Diet planning for good nutrition

In recent years, research to determine the factors that increase the risk of cardiovascular disease has confirmed that following a healthy lifestyle with an adequate diet are essential requirements for living longer and enjoying a good quality of life.

Studies on the subject confirm the benefits that some dietary patterns bring to cardiovascular health, promoting the consumption of plant-based foods such as fruits, vegetables, whole grains, legumes, nuts and virgin olive oil and moderate consumption of fish, dairy products and poultry; limiting less healthy foods such as processed meats, butter, ice cream, industrial pastries, white bread, sugary drinks, canned or precooked foods with a lot of salt and alcoholic beverages, among others.

Dietary patterns most studied in the prevention of cardiovascular diseases:

• The dash diet.

• The Mediterranean diet.

The dash diet

It is a dietary pattern developed by a health institution of the government of the United States of America, to prevent and treat arterial hypertension or pre-hypertension, without the need for medication. The name dash is an acronym that comes from dietary approaches to stop hypertension.

It is characterized by a high intake of fruits, vegetables and low-fat dairy products. It includes whole grains, poultry, fish and nuts. It also recommends low levels of salt, red meat, saturated fats, sugary soft drinks and sweets. The diet is accompanied by a physical exercise plan, advice to quit smoking and the consumption of moderate amounts of alcohol.

According to the results of observational studies, it contributes to the reduction of blood pressure, especially if combined with a reduction in salt intake. It was also found that strict adherence to this diet reduces the risk of serious cardiovascular events such as heart attack and stroke.

The Mediterranean diet

It is defined as a dietary pattern followed by the inhabitants of Greece, southern Italy, Spain, and other olive-producing regions located on the shores of the Mediterranean Sea.

Its main characteristics are the following:

• Use of olive oil for all culinary uses.
• A high consumption of fruits, vegetables, legumes, whole grains, seeds and nuts.

• A moderate and frequent consumption of red wine, normally accompanying meals.

• Moderate consumption of fresh fish and seafood, poultry, eggs and dairy products, mainly milk, yogurt and cheese.

• Reduced or no consumption of sweets, sugary drinks, butter, red or processed meats.

Role of the Mediterranean diet in the prevention of cardiovascular diseases.

The PREDIMED study (prevention with Mediterranean diet): The PREDIMED study is a clinical trial of dietary intervention, to investigate whether the Mediterranean diet supplemented with virgin olive oil or nuts, prevents the occurrence of major cardiovascular complications, such as myocardial infarction and cerebral vascular accident in individuals at high vascular risk, compared to a low-fat diet. The main source of funding was the Spanish Ministry of Health, through the Carlos III Health Institute (ISCIII).

It included a total of more than 7,000 individuals (men aged 55-80 years and women aged 60-80 years) at high risk of cardiovascular disease. Recruitment for the pilot phase began between October and December 2003 and continued until the end of March 31, 2009. The clinical trial concluded on December 31, 2011, so that the first recruits were studied for a period of more than 8 years, and the last recruits for more than three years.

Participants were randomized into three intervention groups: two groups received Mediterranean dietary advice and were supplemented with either extra virgin olive oil or a mixture of nuts, and the third group followed low-fat dietary recommendations. In none of the groups was caloric restriction or physical exercise recommended.

The results of the PREDIMED study showed that following a Mediterranean dietary pattern is effective for the prevention of myocardial infarction, cerebral vascular accident and cardiovascular mortality. In addition, it was also shown that people following the Mediterranean diet had a lower incidence of other diseases, metabolic syndrome, type 2 diabetes, and some complications such as peripheral arterial disease, atrial fibrillation, arterial hypertension, cognitive impairment, and breast cancer.

General recommendations for dietary planning:

• Dietary calories from fat should not exceed 35% of total energy.

• Use extra olive oil as culinary fat, due to its antioxidant qualities.

• Reduce the consumption of red meats, processed meats and canned meats; replace them with chicken or turkey; fish, preferably blue fish; legumes and whole grains.

• Consume about 750 milliliters of milk daily. Substitute whole milk and yogurts for skim milk and yogurts. Consume cottage cheese and fresh cheeses instead of fatty or cured cheeses.

• Limit consumption of egg yolks to less than four per week.

• Plan two or three daily servings of vegetables, alternating the ways of preparation (in salads or