Thursday, October 9, 2014

Mediterranean Diet and Workplace Health -- Challenges in Contemporary America and Scientific Evidence

2014 Initiative for Productivity and Health Management Conference at the Harvard School of Public Health

I had the good fortune to attend the Mediterranean Diet and Workplace Health Conference at the Harvard School of Public Health. Someone there evidently Googled “Mediterranean diet workplace wellness,” stumbled across my blog, and sent me an invitation. (Now that's an incentive to keep blogging.) I’m pretty confident I was the only HR person in attendance, so this was a pretty unique learning opportunity for me.  

The first day was entitled Challenges: Diabesity and Contemporary American Nutrition and Value of the Mediterranean Diet. Day 2 was Promoting Dietary Change: Workplace/School Solutions and Other Best Practices from the Field. I walked away with a lot of notes, so I'm breaking them up into two posts. This post will cover Day 1 and a second post will share what I learned Day 2. 

Here’s some of what I made note of the first day…

They clearly defined what it means to eat Mediterranean. I've plunked the main points into the box above. 

I actually learned a lot about olive oil. Look for EVOO, extra virgin olive oil. It should be labeled cold pressed and first pressed. Then, check the ingredient list. A lot of what is sold as olive oil in the U.S. is a blend of oils. Interestingly, in Greece they never mix their olives. Each bottle of olive oil is made from olives from one of three regions Kalamata, Crete, etc... It was suggested that we use a good, but less expensive olive oil for roasting vegetables and other cooking and then have some really nice oils for finishing dishes. Olive oil does have a low smoking point, so if you're making a dish that involves high heat, it was suggested that we use canola or grape seed oil. 

Interestingly, there is no relationship between milk consumption and fracture risk. It was pointed out that the highest rates of fractures are in milk drinking countries.  We were told that calcium needs are overstated in the U.S. (Guess we can thank the dairy lobbyists for that.) Yogurt and cheese are the healthiest way to consume calcium. It was pointed out that in Greece, they don't eat much cows milk cheese, it is usually made from goats milk. 

They defined a moderately high intake of fish as two to three servings a week. I was also happy to hear some definition around "moderate consumption of wine." It was defined as one drink per day for women and two drinks per day for men. A drink can be 12 oz of beer, 5 oz of wine or 1.5 oz of spirits. (There were no special health benefits noted with red wine, so choose what you like.) You should consume your drink slowly. They also clarified a question I'd heard asked on a number of occasions. Most people can safely have up to three drinks in one day as long as they don't exceed the weekly limit of 7 for women and 14 for men. 

They talked about the health benefits of eating nuts. All nuts, which was refreshing. I've so often heard we she eat this nut or that nut, but all nuts have health benefits and I guess you're sort of splitting hairs by picking one over another. 

Nutrition experts at Harvard School of Public Health developed this Healthy Eating Plate to address key flaws in the U.S. Department of Agriculture’s MyPlate.

I found the graph below rather shocking. Of the 20 leading causes of death worldwide, 14 are linked in some way to food, diet and nutrition. Notice how high a diet low in fruits ranks. We were told that each additional serving of fruit a day results in 5% reduction in the risk of diabetes. Volume is more important than variety. Juice doesn't count. Click on the link in the caption if you'd like to learn more about the graph. 

Low Fruits and Vegetables and Mortality Burden

recent article in JAMA stated, "inadequate intakes of minimally processed foods such as fruits, nuts, vegetables, fish and whole grains together are associated with larger proportions of global death and disability than excess intakes of started fat, trans fat, and sodium." This reinforced that what we eat matters more than what we refrain from eating. I certainly find eating healthy easier when I focus on what I "do" eat rather than on what I "don't." 

There was a presentation by Frank Sacks, MD on randomized clinical trials that was interesting. He was the perfect speaker for after lunch delivering what could have been a dry and complex topic in easy to understand terms with plenty of humor. He said you get the best results lowering blood pressure by combining a low salt and Mediterranean diet. EVOO matters and all nuts have a similar benefits. (Chef Diane Kochilas said olive oil makes vegetables craveable. She has a new cookbook coming out on October 14 that I can't wait to receive.) He showed a slide that summarized the benefits of a Mediterranean diet that have been documented in clinical trials. I recreated that info in this image.  

A few times, the cost of eating well was mentioned, but it was never really explored. In the September 3, 2014 issue of JAMA there is an article on The Real Cost of Food. It states that, “Higher-quality diets typically costs more than lower-quality diets – on average, about $1.50 more per person day.” Obviously this can pose a barrier for many people. It reminded me of the work that Dr. Mary Flynn, a research dietician, is doing in Rhode Island. She partnered with food pantries and provided participants six weeks of cooking classes where they were taught the cooking techniques needed to execute simple healthy recipes. After each class, participants were given a bag of groceries to recreate the recipes at home for their families. Six months after completing the program – they cut their spending on groceries in half and most lost weight (although that was not the focus of the study.) I’ve had this in the back of my mind for at least a year and a half. This weekend inspired me to get in touch with the Embry Rucker Shelter in Reston and see if there is a similar initiative where I could volunteer. If not, maybe I can start one. Anyway, this was one perspective I thought was missing in the conference. (You can learn more about Dr. Flynn's initiative in this post, Eating Mediterranean on a Budget.)

That pretty well summarizes Day 1. During Day 2, the focus shifted to how we help people eat a Mediterranean diet. I'll summarize what I learned the second day in my next post

If I've peaked your interest in olive oils, read Tips on Finding the Best Olive Oil With Eataly Expert Nicholas Coleman. I recommend trying the oils from Flying Olive Farms. They're available in Whole Foods in the Raleigh, NC area and I'm begging the Wine Cabinet in Reston, VA to carry them. I loved their balsamic too. 

I also recommend the series of Huffington Post articles written by the conference organizers and faculty. 

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