Mediterranean Diet… In A Pill?

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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!

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  • How To Grow New Brain Cells (At Any Age)

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    How To Grow New Brain Cells (At Any Age)

    It was long believed that brain growth could not occur later in life, due to expending our innate stock of pluripotent stem cells. However, this was mostly based on rodent studies.

    Rodent studies are often used for brain research, because it’s difficult to find human volunteers willing to have their brains sliced thinly (so that the cells can be viewed under a microscope) at the end of the study.

    However, neurobiologist Dr. Maura Boldrini led a team that did a lot of research by means of autopsies on the hippocampi of (previously) healthy individuals ranging in age from 14 to 79.

    What she found is that while indeed the younger subjects did predictably have more young brain cells (neural progenitors and immature neurons), even the oldest subject, at the age of 79, had been producing new brain cells up until death.

    Read her landmark study: Human Hippocampal Neurogenesis Persists throughout Aging

    There was briefly a flurry of news articles about a study by Dr. Shawn Sorrels that refuted this, however, it later came to light that Dr. Sorrels had accidentally destroyed his own evidence during the cell-fixing process—these things happen; it’s just unfortunate the mistake was not picked up until after publication.

    A later study by a Dr. Elena Moreno-Jiménez fixed this flaw by using a shorter fixation time for the cell samples they wanted to look at, and found that there were tens of thousands of newly-made brain cells in samples from adults ranging from 43 to 87.

    Now, there was still a difference: the samples from the youngest adult had 30% more newly-made braincells than the 87-year-old, but given that previous science thought brain cell generation stopped in childhood, the fact that an 87-year-old was generating new brain cells 30% less quickly than a 43-year-old is hardly much of a criticism!

    As an aside: samples from patients with Alzheimer’s also had a 30% reduction in new braincell generation, compared to samples from patients of the same age without Alzheimer’s. But again… Even patients with Alzheimer’s were still growing some new brain cells.

    Read it for yourself: Adult hippocampal neurogenesis is abundant in neurologically healthy subjects and drops sharply in patients with Alzheimer’s disease

    Practical advice based on this information

    Since we can do neurogenesis at any age, but the rate does drop with age (and drops sharply in the case of Alzheimer’s disease), we need to:

    Feed your brain. The brain is the most calorie-consuming organ we have, by far, and it’s also made mostly of fat* and water. So, get plenty of healthy fats, and get plenty of water.

    *Fun fact: while depictions in fiction (and/or chemically preserved brains) may lead many to believe the brain has a rubbery consistency, the untreated brain being made of mostly fat and water gives it more of a blancmange-like consistency in reality. That thing is delicate and spatters easily. There’s a reason it’s kept cushioned inside the strongest structure of our body, far more protected than anything in our torso.

    Exercise. Specifically, exercise that gets your blood pumping. This (as our earlier-featured video today referenced) is one of the biggest things we can do to boost Brain-Derived Neurotrophic Factor, or BDNF.

    Here be science: Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

    However, that’s not the only way to increase BDNF; another is to enjoy a diet rich in polyphenols. These can be found in, for example, berries, tea, coffee, and chocolate. Technically those last two are also botanically berries, but given how we usually consume them, and given how rich they are in polyphenols, they merit a special mention.

    See for example: Effects of nutritional interventions on BDNF concentrations in humans: a systematic review

    Some supplements can help neuron (re)growth too, so if you haven’t already, you might want to check out our previous main feature on lion’s mane mushroom, a supplement which does exactly that.

    For those who like videos, you may also enjoy this TED talk by neuroscientist Dr. Sandrine Thuret:

    !

    Prefer text? Click here to read the transcript

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  • Natto vs Tempeh – Which is Healthier?

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    Our Verdict

    When comparing nattō to tempeh, we picked the nattō.

    Why?

    Both are great, but in the battle of fermented soybeans vs fermented soybeans with extra steps, it turns out that the simplest option is the best, even if tempeh was a close runner-up:

    In terms of macros, nattō has more carbs and fiber for the same protein and fat; we’ll call this category a tie or a marginal win for nattō.

    In the category of vitamins, nattō has more of vitamins B1, C, E, K, and choline, while tempeh has more of vitamins B2, B3, B6, and B9. A clearer, yet still modest, win for nattō.

    Minerals, however, are what really set them apart: nattō has more calcium, copper, iron, magnesium, manganese, potassium, selenium, and zinc, while tempeh has more phosphorus. An overwhelming win for nattō this time.

    In short: enjoy either or both, but nattō is the more nutritionally dense option!

    Want to learn more?

    You might like:

    21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!) ← nattō is featured as part of the diet 😎

    Enjoy!

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  • Policosanol: A Rival To Statins, Without The Side Effects?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:

    2001: it works!

    After a lot of research in the 1990s, it came out of the gate strong in 2001, with:

    ❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞

    This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.

    Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women

    Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:

    Read: Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind study

    2006–2010: we do not trust the Cubans!

    After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):

    Heart Beat: Policosanol: A sweet nothing for high cholesterol

    And furthermore, US-based labs were unable to replicate the results:

    Policosanols as Nutraceuticals: Fact or Fiction

    The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.

    Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.

    Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.

    2012: never mind, it does work after all!

    An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:

    ❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞

    Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.

    Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol

    2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba

    A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:

    Mystery resolved!

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.

    Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎

    Enjoy!

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  • Breadfruit vs Custard Apple – Which is Healthier?

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    Our Verdict

    When comparing breadfruit to custard apple, we picked the breadfruit.

    Why?

    Today in “fruits pretending to be less healthy things than they are”, both are great, but one of these fruits just edges out the other in all categories. This is quite simple today:

    In terms of macros, being fruits they’re both fairly high in carbs and fiber, however the carbs are close to equal and breadfruit has nearly 2x the fiber.

    This also means that breadfruit has the lower glycemic index, but they’re both medium-low GI foods with a low insulin index.

    When it comes to vitamins, breadfruit has more of vitamins B1, B3, B5, and C, while custard apple has more of vitamins A, B2, and B6. So, a 4:3 win for breadfruit.

    In the category of minerals, breadfruit has more copper, magnesium, phosphorus, potassium, and zinc, while custard apple has more calcium and iron.

    In short, enjoy both, but if you’re going just for one, breadfruit is the healthiest.

    Want to learn more?

    You might like to read:

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    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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  • The Lies That Depression Tells Us

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In this short (6:42) video, psychiatrist Dr. Tracey Marks talks about 8 commonly-believed lies that depression often tells us. They are:

    • “I don’t measure up”
    • “No one cares about me”
    • “I’m better off alone”
    • “No one understands”
    • “It’s all my fault”
    • “I have no reason to be depressed”
    • “Nothing matters”
    • “I’ll never get better”

    Some of these can be reinforced by people around us; it’s easy to believe that “no one understands” if for example the few people we interact with the most don’t understand, or that “I have no reason to be depressed” if people try to cheer you up by pointing out your many good fortunes.

    The reality, of course, is that depression is a large, complex, and many-headed beast, with firm roots in neurobiology.

    There are things we can do that may ameliorate it… But they also may not, and sometimes life is just going to suck for a while. That doesn’t mean we should give up (that, too, is depression lying to us, per “I’ll never get better”), but it does mean that we should not be so hard on ourselves for not having “walked it off” the way one might “just walk off” a broken leg.

    Oh, you can’t “just walk off” a broken leg? Well then, perhaps it’s not surprising if we don’t “just think off” a broken brain, either. The brain can rebuild itself, but that’s a slow process, so buckle in:

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    Want to know more?

    You might like these previous articles of ours about depression (managing it, and overcoming it):

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  • Can Home Tests Replace Check-Ups?

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I recently hit 65 and try to get regular check-ups, but do you think home testing can be as reliable as a doctor visit? I try to keep as informed as I can and am a big believer in taking responsibility for my own health if I can, but I don’t want to miss something important either. Best as a supplemental thing, perhaps?❞

    Depends what’s being tested! And your level of technical knowledge, though there’s always something to be said for ongoing learning.

    • If you’re talking blood tests, urine tests, etc per at-home test kits that get sent off to a lab, then provided they’re well-sourced (and executed correctly by you), they should be as accurate as what a doctor will give, since they are basically doing the same thing (taking a sample and sending it off to a lab).
    • If you’re talking about checking for lumps etc, then a dual approach is best: check yourself at home as often as you feel is reasonable (with once per month being advised at a minimum, especially if you’re aware of an extra risk factor for you) and check-ups with the doctor per their recommendations.
    • If you’re talking about general vitals (blood pressure, heart rate, heart rate variability, VO₂ max, etc), then provided you have a reliable way of testing them, then doing them very frequently at home, to get the best “big picture” view. In contrast, getting them done once a year at your doctor’s could result in a misleading result, if you just ate something different that day or had a stressful morning, for example.

    Enjoy

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