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A Strong Demographic Evidence Base Exists For The Fact That The Population ...



A strong demographic evidence base exists for the fact that the population of Crete has the lowest indigenous prevalence of cardiovascular disease in the region (since at least the 1930s when accurate records have been kept) (Allbaugh, L. G. 1953). By way of comparison it can be shown that the death rate from cancer and cardiovascular disease is three times higher in the USA than it is in Crete. (Allbaugh, L. G. 1953). It is suggested that the national diet, being distinctly different from the mainstream USA diet is at least a contributory factor in this discrepancy.


Mediterranean Diet and cardioprotection
Interest in the Mediterranean Diet (we shall define this term in greater detail shortly) as a cardioprotective diet arguably began in the late 1950's with the work of Prof. Keys and his numerous studies in the field of cholesterol metabolism (Keys et al. 1956) and cardiac mortality (Keys et al. 1957) in a number of different national settings (Keys et al. 1957) (Keys et al. 1955). Keys and his co-workers were able to demonstrate that the populations around the Mediterranean area (particularly the Greek population) had the lowest incidence of some forms of cancer and coronary artery disease of the populations studied and postulated that this may, in part, be genetic in origin, but may also have a specific dietary component. (Keys, A. 1970). Keys work was primarily statistical and simply recorded the differences in demographic and morbidity distribution but it opened the way for further studies by himself (see on) and others to try to determine the relevant factors behind the differences.

The hypothesis relating to the importance of the dietary component has been extensively investigated further by a number of centres and some have reported a reduction in recurrence rates of symptomatic coronary artery disease after an initial episode (or event) of between 30% (Singh R B et al. 1992) and 70% (de Lorgeril M et al. 1994) if patients were placed on a specific type of diet. We note that this is after a spate of studies which considered the effect of primarily reducing cholesterol with variations of low cholesterol, low-saturated-fat, high-polyunsaturated-fat diets all of which showed no real improvement in the overall trajectory of coronary artery disease and its outcome. (de Lorgeril M et al. 1997).

The successful trials of this period were found to be those which were primarily characterised by reduced intake of total cholesterol and saturated fats together with an increase in the dietary intake of either marine or plant derived omega-3 fatty acids. The stated object in these trials was not specifically to reduce total cholesterol levels.


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