In this second blog, Miguel clears up some misconceptions about the Mediterranean diet and focuses on the key nutrients in this style of diet that can contribute to a healthier, younger brain and rest of the body.
Saying that a diet is “Mediterranean” is as broad as saying it’s “vegetarian”, or indeed “vegan”. Vegetarian and vegan diets can be incredibly balanced and healthy but not necessarily so, alas, I am sure everyone knows a vegetarian who lives on crisps and chocolate bars. I have found that some food manufacturers misuse the term Mediterranean diet because it’s trendy and it sells. They may even advertise their products as “rich in olive oil” in a Mediterranean-style TV campaign with people smiling around a table, enjoying a colourful meal. When it comes to reading the label, you may be surprised that there’s hardly any olive oil in the product. Or a tiny percentage, as I found recently in a pesto sauce and a mayonnaise, both sold as “rich source of olive oil”, both with under 5%. The rest was rapeseed and sunflower, not at all Mediterranean! So my advice as a Med-born practitioner is to always read the label.
With that out of the way, I’d like to focus on what I believe to be the key elements that make Mediterranean-style a success for metabolic and brain health:
- Olive oil. As outlined last week, several natural antioxidants in olive oil contribute to mitochondrial health. Mitochondria are the power plants that produce energy inside every cell in the body, and it seems that olive oil keeps them happy and young as we age. Another misconception is that extra virgin olive oil (EVOO) cannot be used for cooking. The only reason you’d not want to use it for culinary purposes is because of its taste. A very strong EVOO can overpower a dish, but you won’t be “eating trans fats” like I’ve heard some people say, particularly promoters of coconut and other fats for cooking. EVOO only degrades at temperatures of 180C and higher, and even then the degradation is minimal because of the protective role of the 300+ natural compounds that it contains. My advice is to cook at low temperature and never deep fry or make the oil smoke. If you’re adding it to dishes where there’s plenty of water already, e.g. a stew or casserole, water can only go up to 100C before it evaporates, so any olive oil you add to that dish whilst cooking will only go up to 100C also. In other words, adding a little water to stir fries or any other dishes where you may use EVOO to cook with is also a great way to reduce the temperature and avoid fumes that can lead to the olive oil degrading. I hear people say also that olive oil can be “dirty” in terms of production techniques. My recommendation is to choose an organic EVOO that’s been produced solely by mechanical means, i.e. this type of EVOO has been cold-pressed so it’s as “clean” as you can get. Olive oil has been shown to be one of the key anti-inflammatory natural substances in Mediterranean style diets. If you’re interested in the science behind this, I suggest you revisit last week’s blog.
- The Mediterranean diet that I was brought up on included regular consumption of pulses (e.g. lentils, chickpeas, beans) and masses of green vegetables. Fibre helps with blood sugar balance after a meal, and it also helps with the excretion of excess fat. There are many dishes in Mediterranean countries that will never make it to any Mediterranean diet pyramid or be featured in any recipe book, yet they are eaten my millions of people in Mediterranean regions every day. In the attached photographs, I’ve included a few of my mum’s most delicious Mediterranean dishes that fit exactly in that category. They’re all intensely high in saturated fat and all contain red meat, all of the things that the “Mediterranean diet” is supposed to include only sporadically (links to recipes are included at the end of the blog).
But they’re also all eaten with copious amounts of fibre from various sources, and particularly from beans, lentils, peas, chickpeas, etc. which are a very important part of Mediterranean cuisine, and who doesn’t like hummus! Fibre from legumes helps bulk up the stool and facilitates the excretion of excess fat. Additional fibre (both soluble and insoluble) from other sources, such as green leafy and cruciferous vegetables is also conducive to better cardiovascular health and less overall inflammation, both in the gut and overall / systemically. Dietary fibre protects LDL (“bad”) cholesterol from oxidising. It’s not the amount of LDL per se, but its oxidation that’s the problem. Hydroxytyrosol and oleocathal, two of the main antioxidant molecules in olive oil, also have the same function. It is perhaps not coincidental that the consensus on the Mediterranean diet is that its beneficial effects are attributed to the synergy between its components, which amounts to a lot more than the mere sum of the individual parts.
- The rich colours in a typical Mediterranean-style diet have an additional mode of action. They regulate the cellular metabolism by modulating the activity of certain enzymes known as sirtuin (SIRT) enzymes. Sirtuin activation is associated with better mitochondrial health and function, as well as with improved repair and growth of brain cells, and with reduced oxidative stress and inflammation, all consistent with enhanced clinical outcomes in later life. It is safe to say that individuals who do not follow a Mediterranean eating pattern, could improve their health by including a range of natural polyphenol sources in their diet. Some include deep greens from leafy cabbages and peppers, white/beige from onions and leeks and bright reds from red grapes and peppers. Failing that, taking a supplement containing a variety polyphenols such as those that would be featured in a Mediterranean region, like quercetin, resveratrol and grape seed extract, in a dose that resembles that of a typical dietary exposure for an inhabitant of the area would be a good thing to invest in. I don’t recommend mega-dosing, and benefits are driven not only by dose but by continuity of exposure, as well as by compound synergy which means that doses should be low in order to be safe. Something as low as 100mg of each / day could provide some of the benefits of these phenolic compounds on a number of body systems. Some of these polyphenols act as “calorie restriction mimetics”, they trick cells to “think” calories are being restricted. Caloric restriction switches on certain protective mechanisms in the brain (like the production of neurotrophic factors) that are associated with enhanced cognition and general brain function.
- B vitamins. Oxidative stress is a hallmark of neurodegeneration and a common biomarker that allows healthcare professionals to assess the severity of this inflammation is homocysteine, a methylation cycle intermediate. High levels are often seen in individuals whose serum and/or blood red cell levels of methyl donor B-vitamins, e.g. folate (B9), B6 and cobalamin (B12) are low. This picture is more prevalent after the age of 60 and very often seen in Alzheimer’s patients. Methyl donor B vitamins are provided in good amounts by a Mediterranean-type diet, by means of readily available foods such as spinach, cabbages, wholegrains and fresh meats, as well as organ meats. I’d rather get B vitamins from non-grain sources. Firstly because grains are not the greatest sources of B vitamins, and secondly because they increase the glycaemic load of meals quite dramatically. Meals that are higher in starch are more likely to disrupt blood sugar control and to contribute to inflammation, two things that we want to avoid at all cost if we want to keep our brain young. Green vegetables and meat (red in moderation) are excellent sources, so I’d stick with these two.
Just a reminder that not all individuals are able to process dietary folate and B12 appropriately due to unfavourable genetic variations. This means that there are plenty of considerations to take into account, many of them genetic, and particularly around MTHFR and other methylation cycle mutations. For example, while some genetic variants seem to be negatively associated with the development of Alzheimer’s some others show a significant association with susceptibility to the development of the disease. A simple saliva swab test can help determine the MTHFR status of the individual, providing further support for the clinical decision to include supplementary folate as part of a nutritional intervention programme. (See Cytoplan blog on Genetics of Alzheimer’s )
- Vitamin A. Retinol, retinal, retinoic acid and β-carotene have all been shown to inhibit the formation, extension and destabilising effects of amyloid β proteins in in vitro studies of Alzheimer’s disease. Vitamin A and β-carotene are also abundant in a Mediterranean-type diet, from sources including cheese and fermented dairy products (sources of vitamin A), carrots, melon, and summer squashes (sources of β-carotene). Additionally vitamin A is widely reported in literature documenting synaptic plasticity, learning and memory, as well as sleep processes, appearing to enhance the effects on acetylcholine transmitter functions in brain cholinergic neurons. Given the extent of the evidence on the amount of neurobiochemical features that require retinoids for optimum function vitamin A warrants a place on the supplementary programme list. (See cautions below).
- The “MediterrAsian diet”. Now we’ve discussed the myriad of protective benefits attributed to a Mediterranean-type diet why not turn our attention to the East and complement the bioactive components of the Mediterranean diet by adding some of those characteristic of Asian diets, e.g., soy bean isoflavones shown to improve cognition by means of modulation of oestrogen receptors and epigallocatechin gallate (EGCG) phenolic compounds from green tea which exhibit a number of beneficial properties, from radical scavenging to metal (e.g., iron and copper) chelating, thereby providing neuroprotective activity. Another interesting compound is curcumin, which is known to improve amyloid β destabilisation in mouse models and has a well-documented anti-inflammatory activity in humans. Soy isoflavones, green tea extracts and curcumin can all be supplemented, but, in order to improve compliance and limit the amount of supplements to be taken daily, these can also be included as “functional foods” in our daily cooking, e.g. adding half a teaspoon of turmeric powder to cooking, eating tofu or drinking green tea a few times a week.
In summary, given the fact that brain ageing is a complex process that develops gradually over time, it would be simplistic to assume that supplementing with one single ingredient of a successful dietary model, e.g. one single vitamin, mineral or antioxidant, would be able to bring about enough change to make a difference. Instead the Mediterranean diet provides a naturally occurring and well documented model for neuroprotection. I recommend introducing food-based changes to a typical British diet, perhaps step by step, the most important being the use of olive oil, some raw (unheated), some in cooking. For specific nutrients that you may be missing or could do better with, a supplement can help.
Links to recipes shown in photos:
Fabada (butter beans):
Cocido (chickpeas): https://madridfoodtour.com/cocido-madrileno-recipe/
Caution with supplementing with vitamin A:
Pregnant women or women planning a pregnancy need to be cautious with vitamin A intake and should discuss any supplementation with their medical practitioner.
Vitamin A should not be taken long-term by heavy smokers or those who have ever smoked heavily.
Relevant Cytoplan products
Cyto Renew – a product that helps to support healthy cell metabolic activity, containing Acetyl-L-Carnitine, Alpha Lipoic Acid, Ginkgo Biloba, CoQ10, N-Acetyl-L-Cysteine and Rosemary extract 5:1.
Phyte Inflam – a natural phytonutrient herbal complex containing curcumin from turmeric and gingerols from ginger root which collectively bestow a wide range of anti-inflammatory properties.
Phyto Flavone – contains 100% natural isoflavones made from soy germ.
Phytoshield – a very potent and powerful phyto-antioxidant nutrient formula containing high levels of flavonoids and carotenoids.
CoQ10 Multi – All-encompassing multivitamin and mineral formula with nutrients at optimal levels in the most bio-effective form, including B vitamins. (Also known as 50+).
Miguel is a nutrition practitioner, author and researcher with extensive knowledge and expertise in functional medicine and ageing science.
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With many thanks to Miguel for this article. If you have any questions regarding the topics that have been raised, or any other health matters please do contact me (Amanda) by phone or email at any time.
firstname.lastname@example.org, 01684 310099
Amanda Williams and the Cytoplan Editorial Team: Miguel Toribio-Mateas, Clare Daley, and Jo Doverman