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The Weekend Neos Kosmos : 18 February 2017
6 THE WEEKEND NEOS KOSMOS | SATURDAY 18 FEBRUARY 2017 DIGITAL.NEOSKOSMOS.COM NIKOS FOTAKIS When facing diabetes, do it like the ‘Healthy Greek Migrant’ Professor Catherine Itsiopoulos describes the benefi ts of following a Greek Mediterranean diet Professor Catherine Itsiopoulos has been a champion of the Greek Mediterranean diet for more than 25 years, doing research and publishing books on the subject, such as The Mediterranean Diet − and the wonderful associated cookbook. Her work at LaTrobe University, where she is head of the School of Allied Health, has allowed her to be in touch with many PhD students undertaking research in diet, offering new, valuable insight on how nutrition can be beneficial in the management and prevention of diseases. This experience will lead her to the Melbourne Diabetes Expo on Saturday, where she will take part in a panel of speakers discussing what the healthiest diet is for managing diabetes. "I've been involved in the Diabetes Expo before," she says. "This year I will describe the role of Mediterranean diet in prevention and management of diabetes." Mediterranean diet has been at the core of her work as a dietitian. "My work started by looking at health differences between Greek migrants to Australia and Australian-born people, with or without diabetes, and from this work we found that Greek migrants who arrived in Australia in the 1950s and ‘60s are now in their 70s, 80s or even 90s," she says, describing what has been code-named 'the Healthy Greek Migrant'. "We're still investigating the Greek migrant story because what we're finding is that first generation of migrants still has longevity, so something is protecting them from early mortality, primarily from cardiovascular disease and stroke and cancer," she explains. "The majority of Greek migrants in the ‘50s and ‘60s came from rural areas of Greece where the availability of meat was low. And they came to a country where there was readilyavailable meat, they could buy a whole lamb for a few shillings. So in the early days the Greek migrants were consuming a lot more meat and also more dairy; they may have changed their diet somewhat, which led to obesity and increased risk of diabetes, but they also retained all the positive elements of the Greek Mediterranean diet; they are using extra virgin olive oil as the main fat in their diet, they consume legumes on a regular basis, as well as lots of leafy vegetables, tomatoes, onions and garlic. Our theory was that they were somewhat protected from the diabetes complications of the traditional Greek Mediterranean diet." PHOTO: PIXABAY. LEGUMES, NOT SOUVLAKI Before explaining the benefits of the Greek Mediterranean diet on diabetes management, Professor Itsiopoulos feels the need to clarify what that means. "In any conversation that I have or presentation that I make I dispel the myth of the 'typical Mediterranean' diet and I preface that by saying 'Greek Mediterranean diet'." This, of course, does not mean souvlaki. "When people think about Greek restaurants they think of festive food, high on meat − lambs on a spit, with a lot of bread and dips. "Traditionally, the Greek Mediterranean diet of the '50s and '60s was primarily a plant-based diet; extra virgin olive oil was the main fat used in all cooking and salads and in desserts as well; legumes are the key protein source, eaten three to four times a week; fruits are the main dessert; other snacks would be dried fruit and nuts; dairy is used in moderate amounts, mostly in the form of yoghurt, fermented, not just glasses of milk and certainly not big mugs of coffee with a litre of milk in it," she adds, laughing. "Feta and other types of cheese would also be consumed in moderation, not in excess. Today we see a 'Greek' salad with 250g of cheese sitting on top. It is not typical to have that amount of cheese daily. Meat is also consumed in moderation, and the same goes with fish. Many people think that the Mediterranean diet is full of fish. It is, in coastal regions, but that also means consumption a couple of times per week. Another common thing is having a glass of wine with meals, but not drinking in between meals and getting drunk. So that's what we define as a typical Mediterranean meal." But what is it that makes the Greek Mediterranean diet so beneficial for the management of diabetes? "The first trial that I did, more than 20 years ago, was in Australianborn people of Anglo-Celtic background with type-2 diabetes," she says. "We put those people on a very traditional Mediterranean diet and followed them for three months. After that, they went back on their usual diet and not only had their glucose control improved but they also reported many other positive changes in their health. The largest evidence we have comes from a Spanish study, PREDIMED (Prevención con Dieta Mediterránea - Prevention with Mediterranean Diet), which recruited 7,500 people at risk of developing diabetes because they were overweight or had hypertension, etc. Within five years, those on a Mediterranean diet had 50 per cent less risk of developing diabetes compared to those on standard care, i.e. a low-fat diet. "The Mediterranean diet is high in healthy fat; extra virgin olive oil is rich in antioxidants. In diabetes there's oxidation damage to the cells. A diet rich in antioxidants helps reduce this risk. Greek migrants with diabetes compared to Australian-born ones had much lower risk of diabetic retinopathy and this was linked to the much higher intake of antioxidants in their food. "The other important factor is the balance between carbohydrate, fat and proteins that is a trait of the Mediterranean diet. It is a more satiating diet, making it less likely for someone to resort to snacks high in carbs. "Also, when you have diabetes, the ability to manage high loads of carbohydrates becomes affected. A great intake of carbohydrate means that you rely on more insulin. People with type 2 diabetes are insulin resistant and those with type 1 need to provide insulin externally.
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