Mediterranean Diet Posts

A collection of my Mediterranean Diet Posts:

Mediterranean Diet Post 13: World Health Organization Says “The Mediterranean Diet Is Gone”

Mediterranean Diet Post 12: Cochrane Review Says Mediterranean Diet For Prevention Of Cardiovascular Disease Is “Uncertain”

Mediterranian Diet Post 11: People In The Middle Ages Ate Up To 3 Pounds Of Bread A Day, As Do Modern Sardinians

Mediterranean Diet Post 10: In Ancient Greece, Wine Was Watered Down

Mediterranean Diet Post 9: Bread, The Most Important Component In The Greek Diet, Did Not Come Easily

Mediterranean Diet Post 8: Actual Meals

Mediterranean Diet Post 7: Olive Oil Is Relatively Devoid Of Nutrients, Except Fat

Mediterranean Diet Post 6: Olive Oil Promotes Atherosclerosis, Impairs Endothelial Function

Mediterranean Diet Post 5: Does The Modern Mediterranean Diet Prevent Heart Disease?

Mediterranean Diet Post 4: The Men Of Mount Athos

Mediterranean Diet Post 3: Religious Fasting

Mediterranean Diet Post 2: Focusing On Greece

What Is The Mediterranean Diet? I Aim To Find Out.

New Study: Plant-Based Diet Better Than AHA Mediterranean Diet

The Mediterranean region is so beautiful, I wonder sometimes if it’s not the location that imparts good health.

Here are two uninhabited islands called Paximadia off the southern coast of Crete. In the foreground is the monastery Preveli in Crete.

The Paximadia islands up close:

Mediterranean Diet Post 12: Cochrane Review Says Mediterranean Diet For Prevention Of Cardiovascular Disease Is “Uncertain”

Mediterranean‐Style Diet For The Primary And Secondary Prevention Of Cardiovascular Disease, Cochrane Library, 19 March 2019

Authors’ conclusions:

Despite the relatively large number of studies included in this review,* there is still some uncertainty regarding the effects of a Mediterranean‐style diet on clinical endpoints and CVD risk factors for both primary and secondary prevention. The quality of evidence for the modest benefits on CVD risk factors in primary prevention is low or moderate, with a small number of studies reporting minimal harms. There is a paucity of evidence for secondary prevention. The ongoing studies may provide more certainty in the future.

* In this substantive review update, 30 randomised controlled trials [RCTs] (49 papers) (12,461 participants randomised) and seven ongoing trials met our inclusion criteria.

I suspect Cochrane found uncertainty regarding the effects of a Mediterranean diet because the Mediterranean diets used in the interventions were higher in fat, alcohol, meat, and dairy food than the Mediterranean diet followed by people prior to Western influence. (The large PREDIMED trial, which did not find benefit for “heart attacks, death from heart disease or other causes” was included.) (See my Mediterranean Diet Posts 1 through 11 for backup).

Tokyo’s Oldest Workers – In Pictures

Tokyo’s Oldest Workers – In Pictures, The Guardian, 12 June 2019

There are 18 photos in the gallery. The photos were taken by Lee Chapman who keeps a wesite called Tokyo Times where you can see a whole lot more, especially on his Instagram account.

These bartenders, sushi chefs and sweetshop owners are still working in their 80s and 90s, running family businesses and maintaining traditional crafts as the city changes around them.

Another coffee shop owner in her late 80s. Her cafe in Ogikubo opens most days. It’s on two floors, and she runs it alone, meaning she is up and down the steep stairs all day long.

This 82-year-old woman has run her little bar in Nerima city for 40 years.

More Advertisement Masquerading As Science, The Case Of Blueberries

This article  was in the New York Times. Mainstream media is doing exactly what industry wants, that is, reporting what looks like science but is really product promotion. What has happened to journalism?

Blueberries May Promote Heart Health, New York Times, 3 June 2019
“Researchers estimate that eating a cup of blueberries a day reduced the risk of any cardiovascular event by 13 percent.”

First of all, eating a cup of blueberries a day (they found that a half cup wasn’t enough), as I found, is economically unrealistic. Second, “heart health” was not their primary endpoint. It wasn’t even a secondary endpoint. It was a projection based on secondary endpoints. In fact, they didn’t even find a positive effect on their primary endpoint (see below). Third, 13 percent is small, like really small.

Here was the study. I’m beginning to suspect articles in this journal:

Blueberries Improve Biomarkers Of Cardiometabolic Function In Participants With Metabolic Syndrome — Results From A 6-Month, Double-blind, Randomized Controlled Trial, American Journal of Clinical Nutrition, 28 May 2019

The primary endpoint* was insulin resistance. Did eating a cup of blueberries improve insulin resistance? No, it did not. The rest of their measurements are all results of fishing expeditions. You will always be able to find some positive effect from an intervention. Do these effects result in less disease and a longer life? Their study was not designed to answer that question, but that didn’t stop them. Those measurements, and there are a lot of them, are there as distractions.

Insulin resistance, pulse wave velocity, blood pressure, NO [nitric oxide], and overall plasma thiol status were unaffected. Likewise, a half cup per day had no effect on any biomarkers.

Also, the blueberry eaters had to limit consumption of other “anthocyanin-rich foods and other foods known to modify vascular function.” They’re saying that lots of foods we eat do the same thing as blueberries. Here are foods listed in the study that participants had to limit:

Blackcurrant, blackberry, cranberry, bilberry, black raspberry, cherry, grapes, strawberry, red raspberry, red currant, lingonberries, black olives, dark chocolate, oily fish (salmon, mackerel, tuna, herring), tea (including herbal), coffee (instant or filter), hot chocolate, alcohol, cabbage, radicchio, black beans, beets, broccoli, carrot, cauliflower, celery, cucumber, lettuce, Brussels sprouts, parsley, potato, radish, spinach.

They should have mentioned watermelon which has a stong nitric oxide effect.

Another giveaway that this study is more advertisement than science is how they word the conclusion. Treatments (in this case a cup of blueberries a day, not a half cup mind you) are never indicated by the results of one small study – a study that didn’t even show good on their primary endpoint!

Conclusions: Despite insulin resistance remaining unchanged we show, to our knowledge, the first sustained improvements in vascular function, lipid status, and underlying NO bioactivity following 1 cup blueberries/d. With effect sizes predictive of 12–15% reductions in CVD risk, blueberries should be included in dietary strategies to reduce individual and population CVD risk.

The study was funded by the US Highbush Blueberry Council.

The study used freeze-dried blueberries. I looked around and found these on Amazon for $8.15 or $6.79 per ounce. I’m guessing one ounce is about a cup. They ate a cup a day. That makes this intervention even more expensive than if they used fresh or frozen blueberries. (Frozen run around $1.50/cup. These freeze-dried are over 4 times that.)

* Wikipedia: “The primary endpoint of a clinical trial is the endpoint for which subjects are randomized and for which the trial is powered. Secondary endpoints are endpoints that are analyzed post hoc, for which the trial may not be powered nor randomized.”

Compounds In Watermelon Affect Blood Flow

Our watermelon from 2011. They don’t make watermelons like they used to.

This is a repost from 2011. I should look up recent studies. In the meantime, I was reminded how compounds in watermelon affect blood flow.

For a food that’s 92% water by weight, it’s amazing it has any other benefit besides sweet hydration. But…

Effects Of Watermelon Supplementation On Aortic Blood Pressure And Wave Reflection In Individuals With Prehypertension: A Pilot Study, American Journal of Hypertension, 2011

In this study, participants (4 men/5 women, mid-fifties, with prehypertension: ~134/77 mmHg) had lower blood pressure after 6 weeks of watermelon:

“To the best of our knowledge, this is the first study demonstrating beneficial effects of L-citrulline/L-arginine from watermelon supplementation in arterial function in humans.”


Watermelon is rich in a substance called citrulline, which the body converts to the amino acid arginine, which can be used to make nitric oxide. (Another name for nitric oxide is nitrogen monoxide – like carbon monoxide except nitrogen instead of carbon.)

When blood vessels are exposed to nitric oxide, the muscles that make up the vessel relax, the vessel opening widens or dilates, and blood flow increases. The drug Viagra uses this same nitric oxide mechanism to increase blood flow through the penis causing erection.

This next study found not just better blood flow but better blood glucose, less body fat, and better serum lipids:

Dietary Supplementation With Watermelon Pomace Juice Enhances Arginine Availability And Ameliorates The Metabolic Syndrome In Zucker Diabetic Fatty Rats, The Journal of Nutrition, 2007

Rats were fed watermelon juice for 4 weeks. Compared to the control (fed water), and to groups fed lycopene and pectin, the melon drinkers had:

  • Increased serum arginine (citrulline was converted to arginine)
  • Improved insulin sensitivity
  • Decreased fat mass (better/higher ratio of brown fat to white fat)
  • Lower serum glucose
  • Lower serum free fatty acids
  • Lower triglycerides
  • Lower cholesterol
  • Lower serum homocysteine
  • Improved blood flow

Supplementing with arginine has been shown to produce many of these benefits in humans (e.g. Effect of oral l-arginine supplementation on blood pressure: A meta-analysis of randomized, double-blind, placebo-controlled trials). However, not all arginine gets converted to nitric oxide. The body has other uses for arginine, notably making urea to get rid of nitrogenous waste! Supplementing with citrulline, however, is more likely to result in these benefits since the body breaks down up to half of oral arginine after we ingest it, then much of what’s left intact goes straight to the liver, not the vessels. Not so with citrulline, which doesn’t get degraded easily and bypasses the liver ending up in the blood stream. Gram-for-gram, less citrulline than arginine is needed for the same effect.

The gentleman holding the melon, Dr. Bhimu Patil from Texas A&M University, says:

“We’ve always known that watermelon is good for you, but the list of its very important healthful benefits grows longer with each study.”

In watermelons, these include lycopene, beta carotene and the rising star among its phyto-nutrients – citrulline – whose beneficial functions are now being unraveled. Among them is the ability to relax blood vessels, much like Viagra does.

“The citrulline-arginine relationship helps heart health, the immune system and may prove to be very helpful for those who suffer from obesity and type 2 diabetes. … Arginine boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has, to treat erectile dysfunction and maybe even prevent it. Watermelon may not be as organ specific as Viagra, but it’s a great way to relax blood vessels without any drug side-effects.”

Almost 92 percent of watermelon is water, but the remaining 8 percent is loaded with lycopene, an anti-oxidant that protects the human heart, prostate and skin health.

“Lycopene, which is also found in red grapefruit, was historically thought to exist only in tomatoes,” he said. “But now we know that it’s found in higher concentrations in red watermelon varieties.”
Watermelon May Have Viagra-Effect, ScienceDaily, 2008

The Beatles, The End

This is the song “The End” by the Beatles, released in 1969. Wikipedia: It was the last song recorded collectively by all four Beatles, and is the final song of the medley that constitutes the majority of side two of the Abbey Road album.

I’m posting it because I can’t get the final part out of my mind. I don’t know how to edit a sound file so you’ll have to fast-forward. The clip extends from 1:29 to 2:02.

And in the end, the love you take is equal to the love you make.

Photo Source: The Beatles

How To Refer To People Over The Age Of 65

When It Comes To Older Adults, Language Matters: Journal Of The American Geriatrics Society Adopts Modified American Medical Association Style, Jounal of the American Geriactrics Society, June 2017

The AMA style guide provides its own guidance on terms NOT to use when describing older people, reinforcing that words like (the) aged, elder(s), (the) elderly, and seniors should not be used. This is because such terms connote discrimination and certain negative stereotypes that may undercut research‐based recommendations for better serving our needs as we age.

In light of this, we are qualifying the AMA recommendation for referring to a person’s age. Specifically, JAGS will require that authors use the term “older adult” when describing individuals aged 65 and older.

Are You Over 50? Drink!

One thing every person over 50 should be doing for their health, regardless of what diet they follow or how much they exercise, is drink. Drink all day. Drink even when you’re not thirsty. Drink whenever you think of it. Water, tea, coffee, diluted juices, all those new sparkling flavored waters. Suck on ice chips. Eat watermelon or grapes, soups or stews. Always be thinking about how you can get fluid in you, because…

Dehydration is a problem in older adults:

  • Who gradually lose their thirst sensation.
  • Who pee more because urine is less concentrated and kidneys use more fluid to remove the same amount of waste (and so urine can be light-colored even when you’re not drinking enough: darker pee is no longer a good indicator of dehydration)
  • Who pee more because they have diabetes, or undiagnosed diabetes, or prediabetes. You start to pee out glucose when it reaches a certain threshold in your blood.
  • Who have more fluid-losing hot flashes as the body becomes less efficient at temperature regulation.
  • Who take more medications that have a diuretic effect.

Signs you may be dehydrated:

  • You’re tired.
  • You have a headache.
  • You’re becoming forgetful or you’re having difficulty concentrating.
  • You’re testy or irritable.
  • You feel lightheaded when you stand up or climb stairs.
  • You’re constipated.
  • Your mouth or eyes are dry.

Read that list again. You could clear up so many issues just by downing a big glass of water. Don’t believe people who tell you that drinking 8 glasses of water a day is a myth.

You know when the best time to drink is? Right now.