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Mediterranean Diet & Vascular Events in Non-Caucasians

Posted Nov 29 2011 3:01am
One of the major issues when attempting to practice evidence-based medicine  (aside from assessing the quality of the study) is making sure the group studied matches the patient in front of you.

Which is why I refuse to write about, propagate & otherwise hype animal trials and how the latest finding might one day have some meaningful impact on our health.  You know what I mean.  The ads describe how some supplement (which they happen to sell) made such a difference in rats, nematodes, drosophilia flies, etc, so you & I should jump on the bandwagon and start taking this very same supplement for which they've managed to corner the market in its latest, most pure, most natural, most organic form, right?

So many chemicals have failed to make the leap of faith from animal model to phase I to phase III to FDA-approval, that I'd rather focus on those w/human data supporting its use.  Don't get me wrong - we need basic science research to advance the cutting edge of medicine.  However, I personally don't see any reason to hype some finding in other life forms decades before we have an equivalent solution in humans.

But is that enough?  Clearly, women don't have to worry about prostate cancer studies.  Likewise, men shouldn't have to worry about ovarian cancer, Chaz Bono notwithstanding .  But what about age?  We specialize our training into pediatrics, adults & geriatrics (that's me), claiming that each age group has its own niche.  Trickier still is the question of race which is fraught w/political overtones.  Having been born & raised in the States in a Western culture, I suspect that my thinking process is closer to my Caucasian colleagues than my ethnic counterparts across the Pacific.  But what about ethnic physiology?  Is there a difference?

For instance, we know that following the Mediterranean diet, based upon Caucasians, is associated with lower risk of vascular events.  But while this way of eating might not come easily to blacks & Hispanics due to culture differences, would the Mediterranean diet make a difference in these non-Caucasian races?  In a population-based cohort study of 2,568 participants, average 69yo, 55% Hispanic, 24% black, and 64% female, followed for 9yrs published early online this month prior to print next month in the American Journal of Clinical Nutrition , the authors noted that the closer one followed the Mediterranean diet, the lower one's risk for vascular death.
Based upon this study, we can comfortably recommend eating more fish & legumes, fruits & vegetables, plus whole grains & monounsaturated fat as well as drinking alcohol (wine) in moderation to patients regardless of ethnicity in an attempt to decrease vascular mortality.

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