The Mediterranean Diet
wwwwwwwwwwwwww
Eric Zacharias, M.D. The Mediterranean Diet A Clinician s Guide for Patient Care
Eric Zacharias, M.D. Chairman, Department of Medicine, Boulder Medical Center Assistant Clinical Professor, University of Colorado Health Sciences Center 2750 Broadway Boulder, Colorado USA Additional material to this book can be downloaded from http://extras.springer.com. ISBN 978-1-4614-3325-5 ISBN 978-1-4614-3326-2 (ebook) DOI 10.1007/978-1-4614-3326-2 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2012934830 Springer Science+Business Media, LLC 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
To my colleagues in all fields of clinical care who strive every day to promote health in their patients.
wwwwwwwwwwwwww
Preface For what is likely the fi rst time in the history of mankind, our health is more threatened by easy access to food speci fi cally, high calorie density and low nutrient density food than by food scarcity. The fact that many individuals in our modern society, perhaps even the majority, over-eat unhealthy foods is a common observation, and there are frequent reports in both the professional and lay media of the dramatic worldwide rise in obesity and other morbidity directly related to our diet. A promising counterpoint to the nearly universal trend of the developed world s worsening dietary pattern is the increasing popularity of one common pattern of eating that has actually been shown to reduce rates of disease and obesity and to promote longevity a Mediterranean diet. As an Internal Medicine specialist I have devoted my professional and personal life to investigating diet for health promotion and longevity; I have been encouraged by the scienti fi c research that consistently shows the health bene fi ts of a Mediterranean diet. My interest in this topic led me to spend a 6-month sabbatical researching the Mediterranean diet and lifestyle at its origins in the countries bordering the Mediterranean Sea. This book is a summary of my research on the critical topic of how, in a world where unhealthy food options abound, a Mediterranean diet may be a powerful tool to help reverse the obesity and disease trends directly related to unhealthy eating. Colorado, USA Eric Zacharias, MD vii
wwwwwwwwwwwwww
Acknowledgments There are many individuals who helped me at the various stages of this book. For the initial inspiration, brain storming, and book proposal review Mickey Haynes, John Sergent, Andy Pruitt, Alex Bogusky, and Benjy Mikel and the Department of Food Science, Nutrition, and Health Promotion at Mississippi State University. For the approval of and logistics for a sabbatical in the Mediterranean countries The physicians of the Boulder Medical Center, Sarah Zacharias, Katherine Zacharias, and Luke Zacharias. For research assistance Angela Fredrickson and Margaret Fletcher. For recipe testing and evaluation J. Hill, Amanda Louey, Tara Raposo, Kim Moss, Patrick Green, Greg Faith, Joanna Faith, Gordon Tanner, Anna Tanner, Karl Maier, Julie Maier, Ben Moss, Angela McGrath, Tim Lindholm, Tommie Zacharias, Donald Lancaster, Hilary Lancaster, Karen Savage, Alex Preiser, Leslie Zacharias, Thomas Landry, Charles Cor fi eld, Steve Hartley, Mindy Hartley, David Packard, LaDawn Oliver, Bobbi Watt, Eric Sorenson, Jeannine Fox, Scott Reardon, Sue Reardon, Alan Zacharias, Robert O Herron, Jane O Herron, Walt Wehner, Sarah Altschuler, Kim Mugler, Jennie Smith, Andrew Biglow, Heather Biglow, Caroline Landry, Tiphaine Bonetti, Paolo Bonetti, Scot Thigpen, Kimberly Inkster Thigpen, David Kirk, Molly Kirk, Katherine Zacharias, Luke Zacharias, Sarah Zacharias. For serving as this book s invaluable development editor Maureen Pierce. ix
wwwwwwwwwwwwww
Contents Part I The Basics of a Mediterranean Diet 1 Introduction... 3 2 History, Composition, Adherence Scores... 7 Part II Effects on Diseases 3 Mechanisms of Action and Effects on Diseases... 19 4 Cardiovascular Diseases... 27 5 Alzheimer s Disease... 41 6 Cancer... 47 7 Arthritis, Allergies, and Immunologic Disorders... 53 8 Diabetes and Metabolic Syndrome... 57 Part III Weight Loss and Obesity 9 Weight, Obesity... 63 Part IV Macronutrients 10 Macronutrients in an Adherence Score: Carbohydrates, Proteins, Fats, and Alcohol... 103 11 Fats and Oils... 105 12 Carbohydrates... 127 xi
xii Contents 13 Proteins... 141 14 Alcohol... 153 Part V Adopting a Mediterranean Diet 15 Goal Is Success in Adoption... 163 16 Meal Plans... 171 17 Shopping List, Keep On Hand... 175 18 Resources... 179 19 Recipes... 183 Erratum... E1 Index... 243