Mediterranean diet 'as effective as statins' in reducing heart attack risk

[malaise]

http://www.theguardian.com/society/2015/sep/06/mediterranean-diet-statins-heart-attack-cardiovascular
<snip>
People at risk of a stroke or heart attack should reduce that risk by adopting the Mediterranean diet rather than necessarily taking statins, leading doctors are urging.

Eating more healthily, being more physically active and stopping smoking can be just as effective as starting to take the cholesterol-lowering drugs, they have said in a paper published on Monday.

Bodies such as the National Institute for Health and Clinical Excellence (Nice), which advise doctors how to treat patients, should rely less on medication to cut cardiovascular risk.

The call, in an editorial in the healthcare journal Prescriber, has come from a trio of doctors, including the British cardiologist, Dr Aseem Malhotra, a prominent sceptic about the value of statins. They believe doctors should tell patients in detail about the risks and benefits of using statins or the alternative of making non-medical, lifestyle changes, and let them decide which approach they favour.

[Arugula Latte]

1. All that plus it's absolutely delicious!

[malaise]

4. Yep

not giving up the white wine though

[Igel]

11. And if you're already not smoking and have a reasonably healthy diet ...

Then it's not for you.

Wonder how much data-dredging went into this study or what the caveats are. The Guardian doesn't report all the news that's fit to print, but does print all the news that fits.

[UTUSN]

2. Yeah well, but who wants to cook instead of popping a pill?!1 n/t

[malaise]

3. Me

I love cooking and adore most of the food on the MD chart.

[UTUSN]

45. I was just being smart-alecky/not snarky. Sorry. But I was reminded of my now "fired" doctor:

When he first prescribed statins, I said I had heard that garlic was good for stuff. He radiated me with a withering look and said, "Do you know how much garlic it would take to substitute for *one* of these pills?!1 A *bushel*!1" It took me several years to "fire" him (change doctors) for his arrogant sarcasm.

[Gidney N Cloyd]

5. So, be sure to order the Filet-O-Fish. Got it.

[malaise]

7. We eat a lot of fish

a whole lot

[mopinko]

6. not everybody has control over what they eat, and not everybody

can make the lifestyle changes that they recommend.
sorta making the perfect the enemy of the good here.

[malaise]

8. True but many who have control don't even attempt to change

their diet.

[mopinko]

14. yeah, like my ex who was the cook. still

it is asking more than it looks like. tried for years.
food is something that is pretty deeply ingrained, deeply emotional, and sometimes one of the few pleasures in life. deep in the root.
i dont have a problem w the advice, but i have a problem with painting people who take the meds as lazy, dumb, whatever.

[malaise]

18. True but the doctors seem to be more concerned with the side effects of the medication

and agree with them that people ought to be given options.

[Populist_Prole]

37. True, that

Stupid stubbornness. As far as I can tell most afflicted with this have small/narrow palettes.

[arcane1]

9. Note tomatoes being described as Mediterranean. One of the many outcomes of the voyage of Columbus.

They also happen to be the only part of the Mediterranean diet that I don't like to eat

[malaise]

13. I love tomatoes

One of my sisters hates them. I developed my love of vegetables because most of my siblings didn't like them so I got a full share

[arcane1]

17. Smart! :) I can enjoy tomatoes in any state but their natural one.

Sauce, paste, sun-dried, all of that is yummy

[malaise]

19. That's amazing

I like them barely ripe - delish with any and everything.

[Tipperary]

40. Me too!

We had a great crop this year and I am eating them all the time. I do love a tomato sandwich!

[smirkymonkey]

44. Me too! A nice garden tomato salad w/ EV Olive Oil and

some fresh herbs is the best!

[onehandle]

10. Hummus is one of the most perfect foods on Earth.

Sliced tomatoes and fresh basil sprinkled with balsamic vinegar on whole grain toast smeared with hummus is heaven.

[Person 2713]

15. Now I'm hungry

[malaise]

16. It is nice food - I'm always amazed at how

chickpeas are used in most cultures.
I love chickpeas boiled soft and stir fried with a finely chopped onion, a lil cilantro, cumin, a teaspoon of curry powder, salt to taste and lots of hot pepper. It's a perfect snack.

[SMC22307]

23. Agree. I had hummus for the first time back in 1985 or so...

at an office party. It was like a revelation. Same with the first time I had salsa and Thai food. I grew up in an area with fabulous seafood, but the Pu-Pu Platter at The Golden Pavilion was about as "exotic" as it got.

[abelenkpe]

31. Love that stuff

Toast sounds yummy

[hedda_foil]

35. Yum! I'm making that tomorrow for lunch.

[IVoteDFL]

12. Looks like I'm already eating a mostly Mediterranean diet by being a vegetarian

Chickpeas and lentils are my go-to's. They are great substitutes for chicken and beef. A few years ago I was a meat and potatoes only kind of girl, fat and unable to walk around the block. Now I ride my bike to work and keep up a physical job. My life has changed for the better, drastically.

[malaise]

21. I love most peas

make a lot of stewed peas with coconut milk

[tavernier]

20. I am the fourth girlfriend in our group.

The other women are widows. Their husbands were all on mainly fish and vegetable diets and quite slim and buff, since they all walked and exercised regularly. My hubby lives on bacon and eggs and beef and hates any form of exercise, and drinks beer every day. I've tried to get him on a better diet for years, to no avail. And yet, he is the last guy left in our circle. The only thing I can say is that I never bitched at him or stressed him out about his eating. I figured that I am not his mother... He was in charge of what he wanted to do.

So perhaps what you eat is not as important health wise as how much you feel stressed out about what you eat. ???

[malaise]

22. Some guys have all the luck

or maybe your hubby has great genes.

[tavernier]

26. You'd think so, but not

since longevity doesn't run in his family. But he went back to work after retirement, just a part time job at a booth letting ppl in and out of a condo association, changing light bulbs, riding around in the golf cart. He watches tv in the a/c, visits with guests. Loves it. I made him take the job because he was miserable not working.

It's not the diet so much as being needed.

[malaise]

27. I have found that men don't handle giving up work that well

unless they have hobbies. I don't have data but many of those I know either die or suffer from some form of dementia in no time.

[840high]

29. Agree with you on that.

[840high]

28. My Dad lived to 94 and he

ate anything he desired - small portions.

[Texasgal]

24. Am I missing the diet?

In this article, am I missing what a Mediterranean is?

I assume it's fish and veggies?

[malaise]

25. Yep

[SoapBox]

30. Great chart!

I really want to eat well everyday...but sometimes it just doesn't happen. And when I eat crap, I feel guilt about my body but sometimes it comes down to needing food.

My usual (and weird) to most, is that is simply forget to eat...and I'm not big anyway (male, 5'9", 150 if I'm lucky) so I really, really need to eat. I take food to work but the calories are probably not compensating for the energy burn (add a "high" metabolism)...it's always a challenge.

I've been thinking of trying to keep more canned beans on hand (I would get low or no sodium...my pet peeve in prepared foods is all that sodium) as well as making grains in advance, so that I can whip up some healthy and hearty salads.

Great OP!

[Nevernose]

32. That's how I was before I had kids

Even though, since I lacked the lady parts, I obviously was never pregnant (my pet peeve is when a man says "we are pregnant&quot .

Within a couple of years I was preparing meals three times a day, taking snacks everywhere I went, not carousing (as much).

Before the kid, though, I would go days without eating. Didn't even think about it. I still probably wouldn't eat very often if my wife didn't force me to. Of course, she also insists that we eat healthy things, so I've lost sixty pounds in the last couple of years.

[malaise]

38. Thanks

We don't eat canned food at all. That said - we all eat trash occasionally. Don't be so hard on yourself.
I never forget to eat - I love fresh food. How do you forget to eat???

[Fuddnik]

33. I try to avoid grains and most other carbs.

I went on an Atkins diet 2 years ago, dropped 40 pounds in 2 months, and my labs were the best they've ever been. Lower cholesterol, blood pressure, etc.

No potatoes, corn, pasta, rice, sugar,etc.

But, I ain't giving up my ice cream!

[trackfan]

34. Do cannolis count?

If so, I'm in!

[LostOne4Ever]

36. I am skeptical about this

[font style="font-family:'Georgia','Baskerville Old Face','Helvetica',fantasy;" size=4 color=teal]What is meant by "leading doctors" that sounds like weasel words to me. Leading according to who?

Further, Three doctors coming out and telling the NHS how to do their job raises major red flags to me.

The fact that they are advocating a fad diet based upon the idea that people from the mediterranean area live long healthy lives despite heart disease being the major cause of death for people living in that region REALLY makes me question this.

Looking up Dr. Malhotra and seeing that not only is he against statins, one of the best drugs ever released by science, and calls the problems with saturated fats a myth, but that he also claims sedentary lives styles are not a major contributor to obesity just SCREAMS to me not to truth this.

You are all free to believe this but I have serious doubts about this article.[/font]

[Vinca]

39. I've always held the opinion that the ones benefiting most from statin drugs are

the pharmaceutical companies. Their goal is to have everyone taking them from cradle to grave and it's all so unnecessary. For a few people who have a disorder that causes their bodies to make enormous amounts of cholesterol they may be beneficial, but the rest of us are better off without them. Try to live without stress, eat halfway decently, enjoy a glass of wine and don't smoke. It doesn't hurt to exercise a little either.

[malaise]

42. +1,000

That's the truth. Were big pharma depending on me, they'd be out of business - that said I'm one of those lucky persons who has been disgustingly healthy from birth. I remember as a teenager wishing to find out what a headache was - hahahahha

[Yo_Mama]

41. Well, this does not work at all for those with certain genes.

So if lifestyle modification, including exercise or aspirin, doesn't lower lipids within six months, a patient would be insane not to take statins if the patient can tolerate them.

Studies have already borne out that taking statins while following an unhealthy lifestyle will not produce as much benefit as taking statins and modifying lifestyle, but this study ignores the reality that those at most acute risk for cardiovascular disease are those that have genes that predispose them to it!

In short, this is stupid and grossly misleading. "Can be" doesn't say anything about the outcome for a particular patient. The reality is that those who can drop lipids via lifestyle modification were never those who were at acute risk for CV disease in the first place!

[DFW]

43. Like me, for example!

My mom was taking cholesterol-lowering medication like crazy. Didn't help. Stoke killed her anyway. My wife cooks only with olive oil, no butter, and mostly fish. Meat is only poultry. No cheese, no eggs. I need the statins anyway. No way around it. Just my genetic make-up. My dad's parents died of heart attacks before they made it to 70.

Besides, ever been to the Mediterranean? Almost everyone smokes there. Without statins, I would have been dead ten years ago. Without my modified diet, I would haven been dead five years ago despite my statins. Not everyone fits into some mold published in an article in a medical journal.

[Yo_Mama]

46. Yes, that's a vivid demonstration of reality.

Because doctors usually recommend lifestyle modification in the first place, and then start statins if lifestyle modification doesn't do it, or screen patients for early statins based on intensive testing suggested by familial history, if you find a group of patients that do well on lifestyle modification only, it is a group that has been sorted for lower genetic risks.

Thus the authors may be making a claim that is factually true, but they are also making a nonsensical therapeutic claim.

In my family, both paternal and maternal sides, all males will have heart attacks in their 50s without statins. It's purely genetic. It is so genetic in my family that lifestyle modification actually makes their lipids go UP, not down.

Then there are those unfortunates who have genes that create blockages from plant sterols (fats). Those people can be vegans and will still develop diabetes/cardiovascular disease in their 40s, and it doesn't matter how much they exercise or how little they eat.
http://ghr.nlm.nih.gov/condition/sitosterolemia

Most people with that disorder have to avoid plant fats and substitute animal fats, plus severely limit legume/nut intake, plus take ezetimibe:
https://en.wikipedia.org/wiki/Ezetimibe

[Lyric]

47. I could live on hummus.

Roasted red pepper hummus, sliced fresh ripe tomatoes, cucumbers, kalamata olives, red grapes, smoked gouda cheese and flatbread, all eaten "family style" with fingers--the world's most perfect meal, IMHO.