CRETAN DIET. When does the history of the Cretan Diet start?

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1 CRETAN DIET When does the history of the Cretan Diet start? The history of the Cretan Diet starts just before 1960, when American Ancel Keys and his colleagues launched the Seven Countries Study. This study showed that the reduced mortality rates from cardiovascular diseases as well as cancer observed in Crete, compared to Northern Europe and America but also to other Southern European countries, were result of the special dietary habits of Cretans at that time. Based on the diet of Cretans in the1960s the Mediterranean diet pattern was defined, which has extensively been studied in the international scientific literature during the recent years. After the first results from the Study of the Seven Countries a lot of scientific data continuously underline the beneficial effect of this diet on health and longevity. People who follow the traditional Mediterranean-Cretan dietary pattern live longer and show reduced rates of various chronic diseases. Recent studies suggest that the adoption of the Mediterranean diet is important for maintaining good health and for preventing many diseases, with advantages being obvious at any age. What are the characteristics of traditional Cretan Diet? If we wanted to sketch a rough pattern of the Cretan diet in the 1960s, we could say that the core of this diet consisted of food derived from plant origin, whereas food of animal origin was more peripheral in nature. In general, people consumed seasonal products, available in the wider local area, which underwent minimal processing or none at all. Fresh and dried fruits, pulses, vegetables, endemic wild greens (horta) and aromatic plants, unprocessed cereals and nuts, whose cultivation was favored by the regional climate, were consumed in great amounts and constituted the basis of the Cretan 1

2 diet during that period. Dairy products were consumed on a daily basis in low to moderate quantities. Poultry and fish were consumed moderately, whereas red meat was consumed only a few times a month. The main supply of fat was olive oil, used not only in salads but also in cooking, unlike the Northern European countries which primarily used animal fat. Another essential feature of the Cretan diet in 1960s was the moderate use of alcohol, mainly red wine which accompanied meals. Finally, a common daily dessert was fresh fruit, while various honey-based traditional pastry had been consumed a few times a week (Willett et al. 1995, Kromhout et al. 1989, Simopoulos 2001). Nutritional value of Cretan diet Concerning the nutritional value, Cretan Diet is high in the beneficial monounsaturated fat, due to the daily use of olive oil, while on the other hand it is low in saturated fats, due to the low consumption of red meat. Generally speaking, it is a dietary pattern that provides all the necessary vitamins and minerals, when consumed in adequate quantities, while it is rich in omega-3 fatty acids, dietary fiber, antioxidants and various phytochemicals which all have significant influence on several functions of the organism (Willett et al. 1995, Kafatos et al. 2000, Simopoulos 2001). Cretan diet as a lifestyle When we refer to the Cretan diet of 1960 we should take into consideration that the diet in question was consumed under specific social conditions and constituted an inextricable part of a general lifestyle. Apart from the specific choice of food, there were probably numerous other factors which contributed to the beneficial effects of this diet to human health. One of these factors is physical activity, as in the study of Seven Countries it has been demonstrated that 62% of men from Crete underwent intense daily physical activity, whereas only 7% of them had a sedentary life or mild types of activity. Intense physical activity, which was connected with necessary movements as well as with the type of work, seems to have contributed to the lower rates of body fat of men in Crete as compared to other populations. (Aravanis et al. 1970). The combination of Cretan diet with regular physical activity made feasible the preservation of a healthy body weight. Finally, in Crete of 1960 meals constituted an occasion for family gatherings, as well as for broader social interactions, and were regarded as a pleasant social experience 2

3 (Bellisle 2008). This is particularly important if we take into account that nowadays a large percentage of people have lunch or dinner in front of the TV or the PC a habit which is related to the over-consumption of food and low quality meals, not only in adults but also in children. (Bellisle et al. 2004, Stroebele et al. 2004, Francis & Birch 2006, Wiecha et al. 2006). Aravanis C, Corcondilas A, Dontas AS, Lekos D, Keys A. Coronary heart disease in seven countries. IX. The Greek islands of Crete and Corfu. Circulation. 1970;41(4 Suppl):I Bellisle F, Dalix AM & Slama G. Non food-related environmental stimuli induce increased meal intake in healthy women: comparison of television viewing versus listening to a recorded story in laboratory settings. Appetite 2004;43: Bellisle F. Infrequently asked questions about the Mediterranean diet. Public Health Nutr. 2009;12(9A): Francis LA & Birch LL. Does eating during television viewing affect preschool children s intake? J Am Diet Assoc 2006;106: Kafatos A, Verhagen H, Moschandreas J, Apostolaki I, Van Westerop JJ. Mediterranean diet of Crete: foods and nutrient content. J Am Diet Assoc 2000;100(12): Kromhout D, Menotti A, Bloemberg B, et al. Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev Med May;24(3): Simopoulos AP. The Mediterranean diets: What is so special about the diet of Greece? The scientific evidence. J Nutr. 2001;131(11 Suppl):3065S-73S. Stroebele N & de Castro JM. Television viewing is associated with an increase in meal frequency in humans. Appetite 2004;24: Wiecha JL, Peterson KE, Ludwig DS, Kim J, Sobol A & Gormaker SL. When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med 2006;160: Willett WC, Sacks F, Trichopoulou A, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 6:1402S- 1406S.2007;18(1):3-8. 3

4 CARBOHYDRATE LOADING The role of carbohydrate loading in sports endurance Carbohydrates, also known as starches and sugars, are your body's main energy source. Complex include pulses, grains and starchy vegetables, such as potatoes, peas and corn. Simple are found mainly in milk, fruits, honey as well as in foods made with sugar, such as various processed food and other sweets. During digestion, are converted into sugars which enter blood-stream and are transported into cells in order to provide energy. Sugars are stored in liver and muscles as glycogen. Your muscles normally store only small amounts of glycogen enough to support you during exercise activities up to 90 minutes. If you exercise intensely your muscles may run out of glycogen. At that point, you may start to become fatigued, and your performance may suffer. Muscles in normal circumstances store as much glycogen as they need in order to support up to 90-minutes physical activities. During longer athletic exercises muscle glycogen is exhausted and fatigue starts leading to decreased physical performance. Carbohydrates constitute the main nutritional ingredient that influences sports performance in endurance exercises. That is why, in addition to the energy needed, an athlete s diet must provide adequate quantities of in the context of a balanced diet (50-55% of the total calories or 5 to 7 grams per kilogram of weight). What is carbohydrate loading? 4

5 Carbohydrate loading also known as glycogen loading is a strategy to store as much glycogen in your muscles as possible to delay the onset of exercise fatigue. This is a strategy for athletes with strenuous physical activity for prolonged time such as marathon runners. Various methods of carbohydrate loading have been proposed, which constitute especially combined nutritional and training protocols. These methods can result in an increase of % of glycogen store and are usually used 3 to 4 days before an important athletic event. Benefits of carbohydrate loading Studies have shown that the training time to exhaustion is directly associated with the glycogen stores in your muscles. Increase in this storage maximizes your physical performance. Carbohydrate loading for a marathon runner will not increase his speed but it will prolong his capacity to run at a certain speed. Starting the race with high glycogen levels, that is with stored, the athlete s organism can support continuous and strenuous muscle function, whereas it can also keep cardio-respiratory and mental function in satisfactory levels. How carbohydrate loading works The key in the practice of carbohydrate loading is the transition from a balanced to a high carbohydrate diet The common technique of carbo-loading was developed by Swedish scientists and consists of two phases: a phase of glycogen depletion with prolonged workout and a low carbo-diet for 2-3 days, and a phase of carbo- loading during which the athlete increases carbohydrate intake to about 70% of total calories and decreases training intensity and duration for the next three days before the event. This classic method has been abandoned because of the particularly exhausting first phase which, due to intense workout and low carbohydrate intake, might cause (weakness, lethargy, irritability, loss of appetite, reduced performance, even muscle strain). Milder techniques have recently been put into practice where the first phase of glycogen depletion was abolished in general. On the first 3 days a moderate carbohydrate intake (50-55%) is recommended, while workouts continue as usual. Then comes the phase of 70% of carbohydrate intake (or 8-10g of per kilogram of bodyweight (table 1). This regimen resulted in muscle glycogen content similar to the carbo-loading of the classical protocol, but the first strenuous and exhausting phase has been avoided. 5

6 The protocol: Day event before Training Diet type Calories from Carbohydrates (g/kg) 6 and 5 days Limited Mixed, moderate in 4 days Limited Mixed, high in 3-2 days Limited or rest Mixed, high in 1day Rest Mixed, high in 55-65% % % % 8-10 Table 1: the above table presents the most commonly used loading protocol Ongoing research suggests alternative ways of loading used in accordance with the athlete s needs. What I should have in mind regarding carbohydrate loading Athletes with health problems such as diabetes and hypercholesterolemia should avoid at least the classical loading protocol, as apart from high carbohydrate intake (final phase), the initial phase also includes a diet rich in fats and protein (poor in ). Specific care should be taken in the simple carbohydrate consumption, as increased intake, apart from the burden of the above disorders might result in diarrhea, nausea and cramps, especially in the cases where there are abrupt changes in nutrition. Accordingly complex and plenty whole-grain foods are suggested for consumption during the loading programs, so that the athlete consumes all the necessary micronutrients as well (e.g. vitamins and trace elements) that are included in this kind of food. Finally, athletes should experiment before an event and avoid drastic changes in their diet. In any case, carbohydrate loading is not a simple procedure, hence cooperation between the athlete and specialized scientists is demanded. 6

7 CRETAN DIET AND CARBOHYDRATE LOADING Cretan diet model is ideal in order to cover the athletes nutritional needs. Cretan diet is, by definition, a nutritional model of moderate carbohydrate content, especially in unprocessed, while white meat and legumes consumption helps in protein intake without high intake of saturated fat. Products and recipes properly modified might support the most demanding phases before an important event, such as carbohydrate loading. 7

8 Below follows 1 daily example from the loading phase of a 75 kg athlete: meals 08:00 1 beverage from cretan herbs with 1 tbsp honey 1 pie from Sfakia with 1 tbsp bergamot spoon sweet 10:00 1,5 cup fresh orange juice 4 small sesame rolls 12:00 4 dried figs 14:00 2 artichokes with lemon Snails with pligouri (recipe) Or Rabbit with rice (recipe) 16:00 3 tbsp raisins 2 tbsp roasted chickpeas 18:00 1 yogurt plain 2% with 1 small apple, 1/3 cup pomegranate, 1 tbsp honey and 2 walnuts 20:00 Dakos with barley rusks and sour myzithra cheese (recipe) Or Potatosalad with boiled potato (270gr), 1 barley rusk (60gr), 1 tomato, 1 small cucumber, 1 onion, 1 egg boiled and 1 tbsp of extra virgin olive oil 22:00 2 dried figs grams of calories 67, TOTAL 569, Μετάφραση από τα Ελληνικά: Παναγιώτα Νιαρχάκου Dr. Eirini V. Theodoraki Dietitian-Nutritionist, MSc, PhD 8

9 RECIPES Snails with pligoùri Ingredients for 4 servings 500gr snails 4 tablespoon EXTRA VIRGIN OLIVE OIL 3-4 Fresh ripe tomatoes 2 cup pligouri 1 onion 1 glass wine Preparation After washing the snails, scald them, saute the onion, add the snails and the wine stirring continuously for 1 to 2 minutes. Add the grated tomatoes, some water and allow to boil over low heat. When it is almost done, stir in the pligouri. Rabbit with rice Ingredients for 4 servings 1 small rabbit 1 onion 4 tablespoons EXTRA VIRGIN OLIVE OIL 1 wine glass red wine 3-4 ripe tomatoes 2 glasses of rice Salt and pepper to taste Preparation Cut the rabbit into medium-sized pieces. Pour the olive oil in a pot and brown the rabbit with onion. Extinguish with wine, lower the heat and simmer adding water as necessary. Add the ground tomatoes and finish off the boiling process. Then remove from the pot, pour 4 glasses of water and bring to a boil. Add rice, salt and pepper. After 10 minutes return the rabbit into the pot and turn off the heat. Dakos Cretan koukouvagia Ingredients for 1 serving 2 barley rusks (60gr each) 1 tablespoon EXTRA VIRGIN OLIVE OIL 2 large, ripe tomatoes, peeled and grated 30γρ sour mizìthra chees oregano salt 9

10 Preparation Dip the rusks half-roll slices in water to soak a little and let them stand to drain. Next, sprinkle them with 1 tbsp olive oil and wait, until the oil seeps into the rusk. Top with the grated tomato and salt and add the sour mizithra cheese and oregano. Serve immediately. 10

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