Does It Come In A Pill?

For any as yet unfamiliar with the Mediterranean diet, you may be wondering what it involves, beyond a general expectation that it’s a diet popularly enjoyed in the Mediterranean. What image comes to mind?

We’re willing to bet that tomatoes feature (great source of lycopene, by the way, and if you’re not getting lycopene, you’re missing out), but what else?

• Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
• Bread? Pasta? Prosciutto, salami? Cheese?
• Pizza but only if it’s Romana style, not Chicago?
• Pan-seared liver, with some fava beans and a nice Chianti?

In fact, the Mediterranean diet is quite clear on all these questions, so to read about these and more (including a “this yes, that no” list), see:

What Is The Mediterranean Diet, And What Is It Good For?

So, how do we get that in a pill?

A plucky band of researchers, Dr. Chiara de Lucia et al. (quite a lot of “et al.”; nine listed authors on the study), wondered to what extent the benefits of the Mediterranean diet come from the fact that the Mediterranean diet is very rich in polyphenols, and set about testing that, by putting the same polyphenols in capsule form, and running a randomized, double-blind, placebo-controlled, crossover clinical intervention trial.

Now, polyphenols are not the only reason the Mediterranean diet is great; there are also other considerations, such as:

• a great macronutrient balance with lots of fiber, healthy fats, moderate carbs, and protein from select sources
• the absence or at least very low presence of a lot of harmful substances such as refined seed oils, added sugars, refined carbohydrates, and the like (“but pasta” yes pasta; in moderation and wholegrain and served with extra sources of fiber and healthy fats, all of which slow down the absorption of the carbs)

…but polyphenols are admittedly very important too; we wrote about some common aspects of them here:

Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain

As for what Dr. de Lucia et al. put into the capsule, behold…

The ingredients:

1. Apple Extract 10.0%
2. Pomegranate Extract 10.0%
3. Tomato Powder 2.5%
4. Beet, Spray Dried 2.5%
5. Olive Extract 7.5%
6. Rosemary Extract 7.5%
7. Green Coffee Bean Extract (CA) 7.5%
8. Kale, Freeze Dried 2.5%
9. Onion Extract 10.0%
10. Ginger Extract 10.0%
11. Grapefruit Extract 2.5%
12. Carrot, Air Dried 2.5%
13. Grape Skin Extract 17.5%
14. Blueberry Extract 2.5%
15. Currant, Freeze Dried 2.5%
16. Elderberry, Freeze Dried 2.5%

And the relevant phytochemicals they contain:

• Quercetin
• Luteolin
• Catechins
• Punicalagins
• Phloretin
• Ellagic Acid
• Naringin
• Apigenin
• Isorhamnetin
• Chlorogenic Acids
• Rosmarinic Acid
• Anthocyanins
• Kaempferol
• Proanthocyanidins
• Myricetin
• Betanin

And what, you may wonder, did they find? Well, first let’s briefly summarise the setup of the study:

They took volunteers (n=30), average age 67, BMI >25, without serious health complaints, not taking other supplements, not vegetarian or vegan, not consuming >5 cups of coffee per day, and various other stipulations like that, to create a fairly homogenous study group who were expected to respond well to the intervention. In contrast, someone who takes antioxidant supplements, already eats many different color plants per day, and drinks 10 cups of coffee, probably already has a lot of antioxidant activity going on, and someone with a lower BMI will generally have lower resting levels of inflammatory markers, so it’s harder to see a change, proportionally.

About those inflammatory markers: that’s what they were testing, to see whether the intervention “worked”; essentially, did the levels of inflammatory markers go up or down (up is bad; down is good).

For more on inflammation, by the way, see:

How to Prevent (or Reduce) Inflammation

…which also explains what it actually is, and some important nuances about it.

Back to the study…

They gave half the participants the supplement for a week and the other half placebo; had a week’s gap as a “washout”, then repeated it, switching the groups, taking blood samples before and after each stage.

What they found:

The group taking the supplement had lower inflammatory markers after a week of taking it, while the group taking the placebo had relatively higher inflammatory markers after a week of taking it; this trend was preserved across both groups (i.e., when they switched roles for the second half).

The results were very significant (p=0.01 or thereabouts), and yet at the same time, quite modest (i.e. the supplement made a very reliable, very small difference), probably because of the small dose (150mg) and small intervention period (1 week).

What the researchers concluded from this

The researchers concluded that this was a success; the study had been primarily to provide proof of principle, not to rock the world. Now they want the experiment to be repeated with larger sample sizes, greater heterogeneity, larger doses, and longer intervention periods.

This is all very reasonable and good science.

Read in full: A Randomised, Double-Blind, Placebo-Controlled, Cross-Over Clinical Trial to Evaluate the Biological Effects and Safety of a Polyphenol Supplement on Healthy Ageing

What we conclude from this

That ingredients list makes for a good shopping list!

Well, not the extracts they listed, necessarily, but rather those actual fruits, vegetables, etc.

If nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that.

So, take another list above and ask yourself: how many of those 16 foods do you eat regularly, and could you work the others in?

Want to make your Mediterranean diet even better?

While the Mediterranean diet is a top-tier catch-all, it can be tweaked for specific areas of health, for example giving it an extra focus on heart health, or brain health, or being anti-inflammatory, or being especially gut healthy:

Four Ways To Upgrade The Mediterranean

Enjoy!

Knowledge Is Power Safety, Post-Menopause Too

Note: this article will be most relevant for a subset of our subscribership, but it’s a very large subset, so we’re going to go ahead and address the reader as “you”.

If, for example, you are a man and this doesn’t apply to you, we hope it will interest you anyway (we imagine there are women in your life).

PS: the appendicitis check near the end, works for anyone with an appendix

We’ve talked before about things that come with (and continue after) menopause:

• What You Should Have Been Told About The Menopause Beforehand
• What Menopause Does To The Heart
• Alzheimer’s Sex Differences May Not Be What They Appear

But what’s going on if certain menstrual symptoms reappear post-menopause (e.g. after more than a year with no menstruation)?

Bleeding

You should not, of course, be experiencing vaginal bleeding post-menopause. You may have seen “PSA” style posts floating around social media warning that this is a sign of cancer. And, it can be!

But it’s probably not.

Endometrial cancer (the kind that causes such bleeding) affects 2–3% of women, and of those reporting post-menopausal bleeding, the cause is endometrial cancer only 9% of those times.

So in other words, it’s not to be ignored, but for 9 people out of 10 it won’t be cancer:

Read more: Harvard Health | Postmenopausal bleeding: Don’t worry—but do call your doctor

Other more likely causes are uterine fibroids or polyps. These are unpleasant but benign, and can be corrected with surgery if necessary.

The most common cause, however is endometrial and/or vaginal atrophy resulting in tears and bleeding.

Tip: Menopausal HRT will often correct this.

Read more: The significance of “atrophic endometrium” in women with postmenopausal bleeding

(“atrophic endometrium” and “endometrial atrophy” are the same thing)

In summary: no need to panic, but do get it checked out at your earliest convenience. This is not one where we should go “oh that’s weird” and ignore.

Cramps

If you are on menopausal HRT, there is a good chance that these are just period cramps. They may feel different than they did before, because you didn’t ovulate and thus you’re not shedding a uterine lining now, but your body is going to do its best to follow the instructions given by the hormones anyway (hormones are just chemical messengers, after all).

If it is just this, then they will probably settle down to a monthly cycle and become quite predictable.

Tip: if it’s the above, then normal advice for period cramps will go here. We recommend ginger! It’s been found to be as effective as Novafen (a combination drug of acetaminophen (Tylenol), caffeine, and ibuprofen), in the task of relieving menstrual pain:

See: Effect of Ginger and Novafen on menstrual pain: A cross-over trial

It could also be endometriosis. Normally this affects those of childbearing age, but once again, exogenous hormones (as in menopausal HRT) can fool the body into doing it.

If you are not on menopausal HRT (or sometimes even if you are), uterine fibroids (as discussed previously) are once again a fair candidate, and endometriosis is also still possible, though less likely.

Special last note

Important self-check: if you are experiencing a sharp pain in that general area and are worrying if it is appendicitis (also a possibility), then pressing on the appropriately named McBurney’s point is a first-line test for appendicitis. If, after pressing, it hurts a lot more upon removal of pressure (rather than upon application of pressure), this is considered a likely sign of appendicitis. Get thee to a hospital, quickly.

And if it doesn’t? Still get it checked out at your earliest convenience, of course (better safe than sorry), but you might make an appointment instead of calling an ambulance.

Take care!