s hippocampus (a region vital for forming new memories), and showed that flavanols improved function in this part of the brain.

The Columbia team collaborated with researchers at Brigham and Women’s Hospital studying the effects of flavanols and multivitamins in COSMOS (COcoa Supplements and Multivitamin Outcomes Study). The current study, COSMOS-Web, was designed to test the impact of flavanols in a much larger group and explore the link between flavanol deficiency and cognitive aging in the hippocampus.

How the study was done

More than 3,500 healthy older adults were randomly assigned to receive a daily flavanol supplement or placebo for three years. The active supplement contained 500 mg of flavanols, including 80 mg of epicatechins, an amount that adults are advised to get from food.

At the beginning of the study, all participants completed a survey that assessed the quality of their diet, including foods known to be high in flavanols. Participants then performed a series of web-based activities in their own homes, designed and validated by Dr. Brickman, to assess the types of short-term memory governed by the hippocampus. The tests were repeated after one year, two years, and three years. 

More than a third of the participants also supplied urine samples that allowed researchers to measure a biomarker for dietary flavanol, a test developed by the study’s coauthors at Reading University in the UK, before and during the study. The biomarker gave the researchers a more precise way to determine whether flavanol levels corresponded to performance on the cognitive tests and ensure that participants were sticking to their assigned regimen (compliance was high throughout the study). Flavanol levels varied moderately, though no participants were severely flavanol-deficient.

At the end of the first year of taking the flavanol supplement, participants who reported consuming a poorer diet and had lower baseline levels of flavanols saw their memory scores increase by an average of 10.5% compared to placebo and 16% compared to their memory at baseline. Annual cognitive testing showed that the improvement observed at one year was sustained for at least two more years.

The results strongly suggest that flavanol deficiency is a driver of age-related memory loss, the researchers say, because flavanol consumption correlated with higher memory scores and flavanol supplements improved memory in flavanol-deficient adults.

Next steps

“We cannot yet definitively conclude that low dietary intake of flavanols alone causes poor memory performance, because we did not conduct the opposite experiment: depleting flavanol in people who are not deficient,” Dr. Small says, adding that such an experiment might be considered unethical.

The next step needed to confirm flavanols’ effect on the brain, Dr. Small says, is a clinical trial to restore flavanol levels in adults with severe flavanol deficiency. “Age-related memory decline is thought to occur sooner or later in nearly everyone, though there is a great amount of variability,” he explains. “If some of this variance is partly due to differences in dietary consumption of flavanols, then we would see an even more dramatic improvement in memory in people who replenish dietary flavanols when they’re in their 40s and 50s.”

Flavanols are found in many healthful foods that you can add to your diet for a variety of health benefits: berries, peaches, grapes, onions, scallions, tomatoes, lettuce, broccoli, kale, and tea.

Fitness Flash: The Brain Benefits of Walking

Fitness Flash

The Brain Benefits of Walking

Researchers have long known that moderate exercise has a beneficial impact on the body’s response to inflammation, but what’s been less understood is why. New research done on a mouse model at York University in Toronto, Canada, suggests that the answers may lie within the body’s macrophages, white blood cells responsible for killing off infections, healing injury, and otherwise acting as your internal first responders.

“Much like you train your muscles through exercise, we showed that exercise of moderate intensity ended up training the precursors of those macrophages in the bone marrow,” says Ali Abdul-Sater, PhD, associate professor in the University’s School of Kinesiology and Health Science and York Research Chair. “The way that exercise is doing this is by changing the way those cells breathe—essentially, how they use oxygen to generate energy and then changing the way they access their DNA.”

While many studies have looked at temporary boosts to the immune system immediately after exercise, this study, published in the American Journal of Physiology-Cell Physiology, found these changes occurred even a week later, suggesting that they are long term. 

“Inflammation is amazing—it’s a very important part of our normal immune response,” says Dr. Abdul-Sater. Inflammation is the body’s response to infection and other stressors, and some level of inflammation is necessary and desirable. “What we’re concerned about is excessive inflammation,” he explains. “Heart disease, diabetes, many cancers, and autoimmune diseases all essentially begin because there was an inappropriate inflammatory response.”

The study found that, for active mice, it was around the six-to-eight-week mark into the exercise regimen when changes really became apparent. “There’s a lot of rewiring that’s taking place in the circuitry of how the cells breathe, how the cells metabolize glucose, how the cells then access DNA. So all that just takes time.”

Dr. Abdul-Sater says that because the inflammatory response is a very ancient one, this aspect of the immune system is generally very similar across mammals, and he expects the research will translate well to people. In the next phase, the team will collect immune cells from human volunteers who will do exercises of various intensities to see which workout routines are most beneficial to balance the inflammatory response. 

“The thing with humans is there’s no intervention that will work on everyone. We know that, but what this study suggests is that moderate and persistent exercise not only improves metabolic health, but also will improve immune health in the long run.”

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The Olive Oil Hunter News #129

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Pasta e Fagioli Salad Recipe, Spotlight on Tomatoes, How to Quick Soak Beans and Guard Against Forever Chemicals (PFAS), Plus Exercise and Inflammation

Looking for a satisfying dish that requires a minimum of cooking? You’ll love this adaptation of the classic pasta e fagioli soup, a unique way to savor ripe tomatoes (turning large tomatoes into chunks will work as well as the cherry tomatoes). Canned beans offer convenience, but you can try my quick hack for soaking dried beans if you’d like to make your own. You’ll also find strategies to limit exposure to dangerous PFAS (dubbed “forever chemicals”) and insights into how exercise delivers health benefits. 

Pasta e Fagioli Salad

  • Pasta e Fagioli Salad Pasta e Fagioli Salad

    You know pasta e fagioli as a hearty soup that stars the tiny pasta tubes called ditalini and creamy white beans, perfect for chilly nights. But there’s no reason to “table” this great combination when you can give it a summery twist: a salad composed of all its delicious ingredients, plus a sweet-tart vinaigrette great for all kinds of salads. If you can’t find ditalini, you can use any small-sized pasta—the idea is to get a variety close to the size of the beans. For another layer of flavor, top with shavings of Parmigiano-Reggiano cheese.

    Ingredients

    • 2 tablespoons red wine vinegar
    • 2 tablespoons balsamic vinegar of Modena 
    • 1 tablespoon Dijon mustard
    • 1 tablespoon honey
    • 1/2 teaspoon coarse salt, plus more to taste
    • 1/2 garlic clove, minced 
    • 1/2 cup extra virgin olive oil
    • Freshly ground black pepper to taste
    • 3 cups cooked cannellini beans or one 29-ounce can, rinsed and drained
    • 3 cups cooked pasta, such as ditalini
    • 3 cups cherry tomatoes 
    • 1 medium red onion, slivered
    • 2 tablespoons each chopped fresh parsley and basil, plus more for garnish

    Directions

    Step 1

    Make the vinaigrette: In a medium bowl, whisk together the two vinegars, mustard, honey, salt, and garlic. Gradually whisk in the olive oil until the dressing is emulsified. Season to taste with salt and pepper. Set aside.

    Step 2

    Place the beans, pasta, tomatoes, red onion, and herbs in a large glass bowl and pour on the vinaigrette. Toss gently to coat. Serve at room temperature or chilled, garnished with more herbs.

    Yields 6 generous servings

Healthy Ingredient Spotlight: Tomatoes, Tomatoes, Tomatoes

Healthy Ingredient Spotlight

Tomatoes, Tomatoes, Tomatoes

There’s no better time to enjoy tomatoes than summer. For the sweetest cherry tomatoes, look for Sungolds and other bright-yellow varieties—wonderful in the pasta e fagioli salad. I love to stuff huge beefsteak tomatoes with tuna flakes from a just-grilled filet and then drizzle them with a vinaigrette. Don’t forget to sample heirloom tomatoes in fanciful colors and shapes. 

When shopping your local farmers’ markets, look for tomatoes with smooth, mostly unblemished skin, but remember that organic tomatoes may not look picture-perfect, and that’s OK. More important is that the tomatoes feel ripe all around—firm, but not hard, and definitely not squishy. Then give them the sniff test—they should smell like…tomatoes!

Quick Kitchen Nugget: A Fast Way to Soak Dried Beans

Quick Kitchen Nugget

A Fast Way to Soak Dried Beans

One reason to buy dried beans rather than canned is the greater variety available, plus you control the salt. But, of course, that involves remembering to first soak the beans and then cooking them until tender. Here’s a hack to speed up the process—it’s especially handy if you forget to soak the beans the night before you want to use them.

Step 1: “Hot soak” the dried beans. In a large pot, add 1 pound of dried beans and 6 cups of cold water (multiply as needed). Bring to a boil, and boil for 3 minutes. Remove the pot from the heat, cover, and let soak for 1 hour.

Step 2: Cook the soaked beans. Drain and rinse the beans in cool water, and wash out the pot. Return the beans to the cleaned pot and cover them with cold water. Bring to a boil, turn the heat down to a simmer, cover, and cook until tender, but not mushy, about 1 hour for cannellini beans (larger beans may take up to an hour more). 

For Your Best Health: Guarding Against “Forever Chemicals”

For Your Best Health

Guarding Against “Forever Chemicals”

News of chemical manufacturer 3M agreeing to pay over $10 billion to settle lawsuits over contamination of many US public drinking water systems by its harmful compounds has brought national attention to the problem of per- and polyfluoroalkyl substances or PFAS. They’re called forever chemicals because they don’t degrade naturally in the environment. And they’re dangerous—exposure over time has been linked to health problems, including liver and immune-system damage, heart disease, some cancers, irritable bowel syndrome (IBS), and decreased fertility, according to experts at Hartford Healthcare.

Here’s advice from the watchdog group NRDC you can use to protect yourself:

  • Replace nonstick pans with stainless steel, cast-iron, glass, or ceramic alternatives.
  • Consider transferring store-bought foods to glass containers when you get home. Don’t heat food wrapped in grease-resistant packaging or reheat leftovers in takeout containers. Make popcorn on the stovetop instead of in PFAS-treated microwave bags. Look for BPI-certified compostable packaging, which doesn’t contain PFAS.
  • Choose clothing brands that have removed PFAS from their lines, such as American Eagle and L.L.Bean.
  • Avoid buying any home furnishings labeled water- or stain-repellent, which likely involve treatments that use PFAS.
  • Install reverse osmosis filters on your water faucets to get PFAS out of your drinking water.
Fitness Flash: How Exercise Helps with Inflammation

Fitness Flash

How Exercise Helps with Inflammation

Researchers have long known that moderate exercise has a beneficial impact on the body’s response to inflammation, but what’s been less understood is why. New research done on a mouse model at York University in Toronto, Canada, suggests that the answers may lie within the body’s macrophages, white blood cells responsible for killing off infections, healing injury, and otherwise acting as your internal first responders.

“Much like you train your muscles through exercise, we showed that exercise of moderate intensity ended up training the precursors of those macrophages in the bone marrow,” says Ali Abdul-Sater, PhD, associate professor in the University’s School of Kinesiology and Health Science and York Research Chair. “The way that exercise is doing this is by changing the way those cells breathe—essentially, how they use oxygen to generate energy and then changing the way they access their DNA.”

While many studies have looked at temporary boosts to the immune system immediately after exercise, this study, published in the American Journal of Physiology-Cell Physiology, found these changes occurred even a week later, suggesting that they are long term. 

“Inflammation is amazing—it’s a very important part of our normal immune response,” says Dr. Abdul-Sater. Inflammation is the body’s response to infection and other stressors, and some level of inflammation is necessary and desirable. “What we’re concerned about is excessive inflammation,” he explains. “Heart disease, diabetes, many cancers, and autoimmune diseases all essentially begin because there was an inappropriate inflammatory response.”

The study found that, for active mice, it was around the six-to-eight-week mark into the exercise regimen when changes really became apparent. “There’s a lot of rewiring that’s taking place in the circuitry of how the cells breathe, how the cells metabolize glucose, how the cells then access DNA. So all that just takes time.”

Dr. Abdul-Sater says that because the inflammatory response is a very ancient one, this aspect of the immune system is generally very similar across mammals, and he expects the research will translate well to people. In the next phase, the team will collect immune cells from human volunteers who will do exercises of various intensities to see which workout routines are most beneficial to balance the inflammatory response. 

“The thing with humans is there’s no intervention that will work on everyone. We know that, but what this study suggests is that moderate and persistent exercise not only improves metabolic health, but also will improve immune health in the long run.”

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The Olive Oil Hunter News #128

Posted on by The Olive Oil Hunter

Roasted Ratatouille Recipe, For Your Best Heart Health: The Mediterranean Diet Fights Heart Attacks and Stroke

There’s no shortage of “best diet” lists for losing weight, but they don’t always have scientific backing or address the bigger picture that includes taking care of your overall health.

When I share the benefits of olive oil, it’s often in the context of the Mediterranean diet. After all, no matter how delicious the freshest extra virgin olive oil is, you need other foods to enjoy it fully! The Mediterranean diet has scores of studies that support its adoption.

Now a new research review goes a step further: the authors did a deep dive to compare it to six other diets that claim to lower heart attacks and death rates in people with heart disease. These included the Pritikin diet, the Ornish diet, and a very, very low-fat diet, all known to be extremely restrictive. The Mediterranean diet bested them all, with the bonus benefit of stroke prevention (details below), plus it tastes great.

A case in point is the following recipe. For those who only know “Ratatouille” as the lead character from the Disney classic, let me introduce you to the dish that inspired his name…with my own personal twist, of course!

Roasted Ratatouille

  • Roasted Ratatouille Roasted Ratatouille

    All the flavors of seasonal bounty meld together in this dish. Rather than cooking it on the stovetop, it’s roasted in the oven, with minimal attention. This technique helps preserve the taste and texture of the individual vegetables, even as they cook in each other’s juices, and creates more of a caramelized medley than a stew. Ratatouille makes a delicious side dish, a topping for grilled bread or pasta, and a hearty sauce for roasted chicken or fish.

    Ingredients

    • 1 small eggplant, about 1 pound 
    • 1-1/2 pounds tomatoes, any variety
    • 1 pound zucchini or summer squash, green and/or yellow
    • 3 yellow, orange, or red bell peppers
    • 1 large onion, about 1 pound
    • 8 cloves garlic, sliced
    • 7 tablespoons extra virgin olive oil, divided, plus more for the pans
    • 2 teaspoons coarse sea salt
    • Freshly ground black pepper, to taste
    • 1 tablespoon balsamic vinegar from Modena, plus more to taste
    • 1 tablespoon chopped fresh flat-leaf parsley

    Directions

    Step 1

    Preheat your oven to 350°F. Cut all the vegetables into roughly 1-inch diced pieces and mix together along with the garlic in a large bowl. Add 6 tablespoons of olive oil and the salt, and toss to coat. Lightly oil two rimmed sheet pans (or line them with parchment paper) and divide the vegetables between them. Roast the veggies for a total of 3 hours.

    Step 2

    After the first hour, as the vegetables give up their moisture and shrink in volume, combine them in one of the sheet pans; after the second hour, flip the veggies with a large spatula.

    Step 3

    When done, transfer the vegetables back to the large bowl, taking care to get all the juices. Season with pepper, drizzle on the last tablespoon of olive oil and the vinegar, and sprinkle with the parsley.

    Serves 8

Best Health: The Mediterranean diet fights heart attacks and stroke

For Your Best Heart Health

The Mediterranean diet fights heart attacks and stroke

The study: “Comparison of seven popular structured dietary programmes and risk of mortality and major cardiovascular events in patients at increased cardiovascular risk: systematic review and network meta-analysis,” BMJ, March 2023.

The analysis: In the first study of its kind, an international group of researchers from the US, Canada, Brazil, Colombia, Spain, and China analyzed the effects of seven different popular diet plans designed to reduce “the likelihood of death and heart attack in people at heightened risk of cardiovascular disease.” They compared the plans to each other and to “minimal intervention efforts” such as being handed a brochure on healthy diets. 

After searching through research databases, they identified 40 eligible trials involving a total of 35,548 participants who had heart disease—or at least two known risk factors for it—and who were followed for an average of three years on these popular diets: low fat (18 trials), Mediterranean (12 trials), very low fat (six trials), modified fat (four trials), combined low fat and low sodium (three trials), Ornish (three trials), and Pritikin (one trial). Some trials compared two different diets to each other.

The researchers pointed out that, although many of these diets have the aura of heart health and are often recommended to people at risk of heart problems, such recommendations have relied on “low certainty evidence from non-randomized studies.” Translation: there’s a lack of gold-standard studies supporting their benefits.

The researchers found that of the seven programs, based on “moderate certainty evidence,” Mediterranean dietary programs were better than minimal intervention at preventing all-cause mortality (17 fewer deaths per 1,000 over five years), nonfatal heart attack (17 fewer deaths per 1,000), and stroke (seven fewer deaths per 1,000) for patients at intermediate risk of cardiovascular disease. Low-fat programs were superior to minimal intervention, with moderate certainty for prevention of all-cause mortality (nine fewer deaths per 1,000) and nonfatal heart attack (seven fewer deaths per 1,000) but did not impact stroke risk.

“The absolute effects for both dietary programmes were more pronounced for patients at high risk of cardiovascular disease (36 fewer all-cause deaths per 1,000 and 39 fewer cardiovascular deaths per 1,000 among those that followed the Mediterranean dietary programme over 5 years),” the review concluded. “The five remaining dietary programmes generally had little or no benefit compared with minimal intervention typically based on low to moderate certainty evidence.”

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