Measures of Central Tendency: Mean, Median and Mode
Matala karanou'07.11
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5. The Seven Countries Study (SCS) an epidemiological survey among 12,763 middle-aged men The SCS was the first to reveal the relationship between diet and heart disease
6. 10-year heart disease rates in the SCS Keys A., Circulation, 1970 All-causes mortality was also the lowest in Crete (6 deaths/1,000)
12. 25-year Coronary Heart Disease mortality in the SCS 0 50 100 150 200 250 FIN NL USA SE IT CR GR JP CHD death rates per 1000 in 25 years Hertog et al. Archives of Internal Medicine 1995
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14. The Cretan diet of the 1960s became the basis of a dietary prototype, the Mediterranean diet Oldways Preservation and Exchange Fund, The Mediterranean Pyramid, 1995 Kromhout, Keys, Aravanis et al. 1989 18 100% alcohol 12 Sugar 18 Fish 3 5 Meat 13 & 235 Cheese and milk 95 Olive oil 464 Fruit 191 Vegetables 30 Legumes 190 Potato 30 Pasta & rice 380 Bread Average g/cap 1960-5, n=51 FOOD
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16. Therapeutic Lifestyle Changes based on the Mediterranean diet proposed by the European Heart Association * Lower trans fatty acids ** Emphasize complex sources Expert Panel , JAMA 2001 Balance energy intake and output to maintain expenditure healthy body weight/prevent weight gain Total calories (energy) Less than 200 mg/day Cholesterol Approximately 15% of total calories Protein 20–30 grams per day Fiber 50–60% of total calories Carbohydrate** 25–35% of total calories Total fat Up to 20% of total calories Monounsaturated fat Up to 10% of total calories Polyunsaturated fat Less than 7% of total calories Saturated fat*
17. Olive oil as the critical dietary component ‘ The generic term “Mediterranean diet” has come to be used, as referring to dietary patterns similar to those of Crete in the early 1960s and other regions of the Mediterranean where olive oil is the principal source of dietary fat .’ Willett et al., 1995 But no other epidemiological study has been able to demonstrate a direct relationship between mortality and the intake of olive oil or monunsaturated fat A question raised: Is olive oil beneficial by itself, or is it that it facilitates a high vegetable intake?
18. More questions raised …. Clinical studies using olive oil in high risk patients have failed to provide solid support for an inverse relation between olive oil and coronary heart disease Bertuzzi M, et al. Int J Epidemiol 2002; Fernández Jarne et al., Int J Epidemiol 2002
19. a-linolenic acid (an omega-3 fatty acid) as the critical component The Lyon Heart Study: a clinical evidence Clinical intervention in 605 patients with one non-fatal myocardial infraction Followed for 27 months Randomized into two diets: Modified Med diet (using margarine rich in a-linolenic) & Step I AHA diet Incidence of a 2nd myocardial infraction was reduced in MD by 70% De Lorgeril M. et al. Circulation 1999
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21. Mediterranean-inspired diets The Indo-Mediterranean Diet Heart Study A clinical trial in India to test the efficacy of a-linolenic to reverse the progression of heart disease Clinical intervention among 1000 patients with high risk for MI Followed for 2 years Randomized into two diets Indo- Mediterranean diet : whole grains, fruits, vegetables, soy oil, walnuts and almonds (573±127 g/day; 1.8g/day of a-linolenic), and Low fat diet (Step 1 prudent diet) : whole grains, fruits, vegetables, soy oil, walnuts and almonds 231 ± 19 g/day; 0.8 g/day of a-linolenic) Incidence of fatal myocardial infraction was almost three-fold lower in the Indo-Mediterranean diet (p<0.01) Singh et al. Lancet, 2002, retraction 2005
22. Moderate and daily use of alcohol as the critical component Among Greek adult men and women (n=12 694) of the EPIC prospective study: Moderate consumption of ethanol was found to be the only dietary factor that significantly contributes to decreased mortality when controlling for the other dietary factors Trichopoulou et al. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ 2009
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24. The importance of the geographical and social dimensions of the Mediterranean diet I Olive oil consumption patterns, versus living in the ecosystem where the olive tree grows
25. The mythical Cretan diet is in part, the result of necessity ‘ Τ heir food consists chiefly of olives, beans, onions, bread, cheese and vegetables…’ Basil Stewart 1908 The importance of the geographical and social dimensions of the Mediterranean diet II
29. 25-year CHD mortality in relation to serum cholesterol in the Seven Countries Study Verschuren, W.M. et al. (1995). Serum total cholesterol and long-term coronary heart disease mortality in different cultures: Twenty five-year follow-up of the seven countries study. JAMA, 274 (2).
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31. Meditarranean diet and the metabolic syndrome Kastorini, Milionis, Goudevenos, and Panagiotakos, EAS 2010
Notes de l'éditeur
The Meditarranean diet has been a success story of the nutritional epidemiology in the second half of the 20 th c.
Η SCS ήταν μια πολυεθνική προοπτική μελέτη που διερεύνησε τη σχέση ανάμεσα στη δίαιτα και την ολική και καδιαγγειακή θνησιμότητα σε υγιείς μεσήλικες άνδρες (45-60 ετών) σε οκτώ χώρες και 16 κοορτές (δηλ. Περιοχές).
Το 1970 , όταν προέκυψαν τα ευρήματα μετά την πρώτη πενταετία παρακολούθησης, ο Ancel Keys απέδωσε τις παρατηρούμενες διαφορές στα ποσοστά CHD στην M εσογειακή Δίαιτα Keys A., Circulation, 1970
Menotti and colleagues examined the association between the consumption of simple food-groups and the 25-year mortality from CHD. So the well known results from this study is the idea that dietary patterns are an important determinant of CHD risk, and propososed the Mediterranean diets’ cardioprotective effect.
Menotti and colleagues examined the association between the consumption of simple food-groups and the 25-year mortality from CHD. Diets rich in butter, dairy products and other animal products (usually rich in saturated fatty acids and cholesterol) were associated high rates of CHD while, food consumption patterns high in cereals, legumes, vegetable products, fish, oils and wine were associated with low or relatively low mortality rates from CHD. Greece –and primarily Crete- and Japan experienced the fewest death rates caused by CHD; USA, Finland, and The Netherlands, experienced the most. So the well known results from this study is the idea that dietary patterns are an important determinant of CHD risk, and propososed the Mediterranean diets’ cardioprotective effect.
After 2 5 years of follow up the study demonstrated that the mortality rate from coronary heart disease in southern Europe was 2- to 3- fold lower than in northern Europe or the United States.
Η πυραμίδα της Μεσογειακής Δίαιτας που προτάθηκε το 1995 και έχει υιοθετηθεί και από το ελληνικό Υπουργείο Υγείας ως ένα υπόδειγμα διατροφής για τη πρόληψη της χρόνιας νόσου, βασίσθηκε στα δεδομένα της της Μελέτης των Επτά Χωρών
Deuterogenis prolopsi Rafanidelaio rape seed oil oi thnisimotita logw emfragmatos ;htan sti omada xxx kata 70 % lig;oteri ap’oti stin omada legxou.
8.5 years of follow u; 652 deaths, 12 694 participants followed (more women) Moderate alcohol consumption [10-50 /day men; 5-25 women] as opposed to either high or low consumption. Mean values 11 g men; 1.2 g women.
Katan M. Letter to the editor. American Journal of Clinical Nutrition, 2010-11??
H λιτή δίαιτα των κρητικών όπως καταγράφηκε το 1950 και το 1960, με τις περιορισμένες ποσότητες κρέατος και την εντατική αξιοποίηση της τοπικής χλωρίδας, της ελιάς και του κριθαριού ήταν ως ένα βαθμό , αποτέλεσμα ανάγκης σε μια κοινωνία που δεν είχε αναπτυχθεί οικονομικά. Οι κρητικοί έτρωγαν όσπρια αντί για κρέας, άγρια χόρτα με ελαιόλαδο αντί για πατάτες με βούτυρο, και φρούτα αντί για γλυκά και παγωτά. Μπορούν οι κάτοικοι των δυτικών κοινωνιών σήμερα να επωφεληθούν από την παραδοσιακή δίαιτα της Κρήτης? Οι προτάσεις που μέχρι τώρα η ιατρική επιστήμη δίνει για τον βιοχημικό ρόλο των μονοακόρεστων λιπών, των ω-3 λιπαρών οξέων και των αντιοξειδωτικών παρέχουν κάποιες απαντήσεις, αλλά δεν εξηγούν πλήρως τη μοναδικότητα της κρητικής δίαιτας.
Food sharing was embedded in the life of the rural communities of Crete; its manifestations are apparent in festivals and other occasions. Most of the agrarian festivals not only marked natural agricultural events, but also an attempt to redistribute food sources .
Σύμωνα με το αίτημα που έχει υποβληθεί στην ΟΥΝΕΣΚΟ προκειμένου να συμπεριληφθεί η Μεσογειακή δίαιτα στα μνημεία της Άυλης Παγκόσμιας Πολιτισμικής Κληρονομιάς, περιγράφεται ως το «σύνολο των πρακτικών, εκφράσεων, γνώσης και τεχνογνωσίας, χώρων και σχετικών αντικειμένων τα οποία οι λαοί γύρω από τη Μεσόγειο έχουν δημιουργήσει και αναπλάσει κατά τη διάρκεια της ιστορίας τους στα πλαίσια της αλληλεπίδρασής με τη φύση σε συνάρτηση με την τροφή» ( Reguant - Aleix et al . 2009). Το αιτήμα που έχουν από κοινού καταθέσει η Ισπανία, η Ελλάδα, η Ιταλία και το Μαρόκκο για την ανακύρηξη της Μεσογειακής δίαιτας ως αύλο μνημείο της Παγκόσμιας Κληρονομιάς κατοχυρώθηκε στην UNESCO στις 3 Απριλίου 2010 και αναμένεται να αξιολογηθεί οριστικά το Νοέμβριο του 2010. Spain, Greece, Italy and Morocco, jointly presented to the UNESCO, in Paris, the Nomination of the Mediterranean Diet for its inscription on the Representative List of Intangible Cultural Heritage of Humanity. The decision about the inscription, after the evaluation of the nomination by the Committee, will be made known on November 2010, during the meeting of the Intergovernmental Committee on Intangible Cultural Heritage.
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