Mediterranean diet vs. American Heart Association Diet

18. June 2007 William Davis (4)
In 1994, the Lyon Heart Study demonstrated a 50-70% reduction in coronary events in participants who followed a diet rich in vegetables, olive oil, fish, nuts, red wine, and enjoyed meals as a family activity. Various other studies have documented similar phenomena with less metabolic syndrome, better lipid patterns, less obesity with the Mediterranean lifestyle.

There are two fundamental differences between the Mediterranean diet and the diet advocated by the American Heart Association (AHA) for people with heart disease: the Mediterranean diet uses olive oil more liberally, such that fat calories can reach 40% of total; and, unlike the AHA diet, processed foods are not a part of the Mediterranean diet. Greeks, for instance, are far less likely to eat Count Chocula cereal for breakfast, or snack on Healthy Choice Premium Caramel Swirl Sandwich (ice cream sandwiches) or Malt-O-Meal Honey Nut Scooters. All three of these foods on listed on the AHA Heart-Check Mark heart-healthy program.

In other words, remove all the processed foods, and the AHA diet pretty closely resembles the Mediterranean diet. There are differences but they tend to be relatively small. If the only major difference is the presence of processed foods, wouldn't you therefore expect the AHA to embrace the Mediterranean diet?

Here's what their official stand on the Mediterranean diet states:

Does a Mediterranean-style diet follow American Heart Association dietary recommendations?

Mediterranean-style diets are often close to our dietary recommendations, but they don’t follow them exactly. In general, the diets of Mediterranean peoples contain a relatively high percentage of calories from fat. This is thought to contribute to the increasing obesity in these countries, which is becoming a concern.



The AHA is actually lukewarm towards the diet that was the first to show a dramatic decrease in heart attack and death. Why?

The answer is obvious, once cast in this light. To wholeheartedly endorse the Mediterranean diet might be seen as an indirect rejection of American processed foods. You know, the foods that have caused an extraordinary and unprecedented epidemic of obesity in the U.S., the foods that are manufactured by ConAgra, General Mills, Kelloggs--all also major financial contributors to the AHA, according to the AHA Annual Report.

I tell my patients: If you want heart disease, follow the American Heart Association diet. In my view, it is a diet founded on politics and money, not on health. How else could Cocoa Puffs be regarded as heart healthy?
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Comments (4) -

  • DietKing2

    6/18/2007 1:25:00 PM |

    Hey Doc, leave my Count Chocula and Cocoa Puffs alone, man! Well, at least you didn't go after my beloved Cocoa Pebbles! (This is what I was raised on...wonder why I'm addicted to sugar??)
    I'm just kiddin ya, you know that. It just annoys me when you bring these things to light-the AHA witholding support of a diet (or lifestyle perhaps?) that is obviously so much better than their program. This is a group of supposedly intelligent professionals who you would think would want what's best for the American people as a whole.
    Enjoyed reading this post, but I still wish they'd invent 'Mediterranean Cocoa Pebbles' or something. LOL
    Adam

  • Anonymous

    6/30/2008 12:11:00 AM |

    Uh huh. Now I see what has been going on when my husband has been in the hospital for a 4 in 1 heart procedure (aortic valve replacement, one bypass, MAZE {?} procedure and restructuring of a portion of a heart chamber). I invariably raised my eyebrows at his food tray, but finally flipped out when a breakfast tray had french toast with syrup, Frosted Flakes and apple juice, in addition to eggs, sausage and milk. My husband loved every bit of it because he rarely gets that type of food at home. In fact, Frosted Flakes and their kin are strictly banned in this house since we're both fighting a tendency toward high blood sugar.
    Then there was the hospital version of chicken fried steak, with gravy yet. Pork chop another day, with gravy of course. Plenty of gravy on potatoes and butter for rice and rolls. A turkey sandwich on white bread for an evening snack, with a hefty packet of mayo. Smuckers peanut butter. And on and on I could go.
    I wanted to run through the hospital kitchens screaming, "Are you people nuts? Or are you trying to assure repeat visits?"
    Incidently, this was the "regular" hospital diet which my husband's heart surgeon allows during his patient's recovery period.
    Another week or two of this at home and then he's supposed to buckle down and eat right. Oooookay. But Frosted Flakes are still banned.

  • Anavar

    5/18/2010 11:56:31 AM |

    No diet is necessary if you just change white carbs for whole grains and bad fat for good fat. And weight will be gone for sure. And of course exercise must be included too. No diet is as successful as this.

  • buy jeans

    11/3/2010 7:33:19 PM |

    In other words, remove all the processed foods, and the AHA diet pretty closely resembles the Mediterranean diet. There are differences but they tend to be relatively small. If the only major difference is the presence of processed foods, wouldn't you therefore expect the AHA to embrace the Mediterranean diet?

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How tough is the Track Your Plaque 60-60-60 target?

How tough is the Track Your Plaque 60-60-60 target?

9. August 2007 William Davis (3)
One of the basic requirements that stack the odds in your favor of stopping or dropping your CT heart scan score is to achieve basic lipid targets of 60-60-60.

In other words, we generally see best results when LDL is reduced to 60 mg/dl, HDL raised to 60 mg/dl, triglycerides reduced to 60 mg/dl. Now, these are not absolute requirements. Someone can have a spectacular drop in heart scan score even with an HDL of 56, LDL of 71. But the "Rule of 60" provides a useful target that is easy to remember, packs real power, and is clearly beyond that achieved with conventional approaches.

People often ask, "Just how tough is it to get to these targets?"

It's really not that tough. Interestingly, whenever I tell my cardiologist or primary care colleagues that I advocate these 60-60-60 targets, they declare that it's tough, perhaps impossible, except for the most highly motivated.

I agree that it requires motivation. A cigarette-smoking, TV-addicted, 70-lb overweight, chip- and pretzel-eating couch potato is not going to achieve them.

On the other hand, you don't have to be a marathon running vegetarian to do it, either.

Most people, in fact, engaged in the Track Your Plaque program achieve the 60-60-60 targets---or exceed them. It's not uncommon, for instance, for HDL to skyrocket to 80 or 90 mg/dl with many of our strategies. (Of course, if your starting HDL is 20 or 25 mg/dl, 80 or 90 is not possible with current technology.)

But it certainly does require more than the "Take Lipitor and stick to your low-fat diet" approach that is the mantra repeated in the vast majority of medical offices across the U.S. For instance, reducing LDL to 60 mg/dl when starting at 170 mg/dl will require addition of oat bran and other soluble or viscous fibers; raw almonds and walnuts; perhaps the use of Benecol butter substitute; reduction or elimination of wheat products if small LDL comprises a substantial proportion of LDL particles. Reducing triglycerides requires the generous use of omega-3 fatty acids from fish oil. Attention to vitamin D must be a part of the effort.

So, yes, it is not as simple as the conventional approach. But the results are far superior in reducing or eliminating heart attack and in dropping your heart scan score.

But it can be done. We do it every day.
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Comments (3) -

  • Anonymous

    8/11/2007 3:12:00 PM |

    Dear Dr. Davis,

    I am a 49-year-old woman. I have a 21-year-old mentally handicapped child and a son who is starting at GA TECH this Fall. I homeschooled both of them most of the way through school. I now help my husband run a home-based business. Needless to say, I spent many years pretty much ignoring my health needs. In February, 2007, I became very ill with strep from which I was not recovering well. My FP did blood work and discovered that my blood sugar was 477, my triglycerides 261, my HDL 42, and my LDL 129 (Total cholesterol: 223). He prescribed Metformin (2 extended release per day), and I embarked on a diet and exercise program. I have lost over 30 pounds, and my new lab results from 2 weeks ago were: blood sugar - 102, triglycerides - 119, HDL - 47, LDL - 150, and total cholesterol - 221. I have been taken off of Hydrochlorothiazide and am being switched slowly from Atenolol to Prinivil. My blood pressure is usually around 100/65 now.

    My doctor wants to put me on Simvastatin, but I prefer to try some natural means of normalizing my cholesterol before adding yet another med with another set of side effects.

    I have been eating very little bread, a little fruit (mostly berries or cantaloupe), lots of salad (very little dressing), green veggies, lean meat (mostly chicken or fish), and some beans (lima, garbanzo, pinto, or black).

    I would love further suggestions from you.

    Glenda Parkman

  • Dr. Davis

    8/11/2007 4:11:00 PM |

    Hi, Glenda--

    Those are spectacular results and testimony to what lifestyle changes alone can accomplish.

    Please note that this Blog accompanies the conversations on the Track Your Plaque website. It is not meant to be a source for the full discussion. Please refer to the website.

  • Dick Lyshek

    10/7/2010 4:39:10 AM |

    Dear Dr. Davis,

    I have relatives in Waukesha and Madison that are looking for a doctor that follows your protocols.  I would greatly appreciate any suggestions you could make.

    Sincerely

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