Posted on: Saturday, November 13, 2004

PRESCRIPTIONS
Mediterranean diet shown to be among most healthful

By Landis Lum

The U.S. Centers for Disease Control and Prevention recently reported something startling: In 1961, the average woman weighed 140 pounds; by 2000, the average weight was 164. Men's weights increased from 166 to 191. Women gain on average 0.8 pounds a year — 8 pounds each decade — and men 0.7 pounds a year from age 18 to about age 55, when for most of us our weights peak.

So what to do? The Cochrane Database group used the most accurate studies — randomized, controlled trials — to see whether the usual advice of low-fat diets was any better than other weight-reducing diets, and found that low-fat diets were no better than low-calorie diets for long term weight loss.

And low-carb diets? Well, in May 2003, the New England Journal of Medicine found that those on low-carbohydrate diets did lose more weight than those on conventional weight-loss diets, but after six months, they started gaining weight, and by one year, they weighed the same as those on regular diets. And on May 18, 2004, the Annals of Internal Medicine found the same results.

Indeed, whether you look at diets or behavioral modification, you'll find many randomized studies that show weight loss the first several months, but none that show that this weight is kept off over the next several years. But here's an exception:

In October 2001, Kathy McManus and others from Harvard Medical School found that those on the Mediterranean diet were 14 pounds lighter than those on the usual low-fat diet after 18 months, despite the fact that it was 35 percent fat calories compared with 20 percent in the usual diet. Furthermore, there are only two diets I'm aware of shown in randomized studies to actually prolong life — a higher-fish diet, and the Mediterranean diet.

In June 1994 in the journal Lancet, the Lyon Diet Heart Study put half of 600 patients who had had heart attacks on the Mediterranean diet. After two years, there were three deaths from heart disease in those on the Mediterranean diet, while 16 died on the normal diet. They had to stop the study prematurely because it was unethical to continue it.

The Mediterranean diet is very appetizing and allows carbs. To lose weight on this diet, exercise more and reduce calories to 1200 to 1500 a day. Eat more fruits, vegetables and fish, but less red meats. Replace butter and cream with nonhydrogenated rapeseed (canola) oil-based margarine.

Use canola or olive oil in salad dressings and in cooking: saute vegetables in oil instead of steaming them. Eat nuts and seeds (or peanut butter). And apologies to the low-carb industry for bursting your bubble.

Dr. Landis Lum is a family-practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Send your questions to Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Honolulu, HI 96802; fax 535-8170; or write islandlife@honoluluadvertiser.com. This column is not intended to provide medical advice.