The New England Journal of Medicine Mediterranean Diet Study published online Feb 25, 2013 proves diet plays a key role in preventing heart disease. This shouldn’t be anything super newsworthy, except that it is one of only a very few high quality diet studies that was prospective and randomized and the first major clinical trial to measure the incredible cardio-protective and anti-inflammatory effects of a plant-rich diet containing fruits, vegetables, nuts, beans, whole grains, olive oil and regular fish consumption along with moderate wine drinking with meals. The study was compared head to head against a low-fat diet and was ended early, after almost five years, because the results were so clear it was considered unethical to continue (it was especially noteworthy that participants had a difficult time sticking with the low-fat diet.) Individuals who adhered to the modified Mediterranean diet dramatically reduced their risk of heart attack, strokes and deaths from heart disease.
The diet outlined in our newly-released book Clean Cuisine (Penguin-Berkley Hardcover, Feb 2013) is very similar in many ways to the modified Mediterranean diet published in the New England Journal of Medicine. In the New England Journal of Medicine Mediterranean Diet Study healthy “superfoods” displaced “bad” foods people were previously eating and people continued to eat the superfoods because they were palatable. Consumption of these superfoods resulted in meaningful prospective results (30 % reduction in total heart attacks and strokes). Food therefore matters….it would be great to further optimize the test to study a pure “Clean Cuisine” diet but the results of the study are important nonetheless.
It is critical to understand on a total population level we need to go after things that people will and can actually do…..and the researchers have to be able to prove that the subjects were also actually eating the foods they were studying (the New England Journal study did test that fact by measuring byproducts of fat breakdown in the blood) or the results are meaningless.
The New England Journal of Medicine Mediterranean Diet Study is not exactly the same as our Clean Cuisine program—for example, we are not going to purposely ask you to start increasing your consumption of olive oil because we would much rather you get the majority of your dietary fat from more nutritious “whole” food sources such as nuts, avocados and seeds (we go into great detail in chapter 5 in the Clean Cuisine book talking about the health and weight loss benefits of getting “whole food” sources of dietary fat in comparison to oil.) However, there are plenty of similarities between the two diets, so here are a few simple take-away points for how to modify your own diet based on the study and the recommendations in our own Clean Cuisine book:
- Don’t Count Your Food, Make Your Food Count: Just like Clean Cuisine, the study did not require participants to “count” their food in the form of calories, carbs, fat grams, etc. Instead, empty-calorie and processed foods were eliminated and nutrient-rich “whole foods” (especially plant foods) were encouraged.
- Go Nuts: In the study, participants were encouraged to add approximately ¼ cup of nuts to their diets daily, which is exactly what is recommended as part of the Clean Cuisine program. In the book we show numerous creative ways to add nuts to your diet including using nut milks in place of dairy (we show you how to make fresh nut milk using a high-speed blender), making “nut crumbs” in place of bread crumbs for casserole toppings, sprinkling one of the Clean Cuisine Salad Booster recipes on top of your salad, grains or vegetables, enjoying nut butters as a spread on sandwiches, making a Clean Cuisine “No-Milk Shake” recipe, etc.
- Bean Cuisine: Replacing some animal protein with plant-based protein-rich beans was an important part of the study; beans are loaded with fiber, antioxidants, phytonutrients, vitamins and a special type of starch (resistant starch) that is particularly helpful for weight loss. Clean Cuisine incorporates a serving of beans everyday as part of the 8-week program. Easy ways to increase your bean consumption include making Clean Cuisine bean burger recipes from the book, bean-based hummus, bean soup (pureeing beans makes a great substitute for cream-based dairy), bean salad and even Clean Cuisine black bean brownies!
- More Plants, Less Meat: The study is clear: not all calories are created equal. The more phytonutrients and antioxidants you can get per calorie—which are found in unrefined “whole” plant foods— the better for reducing inflammation and protecting against disease.
- Nothing Fishy About Fish: Although participants in the study ate less animal foods, they were not vegan—nor is Clean Cuisine. In our 8-week Clean Cuisine program we encourage “Fish on Fridays” and at least one or two additional fish meals per week. The only way to get enough of the highly anti-inflammatory and cardio-protective long-chain omega-3 fats EPA & DHA is by eating fatty fish or taking fish oil supplements. In the Clean Cuisine book we explain how to make the “cleanest” and most sustainable fish choices (note: canned wild sockeye salmon is an inexpensive and very “clean” fish option—great for making salmon burgers too!)
- Nothing Wrong with Enjoying a Glass of Wine: Clean Cuisine dedicates an entire chapter to exploring the research behind moderate wine consumption, which unveils the fact that wine is not only cardio-protective but also does not contribute to weight gain as once thought (alcohol calories are not utilized by the body the same as calories from fat, carbs and protein.)
One of the biggest take-away points from The New England Journal of Medicine Mediterranean Diet Study is that you do not need to go to extremes to enjoy good health. One of the things that set Clean Cuisine apart from every other “diet” out there is that it really is both easy and enjoyable to follow—it is strict only when and where it counts most. My wife and I have been adhering to the Clean Cuisine diet for almost 15 years, ever since she was diagnosed with MS (multiple sclerosis) in 1998—eating this way has helped me lose weight and lower my blood pressure and I credit the diet with keeping my wife’s disease in remission.
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