Go Nuts with the Mediterranean Diet to Reduce Disease Risk

Good news for nut lovers everywhere: the traditional Mediterranean diet plus a daily dose of nuts may help conquer metabolic syndrome, a condition defined by the presence of several risk factors for heart disease, diabetes, and stroke. These risk factors include high blood pressure, high triglycerides (fat in the blood), low HDL (“good”) cholesterol, insulin resistance or high blood sugar, and carrying excess weight around the belly and upper body (central obesity).

Up to 25% of US adults have metabolic syndrome, so identifying ways to better manage this condition is vital. A large study of Spanish adults suggests the answer may lie in nuts.

Think Mediterranean

These findings come out of Prevenci?n con Dieta Mediterr?nea (PREDIMED), an ongoing diet study of 9,000 Spanish adults. To arrive at the latest results, researchers assigned 1,224 men and women to follow one of three diets: a Mediterranean diet plus about one ounce of mixed nuts (walnuts, hazel nuts, almonds) per day; a Mediterranean diet plus additional extra virgin olive oil; or a low-fat diet (control group).

Participants were 55 to 80 years old and free of heart disease at enrollment. They had other heart disease risk factors including diabetes, high blood pressure, high LDL (“bad”) cholesterol, low HDL (“good”) cholesterol, being a current smoker, being overweight, or having a family history of heart disease. An average of 61.4% of people in the three diet groups had metabolic syndrome at the beginning of the study.

After one year of follow-up, the presence of metabolic syndrome was significantly lower only in the Mediterranean diet plus nuts group. Metabolic syndrome prevalence was reduced by 13.7% in this group. As well, researchers noted that metabolic syndrome was 70% more likely to reverse in people in the Mediterranean diet plus nuts group compared with the low-fat diet control group. In other words, people in the Mediterranean diet plus nuts group were significantly less likely to show features of metabolic syndrome, such as high blood pressure or insulin resistance, after following the diet for a year.

Nuts and beyond

Metabolic syndrome is a serious condition that requires serious attention. Use the following tips to avoid this condition or manage it more effectively.

• The single best way to avoid or manage metabolic syndrome is to maintain a healthy body weight. If you are overweight, especially if you carry that weight around your mid-section, make weight loss a priority.

• Ask your doctor for a referral to see a dietitian, who can develop a weight loss plan tailored to your individual needs. With the right support, you can reach your weight loss goals.

• Tend toward Mediterranean eating habits. The Mediterranean diet is characterized by using extra virgin olive oil for cooking and as the main fat in your diet, eating plenty of vegetables and fruit, having fish a few times per week, enjoying nuts as a snack and for cooking, replacing refined grains with whole grains, and limiting red meat, butter, and other sources of saturated fat.

• Move more. Regular exercise is important not only for weight loss and maintenance, but also to lower blood pressure, improve insulin resistance, and lower cholesterol levels.

December 24, 2008

(Arch Intern Med 2008;168:2449–58)

Suzanne Dixon, MPH, MS, RD, an author, speaker, and internationally recognized expert in chronic disease prevention, epidemiology, and nutrition, has taught medical, nursing, public health, and alternative medicine coursework. She has delivered over 150 invited lectures to health professionals and consumers and is the creator of a nutrition website acclaimed by the New York Times and Time magazine. Suzanne received her training in epidemiology and nutrition at the University of Michigan, School of Public Health at Ann Arbor.

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