Mediterranean Diet: A Still Open Debate

Friday, 17 September 2010 00:00

What about the bio-chemical, bio-historical, and bio-social grounds of the nutrition?
What about the clinical evidence of Mediterranean diet?
What about the alcohol intake factor in the diet?

Both INTERHEART (Lancet 2004; 364: 937-952) and INTERSTROKE (Lancet 2010; 376:74-5 and Lancet 2010; 376:112-123) studies suggest that apolipoproteins, hypertension, current smoking, abdominal obesity, diet, physical activity, diabetes mellitus, alcohol intake, psychosocial factors, although with some differences of relative risk between the two pathologies,  should be taken into consideration in the strategies directed to prevent  Myocardial Infarction and Stroke. The findings on diet, physical activity, and alcohol intake are particularly relevant because they could and should be considered target of health policy and consequently health economy positions by health and economy authorities within the countries.
The WHO, setting the global goal to reduce rates of death by chronic (non-communicable) diseases by an additional 2% every year (Lancet 2007; 370:2044-53) indicated tobacco and salt as targets of a worldwide interventions. These two population-based intervention strategies could therefore substantially reduce mortality from chronic diseases, and make a major (and affordable) contribution towards achievement of the global goal to prevent and control chronic diseases. Following the theoretically calculated success of that strategy, other institutions designed policies to better afford within the countries the other components of the diet, promoting intervention also in educating people to better know the relations between diet (including alcohol), physical activities and the development of diabetes, obesity, some tumors, and cardiovascular diseases. The goal is to produce recommendations and rules directed to support standard policies for diet equally within  all the countries. The development of such approach could find barriers not only within the stakeholders (read agricultural and related industry), but mainly in the local people or individual traditional nutrition approach.    
Besides the public institutions also the experts of academia, basic & clinical  research, and the family doctors are requested to participate in better defining  lines and methods of education of the single subject to be better responsible of his/her life style.   Among the many initiatives which deserve a non marginal attention are the debates on the a.m. topics during several scientific meetings of medical societies. Among the last ones it seems useful to report about a meeting held in Florence last September 15-17, 2010. The  meeting organized and realized by M. Mariani (Pisa) and G.F. Gensini (Firenze) was devoted to the primary prevention and advanced intensive treatment of coronary artery disease.
A round table has been dedicated to a mediterranean diet and to the still open questions to this very much mentioned but not yet completely understood nutrition approach. The debate was focused on some main questions such as, among others:

What about the bio-chemical, bio-historical, and bio-social grounds of the nutrition?
What about the clinical evidence of Mediterranean diet?
What about the alcohol intake factor in the diet?

…..Read more…..

Andrea Peracino

September 17, 2010


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