In this post, I will review the evidence that supports the allegation that Mediterranean Diets are safe, efficient and cost-friendly insofar as optimal longevity and wellbeing are concerned (SECTION A). Thereafter, i will briefly examine a few mechanisms of action that help to explain the clinical and culinary superiority of the Mediterranean Holistic Diet and Lifestyle over many other diets and lifestyles (SECTION B).
The scientific literature contains thousands of peer-reviewed studies that show the benefits of the Mediterranean Diet (hereinafter, MD) for just about all diseases, including inflammatory illnesses like cancer, Alzheimer and cardio-vascular events.
Even though there are many variants of MDs among Europeans, North Africans and Middle Easterners, there is a core that permeates all MDs. Of all Mediterranean diets, the Joubert campaign prefers the French Mediterranean diet, the composition of which is mostly a plant-based diet, with a large section devoted to “crudités” (raw foods), some of which are flavanoid-rich fruits, figs, tomatoes, garlic, onions, avocados, leafy greens, roots, nuts and vegetables, in combination with cooked fibrous legumes, whole grains, herbal teas, chocolate, lignans spices, mushrooms (ie, the French go wild over mushrooms and truffles) olives and olive oil, small amounts of free-range eggs and mostly raw goat and sheep cheese (1), other fermented foods like sauerkraut and yogurt, wild omega-3 and coenzyme-Q10 rich fish and quality wine at most meals, especially if the plate contains animal foods (2).
When this diet is combined with congenial company, a lots of testosterone boosting sunlight (3), siesta, romance, exercises (ie, the French pétanque being one of the most destressing forms), culture, music, meditation, spirituality, a healthy and unflappable positive attitude, a friendly eco-community and “joie de vivre” (enjoyment of life), the longevity and wellbeing impact is amazing. In this perspective, the longest recorded person (to this day) to have lived the longest is still a French Mediterranean gal named Jeanne Calment, who decided to pass when she was in her 122 year, being in relatively good health until about one month before her death (2a).
(SECTION A). THE EVIDENCE FROM META-ANALYSES THAT THE MEDITERRANEAN DIET IS A SAFE AND EFFICIENT STRATEGY TO ADDRESS CHRONIC DISEASES AND OPTIMIZE WELLBEING
In a meta-analysis published in BMJ in 2008, it was showed that following the Mediterranean diet reduced the risk of dying from cancer and cardiovascular disease as well as the risk of developing Parkinson’s and Alzheimer’s disease, the results of which were around 10 percent. (4)
Another meta-analysis published by the The American Journal of Clinical Nutrition” two years later in 2010 found that the Mediterranean diet conferred a significant benefit with regard to the risk of chronic diseases, such as cardiovascular disease and cancer. (5)
In 2011, still another meta-analysis published in the Journal of the American College of Cardiology analyzed the results of 50 studies (35 clinical trials, 2 prospective and 13 cross-sectional) covering about 535,000 people to examine the effect of a Mediterranean diet on metabolic syndrome.The researchers reported that a Mediterranean diet is associated with lower blood pressure, blood sugar, and triglycerides, parameters which are also relevant for cancer. (6)
Another couple years later, in 2013, the American Journal of Clinical Nutrition published in 2013 a study that compared Mediterranean, vegan, vegetarian, low-glycemic index, low-carbohydrate, high-fiber, and high-protein diets with control diets. The research concluded that the Mediterranean diet, like low-carbohydrate diets, is one of the best in terms of improving markers of risk for cardiovascular disease and diabetes and cancer. (7)
In 2014, two meta-analyses found that adherence to a Mediterranean diet was associated with a decreased risk of type 2 diabetes. (8) while during this same year, a systematic meta-analytical review found that adherence to the Mediterranean diet was associated with a decreased risk of over-all cancer mortality. (9) (10)
Lastly in 2015, the highest adherence score to a MD was significantly associated with a lower risk of all-cause cancer mortality.
“The aim of the present systematic review and meta-analysis of observational studies was to gain further insight into the effects of adherence to Mediterranean Diet (MD) on overall cancer mortality, incidence of different types of cancer, and cancer mortality risk in cancer survivors. (…) The updated meta-analyses confirm a prominent and consistent inverse association provided by adherence to an MD in relation to cancer mortality and risk of several cancer types”. (Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies, by Schwingshackl L, Hoffmann G1, Cancer Med. 2015 Oct 16).
(SECTION B): MECHANISMS OF ACTION: CELLULAR REDIFFERENTIATION AND MORE
In 2013, a study orchestrated by the Ohio State University’s Comprehensive Cancer Center’s geneticist and health science experts (11) found apigenin, a flavonoid, was prevalent in the Mediterranean Diet, in particular in plant-based foods, vegetables, fruits, celery, parley and chamomile tea in particular. This is a significant finding because apigenin can reeducate a cancer cell to redifferentiate back into a healthy cell.
“By altering a very specific step in gene regulation, (12) this compound essentially re-educates cancer cells into normal cells that die as scheduled ”. (13)
The researchers also showed in this work that apigenin binds with an estimated 160 proteins in the human body, suggesting that other nutrients linked to health benefits (eg, “nutraceuticals”), might have similar far-reaching effects.
OTHER SIGNIFICANT ANTI-CHRONIC DISEASES PATHWAYS ARE ACTIVATED THANKS TO THE MEDITERRANEAN DIET AND ITS RED WINE ELEMENT
Another beneficial effect that comes from the MD’s core, in particular from oleuropein aglycone (OLE), the main polyphenol found in the extra virgin olive oil, is it’s cellular autophagy activation, that which has a beneficial impact on cancer control and reversal. (14)
Thanks to their great fat content, inter alia, Mediterranean nuts have also shown to help lots with vascular health, glucose stability, ketones and the immune system, thanks to which cancer incidence is lowered, even for those who do not strictly adhered to the MD’s core.
“Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study”. (Br J Nutr. 2015 Sep 14;114(5):804-11). (15)
And of course, there’s good quality wine, which can be healing in small amounts and-or moderately, from its use as a longevity elixir that can help to avoid and treat many serious diseases, from cancer, hormonal problems and digestion issues to coronary vascular diseases, hormonal problems, diabetes, obesity, carotid arteriosclerosis and atherogenesis (16) and amyloidosis three forms of which are Alzheimer’s, Huttington’s and Parkinson’s diseases. (17) A few of the mechanisms of action that help to explain wines therapeutic effect are based on its longevity gene activation, in particular regarding the sirtuin family of genes. Other health biochemical pathways that have also been identified range from wine’s aromatase inhibiting impact to its effect on platelet aggregation, blood thinning, HDL production, blood sugar regulation, brain function and much more.
Contrarily to most pharmaceutical drugs which target a single molecule or pathway, the Mediterranean diet, potentiated by good quality wine (ie either in small amounts or moderately), a sunny climate and “Midi” lifestyle (which includes daily siestas, pétanque exercising, culture, meditation, music and romance), targets many pathways and feel-good neuro-peptides while enhancing vitality and even optimal longevity (via the telomere length “pathway”). (18)
This cost-friendly holistic lifestyle is equally accessible to all, anyone should be able to afford onion leaves and black tea for example. The highest total flavonoid content (of which quercetin and apigenin are significant) was determined to be in onion leaves (1497.5 mg/kg quercetin, 391.0 mg/kg luteolin, an.d 832.0 mg/kg kaempferol), and the fourth highest in black tea. (19) We therefore do not need to be wealthy to eat a diet rich in flavonoids, polyphenols and, inter alia, anthocyanins. (20)
The Mediteranean Diet is therefore one of the safest there is, while being efficient and cost-friendly in its over-all impact on wellbeing and longevity. Combined with the other elements mentioned above, the Meditarranean Diet should therefore be part of Washingtonians’ education and public food systems, both for the young and the less young. This holistic proposal would also save the State billions of “sick-care” dollars. See Joubert’s Holistic Governance Platform Issue one for the supporting evidence.
Christian Pierre Joubert (2016 Holistic Party’s Washington State’s governor candidate).
PRECISION AND REFERENCE NOTES
(1). For the mountainous Mediterranean areas in countries like South France and South Italy and even Northern Spain, cheese is often pesticide free or organic, raw and from sheep or goat more than from the cow. This is significant in terms of saturated fats, cholesterol and, inter alia, vitamin K2, whose biochemistry helps to distribute calcium to where it is needed, including removing calcium from the arterial plaque where it should not be.
(2). Several studies have demonstrated that resveratrol from red wine, in combination with polyphenols from olive oil, lycopene from tomatoes, and capsaicin from red pepper have multiple anticancer properties affecting several metabolic pathways involved in cancerogenesis, apoptosis, and metastasis. Sometimes, small amounts of meat, in particular lamb, can also be consumed in French Mediterranean meals, but when this is done, the red wine is usually increased, thanks to which there is less large intestine putrefaction, better blood glucose stability (meat can lead to blood sugar dysregulation and promote diabetes) and an increased boost in HDL, the good cholesterol, inter alia. However, for ethical, health and environmental reasons, the Joubert campaign recommends no meat. But if there is meat, then it’s important to know that red wine, garlic and onions combined with resistant starches will help to avoid chronic diseases.
(2 a). Jeanne Calment’s descent though began after she was forced go to a retirement home at 110 years, following a cigarette fire she had caused in her kitchen with one of her cigarettes. As she said herself, she hated the “baby food” that was served therein and the retirement house did not feel like “home”, she was not able to access to her 2 pounds of dark chocolate each week as she would have liked, nor have fresh meals with wines as before. Without a symphony of the feel-good neuropeptides, including great tasting food and wine, the French usually prefer to die. So that is what Jeanne, unflappably, did, she died at age 122 and a half, after having half jokingly claimed that God had forgeotten her.
(3). A recently emerging alternative or complementary hypothesis to the Mediterranean diet is that differential exposure to solar ultraviolet radiation accounts for the disparity in cardiovascular health and cancer between residents of Mediterranean and more northerly countries. The proposed mechanism is solar UVB-induced synthesis of Vitamin D in the oils of the skin, which has been observed to reduce the incidence of coronary heart disease, and which rapidly diminishes with increasing latitude. Wong A (2008). “Incident solar radiation and coronary heart disease mortality rates in Europe”. Eur J Epidemiol. 23 (9): 609–14 Furthermore, the incidence of melanomas in the Mediterranean countries is lower than in Northern Europe and significantly lower than in other hot countries such as Australia, just like with most other countries, as show all cancer maps.
(4). Sofi F, Cesari F, Abbate R, Gensini GF, Casini A (2008). “Adherence to Mediterranean diet and health status: meta-analysis”. BMJ (Clinical research ed.) 337 (sep11 2): a1344.
(5). Sofi, F; Abbate, R; Gensini, GF; Casini, A (November 2010). “Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis.”. The American journal of clinical nutrition 92 (5): 1189–96.
(6). Kastorini C-M, Milionis H, Esposito K, Giugliano D, Goudevenos J, Panagiotakos D. (2011). “The Effect of Mediterranean Diet on Metabolic Syndrome and its Components”. Journal of the American College of Cardiology 57 (11): 1299–1313.
(7). Ajala O., English P., Pinkney J. (2013). “Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes”. The American Journal of Clinical Nutrition 97 (3): 505–516.
(8). Koloverou, E; Esposito, K; Giugliano, D; Panagiotakos, D (July 2014). “The effect of Mediterranean diet on the development of type 2 diabetes mellitus: a meta-analysis of 10 prospective studies and 136,846 participants.”. Metabolism: clinical and experimental 63 (7): 903–11
(9). Schwingshackl, L; Hoffmann, G (15 October 2014). “Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies.”. International Journal of Cancer. Journal International Du Cancer 135 (8): 1884–97
(10). Which is not surprising since we know that cancer regression also benefits when insulin and IGF-1 (ie, an insulin growth factor hormone) are decreased.
(11). Doseff oversaw this work with co-lead author Erich Grotewold, professor of molecular genetics and director of Ohio State’s Center for Applied Plant Sciences (CAPS). The two collaborate on studying the genomics of apigenin and other flavonoids, a family of plant compounds that are believed to prevent disease. The research appeared in the online early edition of the journal Proceedings of the National Academy of Sciences. See http://researchnews.osu.edu/archive/apigenin.htm
(12). Through additional experimentation, the team established that apigenin had relationships with proteins that have three specific functions. Among the most important was a protein called hnRNPA2. This protein influences the activity of messenger RNA, or mRNA, which contains the instructions needed to produce a specific protein. The production of mRNA results from the splicing, or modification, of RNA that occurs as part of gene activation. The nature of the splice ultimately influences which protein instructions the mRNA contains. Doseff noted that abnormal splicing is the culprit in an estimated 80 percent of all cancers. In cancer cells, two types of splicing occur when only one would take place in a normal cell – a trick on the cancer cells’ part to keep them alive and reproducing.In this study, the researchers observed that apigenin’s connection to the hnRNPA2 protein restored this single-splice characteristic to breast cancer cells, suggesting that when splicing is normal, cells die in a programmed way, or become more sensitive to chemotherapeutic drugs.“So by applying this nutrient, we can activate that killing machinery. The nutrient eliminated the splicing form that inhibited cell death,” said Doseff, one of the main scientists in the Ohio State’s team.
(13). http://researchnews.osu.edu/archive/apigenin.htm See also AACR (2015) The dietary flavonoid apigenin sensitizes malignant tumor cells to tumor necrosis factor–related apoptosis-inducing ligand Mano Horinaka1, Tatsushi Yoshida1, Takumi Shiraishi12, Susumu Nakata1, Miki Wakada1 and Toshiyuki Sakai1
(14). Oncotarget. 2015 Oct 14. doi: 10.18632/oncotarget.6119 “Oleuropein aglycone induces autophagy via the AMPK/mTOR signalling pathway: a mechanistic insight”, by Rigacci S1, Miceli C1, Nediani C1, Berti A1, Cascella R1, Pantano D2, Nardiello P2, Luccarini I2, Casamenti F2, Stefani M1. The healthy effects of plant polyphenols, many of which characterize the so-called Mediterranean diet, have been shown to arise from epigenetic and biological modifications resulting, among others, in autophagy stimulation. The main beneficial effects of oleuropein aglycone (OLE), the main polyphenol found in the extra virgin olive oil, against neurodegeneration has been established for years. In particular, the scientists of this study have found that OLE induces a rapid release of Ca2+ from the SR stores which, in turn, activates CAMKKβ, with subsequent phosphorylation and activation of AMPK. The link between AMPK activation and mTOR inhibition was shown in the OLE-fed animal model in which it was found that decreased phospho-mTOR immunoreactivity and phosphorylated mTOR substrate p70 S6K levels match enhanced phospho-AMPK levels, supporting the idea that autophagy activation by OLE proceeds through mTOR inhibition. Our results agree with those reported for other plant polyphenols, suggesting a shared This molecular mechanism, that other plant polyphenols also have, confirm by a preponderance of the evidence that aging, neurodegeneration, cancer, diabetes and other diseases implying autophagy dysfunction can be better controled, if not reversed.
(15). Br J Nutr. 2015 Sep 14;114(5):804-11. Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study by Bonaccio M1, Di Castelnuovo A1, De Curtis A1, Costanzo S1, Bracone F1, Persichillo M1, Donati MB1, de Gaetano G1, Iacoviello L1; Moli-sani Project investigators. Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. This study found a significant reduction in cancer and CVD deaths Biomarkers of low-grade inflammation were reduced in nut consumers as well.
(16). Because monocyte adhesion to the endothelium is crucial in early atherogenesis, it has been shown that both olive oil (rich in in oleuropein) and red wine polyphenols and resveratrol beneficially affect endothelial–leukocyte adhesion molecule expression and monocyte adhesion. In this perspective, the combination of olive oil and red wine antioxidant polyphenols at nutritionally relevant concentrations transcriptionally inhibit endothelial adhesion molecule expression, thus partially explaining cardio-vascular benefits and atheroprotection from red-wine rich Mediterranean diets. Among other sources, see Martinez-Domingues E, de la Puerta R, Ruiz-Gutierrez V. Protective effects upon experimental inflammation models of a polyphenol-supplemented virgin olive oil diet. Inflamm Res. 2001; 50: 102–106 and Iijima K, Yoshizumi M, Hashimoto M, Akishita M, Kozaki K, Ako J, Watanabe T, Ohike Y, Son B, Yu J, Nakahara K, Ouchi Y. Red wine polyphenols inhibit vascular smooth muscle cell migration through two distinct signaling pathways. Circulation. 2002; 105: 2404–2410
(17). Granzotto A, Zatta P. Resveratrol and Alzheimer’s disease: message in a bottle on red wine and cognition. Front Aging Neurosci. 2014 May 14;6:95.
(18). Cf Age (Dordr). 2015 Apr;37(2):24. Mediterranean diet and leukocyte telomere length in a multi-ethnic elderly population.
(19). J Agric Food Chem. 2001 Jun;49(6):3106-12.
(20). Flavonoids are plant-made chemicals (phytochemicals) in the “polyphenol” family of molecules. They are widely found in fruits, vegetables, cereals, herbs, spices, stems and flowers, teas, red wine, beer, beans, cocoa, and many other botanical foods and beverages. Anthocyanins are versatile and plentiful flavonoid pigments found in red/purplish fruits and vegetables, including purple cabbage, beets, blueberries, cherries, raspberries and purple grapes. Within the plant they serve as key antioxidants and pigments contributing to the coloration of flowers.
Disclaimer: Nothing in this educational post should be construed as medical advise.
2016 (c). Holistic Party and Christian Pierre Joubert. All rights reserved.