Mediterranean diet healthy but no guarantee of good health

If things worked the way we thought they should, Dun Gifford would still be alive. • Gifford, a longtime advocate of healthful eating and particularly of the Mediterranean diet, died May 9 at age 71. The cause was reported as a heart attack. (More on that in a moment.) • We never like to hear of someone's death, especially someone as full of life as Gifford was. I interviewed the founder of the Boston "food think tank" Oldways in December 2008 for a column about preparing a Mediterranean-style holiday feast. But Gifford's death is unsettling on another level. The olive oil- and veggie-filled Mediterranean diet is supposed to help ward off Alzheimer's disease, colon cancer and, yes, heart disease. If a man who adhered to the diet considered by many experts to be the most healthful succumbs before he hits 75, how much stock can we put in it?

Linda Van Horn, professor of preventive medicine at Northwestern University and chairwoman of the 2010 Dietary Guidelines for Americans Advisory Committee, says Gifford's death is no reason to lose faith.

"There is no question that a Mediterranean-type diet, when consumed under energy-balanced conditions, offers a vast array of essential nutrients that can help meet the requirements of most healthy people," she said via e-mail. "The emphasis on plant-based foods, unsaturated fats, fish and fiber-rich grains will achieve nutrient adequacy for most people."

Van Horn points out that no diet alone can guarantee good health. "Diet is a major influence on health, but not the only influence," she writes. She cites behaviors such as exercise and stress, as well as effects from the environment and genetics as factors that affect a person's longevity.

By one measure, Gifford's death wasn't all that premature. According to federal life-expectancy tables, a white man born in 1938, as Gifford was, can expect to live to 63.

But most of us want to live far longer than 71 years. And many of us are counting on our diets to help get us there.

One of the trickiest issues to resolve when choosing such a diet is whether to partake of alcohol. We've all heard that moderate alcohol consumption can reduce risk of cardiovascular disease, and the Mediterranean diet promotes moderate drinking, specifically of wine, with meals, in part because it's good for your heart.

That's backed up by science. Kenneth Mukamal, associate professor of medicine at Harvard Medical School and author of a recent article on alcohol and health in the Journal of the American Medical Association, says numerous studies have shown that "regular consumption of small amounts of alcohol is beneficial" and that, "on average, countries that have higher proportions of people drinking moderately tend to have lower rates of heart attack."

Yet that's not how things worked out for Gifford.

I spoke with Sara Baer-Sinnott, Gifford's partner and, since his death, president of Oldways, in hopes that she could offer some perspective. She explained that Gifford's heart attack most likely was due to a blood clot. He had a lot of those, she said, since having leg surgery decades ago. He had confessed to forgetting to pack his special anticlot socks when the couple traveled to Europe and Australia just before he died, she said. (Long airplane flights increase the risk of blood clots forming.) She'll never know for sure because no autopsy was conducted.

Baer-Sinnott does allow that Gifford, at 6 feet 4 and about 230 pounds, "had a little extra around his waist." "He did love food," she says with a laugh.

Naturally, she doesn't think people should discount the Mediterranean diet because of Gifford's death. "There are people whose time comes sooner than it should," she says.

Van Horn agrees. "The Mediterranean diet is rich in nutrients, fish, fiber and flavor that offer benefits that transcend cardiovascular disease, to also help lower risk for diabetes, certain types of cancer and hypertension, as long as weight gain is avoided and other lifestyle behaviors such as physical activity are also included," she writes.

Mukamal notes that Gifford's father, Clarence, a renowned wine expert, lived to age 91. In any case, Mukamal says, "it's a bad idea to make policy based on anecdote."

I suppose the real lesson here is to continue to eat as healthful a diet as you can and to savor every mouthful, because you never know if it might be your last.

Mediterranean diet healthy but no guarantee of good health 07/02/10 [Last modified: Friday, July 2, 2010 1:16am]

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