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How the Mediterranean Diet Beats the Four Horsemen: Prerequisites for Longevity, Part 2

The Mediterranean diet beats the “Four Horsemen of Chronic Disease” via a plant-dominant diet that features phytonutrients, fiber, fermented foods and less meat consumption. Devote yourself to it and keep yourself disease-free!

When I say that the Mediterranean Diet beats the “Four Horsemen”, I assert that a plant-dominant diet can help you prevent suffering and dying from the four leading causes of death of those living in the developed world, which are:

• Atherosclerotic disease
• Cancer
• Neurodegenerative disease
• Metabolic disorders

These four “Horsemen”, a takeoff from the biblical Four Horsemen of the Apocalypse, must be confronted before one or more of them take your life. That’s why doing so is among the “prerequisites for longevity”, and is hereby addressed in Part 2 of this four-part series.

Part 1 is the Four Exercise Prerequisites of Longevity;

Part 2 you’re reading now;

Part 3 will be about detoxification and hormones; and

Part 4 will be about mindset, sleep and intimacy.

This post will examine:

• What’s the Mediterranean Diet and why it protects against the Four Horsemen
  • Phytonutrients from plant food
  • Meat and longevity
  • Fiber for lower cholesterol and blood sugar
  • Fermentation
• Foods in the Med Diet that beat the Four Horsemen
  • Foods, nutrients and tests for atherosclerotic disease
  • Foods, nutrients and tests for cancer
  • Foods, nutrients and tests for neurodegeneration
  • Foods, nutrients and tests for metabolic disease
• Med Diet recipes
• Your takeaway

 

Let’s dig in…

The term “Four Horsemen of Chronic Disease” often refers to:

1. Atherosclerotic disease: Encompasses conditions like heart disease and stroke, caused by plaque buildup in arteries.
2. Cancer: Uncontrolled cell growth with the potential to harm healthy tissues.
3. Neurodegenerative disease: A group of conditions like Alzheimer’s and Parkinson’s, marked by progressive brain cell degeneration.
4. Metabolic disease: Includes insulin resistance, fatty liver disease, and type 2 diabetes, affecting how the body processes blood sugar.

Heart disease, cancer, stroke, neurodegenerative diseases and metabolic diseases are among the top killers in the USA, Canada and Europe [1][2][3][4][5].

If you want to do a deep dive into these specific chronic diseases, read my post, The Four Horsemen of Disease: The Impact of Aging Hallmarks and Signaling Dysfunction.

This post explores how your dietary choices significantly impact these diseases, serving as both a potent weapon and a potential shield. Let’s explore how specific foods, nutrients and supplements can help prevent you from suffering from one of these illnesses, or ameliorating their impact upon your health.

 

What’s the Mediterranean Diet and Why It Protect Against the Four Horsemen

The Mediterranean Diet is not a strictly defined set of foods. Depending on the who and where this diet is embraced in the world, different foods can be dominant. I gave some examples of this in my post, The Blue Zone Diet Will Transform You. The “Blue Zone Diet” refers to alterations that the longest-lived people in the world — denizens of the Blue Zones — make to what is fundamentally a Mediterranean Diet, which is a plant-dominant diet.

“Plant-based” does not mean “no meat”, but rather that plant food is the focus. In all of the Blue Zones, most of the diet consists of legumes (beans, peas, lentils and chickpeas), greens, whole grains and nuts, but the mix of these foods vary by Blue Zone.

For instance, note the varying amounts of food groups that constitute these Blue Zones:

• Okinawa, Japan: 67% of their diet is from sweet potatoes; 12% rice; 9% vegetables; 2% meat and fish.
• Loma Linda, California: 33% vegetables; 27% fruits; 12% legumes; 4% meat.
• Sardinia, Italy: 47% whole grains, 26% dairy, 12% vegetables; 5% meat and fish.
• Ikaria, Greece: 20% other vegetables; 17% greens; 16% fruits; 11% legumes; 5% meat.
• Nicoya Peninsula, Costa Rica: 26% whole grains; 24% dairy; 14% vegetables; 9% fruits; 7% legumes; 5% meat and fish.

Obviously, the people inhabiting these different Blue Zones eat from a different composition of foods, but what they have in common are:

• Most of their calories come from plant food.
• Few of their calories come from meat.
• The food is rich in fiber.
• Much of the food is rich in phytochemicals.
• Some food is fermented.

It turns out that these attributes of their diet are also common in the Mediterranean Diet and are protective against chronic disease. This diet boasts a potent synergy of components, each contributing to its disease-fighting prowess against the Four Horsemen: atherosclerosis, cancer, neurodegeneration and metabolic disease. Let’s delve into the specific elements that are particularly potent.

Phytonutrients from plant food

• Atherosclerosis & Antioxidant Army: Fruits, vegetables, and olive oil in the Mediterranean diet are teeming with colorful phytonutrients like carotenoids, flavonoids, and phenolic acids. These potent antioxidants combat oxidative stress and inflammation, two key drivers of atherosclerosis. A meta-analysis in the American Journal of Cardiology demonstrated that higher intakes of fruits and vegetables are associated with a lower risk of coronary heart disease [6] .
• Cancer-Quenching Cavalry: Phytonutrients exhibit anti-proliferative and pro-apoptotic properties (aka apoptosis, programmed cell death), potentially hindering cancer cell growth and survival. Research studies highlight the potential of dietary flavonoids in cancer prevention and therapy [7].
• Neurodegeneration & Cognitive Champions: Phytonutrients like flavonoids and curcumin in the Mediterranean diet may protect against cognitive decline and neurodegenerative diseases. Studies like this one in the journal of Molecular Science suggest that flavonoid intake may be associated with a reduced risk of Alzheimer’s and other neurodegenerative diseases [8].
• Metabolic Militia: Phytonutrients in the Mediterranean diet have anti-inflammatory and insulin-sensitizing properties, potentially aiding in metabolic health. A review in the journal Food Frontiers highlight the potential of phenolic acids in promoting metabolic health and preventing diseases like type 2 diabetes [9].

Meat and longevity

This is a polarizing subject. People who eat and like meat regularly don’t want to be told that it’s unhealthy, or that the planet can not continue to support meat production on the scale required to feed the world’s current appetite for it. So, my suggestion to those devoted to meat is simply to eat less of it.

Why?

In the following seven-minute video, How Much Does Meat Affect Longevity, Dr. Michael Greger walks you through the evidence.

 

Fiber for lower cholesterol and blood sugar

• Shield against Atherosclerosis: A systematic review and meta-analysis on randomized clinical trials published in the journal Frontiers in Nutrition confirmed that the supplementation of viscous soluble dietary fiber has potential benefits for the control of blood glucose and lipids in patients with type 2 diabetes. The recommended supplemental dose is from 8.3 g to 10.2 grams/day [10].

 

• Cancer-Fighting Champion: Fiber promotes healthy gut bacteria that produce beneficial short-chain fatty acids, potentially reducing the risk of colon cancer. Research studies find evidence that high fiber intakes, particularly from cereals or grains and fruit, are associated with a reduced risk of incident colorectal adenoma and cancer [11]. (colorectal adenoma, also known as a colonic polyp, is a non-cancerous growth that develops on the inner lining of the colon or rectum, and can develop into colorectal cancer if not removed.)
• Neuroprotective Ally: Fiber, particularly prebiotics, nourishes gut bacteria, influencing neurotransmitter production and potentially supporting cognitive function. Certain gut bacteria strains may interact with the brain via the gut-brain axis, influencing cognitive health [12][13].
• Metabolic Maestro: Fiber slows down sugar absorption, improving insulin sensitivity and blood sugar control, crucial for preventing type 2 diabetes, says the CDC [14]. A meta-analysis of 15 studies published in the JABFM highlight the beneficial effects of dietary fiber on HbA1c levels in individuals with type 2 diabetes [15]

Fermentation

Fermented foods were not specifically addressed above in the discussion of the Mediterranean diet, but they are a valuable component of any diet that seeks to improve healthspan due to their beneficial impact on the gut microbiome.

• Atherosclerosis & Microbiome Magic: Fermented foods like yogurt, kimchi, and sauerkraut harbor beneficial probiotics that improve gut health. Studies suggest that probiotics may lower LDL cholesterol and improve blood pressure, contributing to cardiovascular health [16].
• Cancer Ally: Probiotics may modulate the immune system and influence the gut microbiome, potentially impacting cancer development. Research suggests that certain probiotic strains may have anti-tumor properties [17].
• Brain Booster: Probiotics may influence the gut-brain axis, potentially impacting cognitive function and neurodegenerative diseases. Probiotics may improve cognitive function and memory in individuals with mild cognitive impairment [18].

At this point, you’ve gotten a picture of how some of the basic components of the Mediterranean Diet — such the abundant consumption of phytonutrients, fiber and fermented foods, along with deprioritizing meat — can protect you from becoming afflicted with any of the Four Horsemen of disease.

Now, I want to explore with you what specific foods to embrace that can help prevent or ameliorate the deleterious impact of the four chronic diseases we’ve covered.

 

These Foods In the Mediterranean Diet Beat the Four Horsemen

You may know which of the four diseases you have or are prone to get. In either case, you can scroll down and quickly see what foods you can begin to prioritize in your diet. I’ve also included what tests you can take to evaluate your status relative to atherosclerotic disease, cancer, neurodegenerative disease and metabolic disease.

Atherosclerotic Disease

Foods to Embrace:

• High-fiber foods: Fruits, vegetables, whole grains, and legumes help lower cholesterol and reduce inflammation.
• Fatty fish: Rich in omega-3 fatty acids, which decrease bad cholesterol and improve blood vessel function.
• Nuts and seeds: Rich in protein, fiber, and healthy fats, they lower inflammation and improve blood vessel health.

Nutrients to Boost:

• Potassium: Found in fruits and vegetables, it helps regulate blood pressure and counteracts the negative effects of sodium.
• Magnesium: Abundant in nuts, seeds, and leafy greens, it improves endothelial function and blood pressure.

Blood Tests:

• Lipoprotein profile: Measures various cholesterol types like LDL (bad) and HDL (good).
• C-reactive protein (CRP): Indicates inflammation, a risk factor for cardiovascular disease.

Sodium’s Impact:

• High sodium intake elevates blood pressure, increasing heart disease risk. Aim for less than 2,300mg/day, ideally 1,500mg for those with hypertension.

Cancer

Foods to Embrace:

• Cruciferous vegetables: Broccoli, kale, and cabbage contain sulforaphane, a compound with anti-cancer properties.
• Berries: Rich in antioxidants like anthocyanins, which protect cells from damage.
• Turmeric and ginger: Contain curcumin and gingerol, respectively, with anti-inflammatory and anti-cancer effects.

Nutrients to Boost:

• Vitamin C: Found in citrus fruits and bell peppers, it protects cells from free radical damage.
• Vitamin E: Abundant in nuts, seeds, and avocados, it has antioxidant and anti-inflammatory properties.

Blood Tests:

• Tumor markers: Can indicate the presence of certain cancers, though not definitive.
• Cancer screening tests: Based on age and risk factors, like colonoscopies or mammograms.

Neurodegenerative Disease

Foods to Embrace:

• Fatty fish: Provide DHA, an omega-3 fatty acid crucial for brain health.
• Berries and dark leafy greens: Rich in antioxidants and flavonoids, which protect brain cells.
• Nuts and seeds: Contain vitamin E and other nutrients beneficial for cognitive function.

Nutrients to Boost:

• Vitamin D: Promotes brain cell health and may reduce Alzheimer’s risk.
• Curcumin: Has anti-inflammatory and neuroprotective properties.

Blood Tests:

• Beta-amyloid and tau proteins: Potential markers for Alzheimer’s, but interpretation is complex.
• Cognitive function tests: Assess memory, reasoning, and other cognitive abilities.

Metabolic Disease

Foods to Embrace:

• Low-glycemic foods: Fruits, vegetables, and whole grains cause slower blood sugar rise, improving insulin sensitivity.
• Healthy fats: Avocados, fatty fish, and nuts provide satiety and improve insulin sensitivity.
• High-protein foods: Legumes, nuts, and lean meats help regulate blood sugar and appetite.

Nutrients to Boost:

• Fiber: Slows down sugar absorption and improves gut health.
• Magnesium: Enhances insulin sensitivity and regulates blood sugar.

Blood Tests:

• Fasting glucose and insulin: Evaluate how your body processes sugar.
• HbA1c: Provides a longer-term view of blood sugar control.

 

Mediterranean Diet Recipes

YouTube has hundreds if not thousands of videos that can show you how to make the many, many Mediterranean Diet-based meals that can fuel your resistance to chronic disease and prolong your healthspan.

Blue Zone recipes

The Blue Zone website lists hundreds of recipes that take 30 minutes or less to make. The search tool can quickly help you find what you want. A screenshot example:

 

If you want more help, consider the Blue Zone meal planner. For $14/month, you’ll get customized meal plans delivered to you.

Nutritionfacts recipes

Nutritionfacts.org run by Dr. Michael Greger, whose video you might have watched above, also has hundreds of plant-focused recipes you can sort through or find via their search tool.

Here’s a screenshot:

allrecipes

allrecipes has a dazzling number of recipes for any meal you can think of. Use its search tool to give you a list of a food category or a specific meal. I typed in “vegan” and was immediately shown many pages of recipes.

Here’s a screenshot of a few:

Your Takeaway

Remember these three things:

1. The “Four Horsemen of Chronic Disease” represent the top killers of people in the developed world. Typically, we don’t die from old age, but from one of these: atherosclerosis, cancer, neurodegeneration and metabolic disease.
2. The type of food consumed within the Mediterranean Diet can help prevent or reduce the ill effects of the “Horsemen”. If you’re not eating this way already, gradually add plant foods to your diet so that you can get the phytonutrients, fiber and fermented foods into your body on a regular basis, while at the same time limiting your meat consumption.
3. There’s plenty of help available to you — just consult the three recipe resources I linked to above, or take a stroll through YouTube’s Mediterranean Diet advocates.

If you know someone that’s wrestling with any of the Horsemen, send them this post.

 

Go to:

 

Last Updated on February 7, 2024 by Joe Garma