December 20, 2013

Ask the Doctors

We hear a lot about the Mediterranean diet. Is it better than a vegetarian diet—either vegan or lacto-ovo vegetarian?

The Mediterranean diet has been in the news since a study published recently in the New England Journal of Medicine reported their positive findings. Actually, in the study, the larger group was divided into three groups. One was supplemented with mixed nuts, another with olive oil, and the third on a fairly typical Mediterranean diet.

A Mediterranean diet is low in saturated fats but high in monounsaturated fats (MUFAs). It contains little red meat, processed foods, or dairy. The use of fish and poultry is common in the diet, and liberal use is made of vegetables, fruits, whole grains, legumes, wine, and olive oil.

It’s very difficult to isolate the effect of individual components of a diet, but the recent study did help somewhat in that it demonstrated that the addition of about one ounce of nuts and four tablespoons of olive oil a day reduced risks of cardiovascular events.

The message this study brings to the forefront is that rather than total fat intake, we ought to focus on the type of fat we consume. Fat, of course, is very high in calories, and while we should shift to good fats (as found in nuts and olive oil) and away from saturated fats (as in meat and dairy fat), we can have too much of even good things and easily become overweight.

Many have felt that the wine in a Mediterranean diet must be beneficial, but considerable doubt exists about the quality of many of the studies purporting to show cardiac benefits of alcohol, and considerable evidence is accumulating about the negative effects of alcohol, such as increased cancer rates and a propensity to its abuse.

The fish content of a Mediterranean diet may also contribute a better fat profile, as fish oils are significantly better than animal fats.

The Adventist Health Studies have demonstrated a colon cancer risk even with white meats. Currently the Adventist Health Study II (AHS2) is not fully conclusive, but has demonstrated a clear advantage to the three main types of vegetarian diets: total, lacto-ovo, and pesco (fish-containing). Eventually the AHS2 might be able to show the differences between even these three vegetarian types of diet, but at this point they are not statistically significant.

It’s our belief that a well-balanced vegetarian diet is somewhat superior to the Mediterranean diet, and it appears that even a good diet may be improved by the substitution of nuts and olive oil for the more usual fats in our diet.