Dr. Zorba Paster: Mediterranean diet still the way to go

As many of you know, I am a great proponent of the Mediterranean diet. I have commonly called it the king of diets, with study after study showing it’s worthwhile. If you Google it, you’ll see what it is – a diet loaded with veggies and fruits, less animal protein, plentiful fish, nuts and olive oil, often accompanied at dinner by a glass of wine.

For years, I’ve been quoting a landmark New England Journal of Medicine article showing that among the 7,000 people who followed an enriched Mediterranean diet, the data was overwhelming. There was a whopping 30 percent reduction in heart disease seen in that group versus the group that followed the American Heart Associate low-fat, or what I call “cardboard,” diet.

Great results. But there was one problem: Statisticians looking at the data, revisiting it again, found that 14 percent of the people involved in the study were not randomized properly. Remember, in a randomized study everybody has to be randomized in order to make the data what I would call “super-strong.”

So why did this happen? First off, the study design. If a husband and wife were both entered into the study and one was eating extra olive oil and nuts, was it really possible for the other not to eat the same thing? I can just imagine saying to Penny, “Sorry, honey, these nuts are for me, not you.” After nearly 45 years of marriage, I know that wouldn’t have cut the mustard.

Then there turned out to be a small town in Spain where half the people were getting olive oil and nuts as part of the study and the other half were not. Small town. People talk. Those not getting the freebies were upset. So the sub-investigator in the study gave everybody the free stuff. Not only that, but he didn’t ask the main scientists if that was OK. He just did it and never mentioned it.

So the whole town wasn’t randomized. They were happy getting the olive oil, but it destroyed some of the strength of the study.

Now, the bottom line is what does this mean to you? Well, the data for 86 percent of the people who were randomized in the study still showed the Mediterranean diet is terrific. But because of this latest information, perhaps we should not call it the king of diets but more like the prince. Just like Charles is Prince Charles – still a royal diet and still something worth trumpeting.

Dear Doc: I’ve heard fasting will help me lose weight. I’ve been on lots of diets but none of them seem to work for long. What’s the scoop? – J.K. from Milwaukee

Dear J.K.: I get lots of questions about fasting. The latest article published in the journal Nutrition and Healthy Aging shows it might work.

It’s a small study, only about 20 overweight men and women (average body mass index was 35, average age was 45) but the fasters lost 3 percent of their body weight and dropped their blood pressure by 7 mmHg in just 12 weeks.

The food the participants ate was measured and researchers found the fasting folks were consuming 350 fewer calories a day. Here’s how they did it: Participants in the study ate anything they wanted from 10 in the morning until 6 in the evening. Then they fasted until the next day.

My spin: This may be a good way to kick-start your diet, but I doubt if anyone can follow this forever. Stay well.