Mediterranean diet improves cardio health, but only for the rich


Choosing a Mediterranean diet has long been linked to a bevy of health benefits, including reduced risk of heart disease and lower rates of cancer. But new research shows if you are going to mimic the eating habits of someone who hails from the region, you had better make sure they are rich and highly educated.

Mainstays of the Mediterranean diet include a high intake of vegetables, legumes, fruits, nuts and unrefined cereals, as well as plenty of olive oil, moderate intake of fish, and low-to-moderate dairy, low red meat and poultry, and moderate wine consumption, according to a 2003 study published in the New England Journal of Medicine.

A new Italian study led by a team of researchers at IRCCS Neuromed looked at the dietary information of 18,991 southern Italian men and women over 35 between March 2005 and April 2010.

The sample group did not include individuals with a history of cardiovascular disease, diabetes, inordinately high or low calorie intakes, or incomplete personal data.

Socioeconomic information and food intake statistics were collected through questionnaires. The researchers measured factors such as food antioxidant content, variety of fruits and vegetable intake, health of cooking practices (boiling, frying, roasting, grilling), organic food intake, and consumption of whole grain products.

Overall adherence to the Mediterranean diet was given a score measured against the definition outlined by the 2003 New England Journal of Medicine study.

More than 250 cardiovascular disease events were recorded over a median follow-up period of 4.3 years.

Overall, a two-point increase in participants’ Mediterranean diet scores resulted in a 15 per cent decline in cardiovascular disease risk.

But that benefit did not materialize for less educated subjects. Similarly, the cardiovascular disease fighting benefits were confined to the high-income households, compared to lower-earning peers.

“Given a comparable adherence to this eating pattern, the study has shown that the reduction in cardiovascular risk is observed only in people with a higher educational level and/or greater household income. No actual benefits were observed for the less advantaged groups,” said the study’s authors in a release accompanying the study.

The cardiovascular disease findings are even more striking when high education, high income individuals are observed in isolation.

The study notes a two-point increase in the Mediterranean diet score drops cardiovascular disease risk by 57 per cent among those with post-secondary education, and 61 per cent for those in the highest category of household income.

Once again, no such relationship was observed among the less educated and less wealthy.

The difference comes down to “different intakes of antioxidants and polyphenols, fatty acids, micronutrients, dietary antioxidant capacity, dietary diversity, organic vegetables and whole grain bread consumption,” according to the study.

The more highly educated subjects were found to eat a wider variety of vegetables, more organic produce, and whole grain breads. They also opted for higher fish intake versus meat consumption. Greater income was also associated with eating more fruits, nuts and fish, and eating fewer meat products.

The study’s authors admit the limitations of self-reported dietary intake profiles means the research falls short of establishing a direct link between better-heeled groups and the selection of more nutritious food. However, they suggest their findings make a strong case for further investigation of into the role of income and education on diet-based health outcomes.

“Socioeconomic disparities in health are growing, also in access to healthy diets,” wrote IRCCS Department of Epidemiology and Prevention head Giovanni de Gaetano. “We cannot be keeping on saying that the Mediterranean diet is good for health if we are not able to guarantee an equal access to it.”

The findings were based on subjects within the Moli-sani study, which has examined environmental and genetic factors underlying cardiovascular disease, cancer, and degenerative pathologies for the past 12 years.

The research has been published in the International Journal of Epidemiology.

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By Jeff Lagerquist,

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