Mediterranean diet could be preventative medicine, according to study


I saw a recent study, published in the New England Journal of Medicine, that compared the Mediterranean diet to a traditional low-fat American diet.

After tracking 7,000 people over five years, they saw a significant reduction in strokes and heart attacks among those participants on the Mediterranean diet.

Today, I had the chance to visit WAKR’s studio and speak with host Ray Horner about this study and its results. We also discussed shoulder injuries in adult and youth athletes, after hearing about Indians player Chris Perez’ shoulder injury last week.

Below is a transcript and embedded audio player of our discussion.


Dr. Joe Congeni

Dr. Joe Congeni

Horner: Each Wednesday, Dr. Joe Congeni from Sports Medicine Center at Akron Children’s Hospital, joins us. And once a month, he comes on in to the studio and gives us a little bit more detail on subjects. You’ve got a Mediterranean diet for us this morning?

Dr. Congeni: Well, this is particularly for you when I saw this story (laughter), but it is what everybody is talking about. You might say, gosh, is this really sports medicine? But sports medicine is preventative medicine.

This is a really well done study [conducted] in Barcelona, Spain. They started in the year 2002. They looked at 7,000 people, 3 different diets: 2 different types of Mediterranean diets versus just a low-fat American diet. The Mediterranean diets included one with extra-virgin olive oil and one supplemented with mixed nuts. They [studied] people over 5 years, so it was a well-done study.

In the Mediterranean diet, there was high intake of olive oil, fruit, nuts, vegetables and cereals, a moderate amount of fish and poultry, and very low intake of dairy products, red meats, processed meats and sweets. At the end of 5 years, [researchers saw] a significant reduction of strokes and heart attacks in both Mediterranean diet [subjects] — not a big difference between the mixed nuts or the olive oil ones.

But both Mediterranean diets showed significantly less [risk] than the American low-fat diet that they looked at, stronger even than taking, for instance, some of the statins that lower your cholesterol and other things. It even looked better in the long run than some of the medicines we use in this country to try to prevent heart disease.

Horner: So, do you point to diary products as one of the main things there?

Dr. Congeni: There are [too many] different variables to know what it was about this Mediterranean diet, but people have been talking about this for years. This was in last week’s New England Journal of Medicine and everybody in the adult world is talking about it. It’s real hot in the medical world.

They even had 7 servings of red wine (over a week on average) during it, so people are looking at a lot [of variables] in the Mediterranean diet. But, very powerful reduction in strokes and heart attacks in people on this Mediterranean diet.

Horner: And we’re hearing more and more about the nuts, as far as good in the diet on a moderate level.

Dr. Congeni: In a moderate level, yes, but the olive oil also, no question about it, showed a significant reduction in heart attacks.

Horner: Do you use olive oil, Joe?

Dr. Congeni: We do.

Horner: I had a hunch. Yeah, we do too.

Dr. Congeni: So I think that maybe validates some of what you like already with the diet. It’s being discussed a lot, so I wanted to at least mention it today.

Horner: Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital, joins us, 1590 WAKR.

Last week, Joe, I was in Arizona as you know with the Indians, and the day I’m leaving, Chris Perez gets a shoulder strain — out 3 to 4 weeks. I started thinking, shoulder strain, we talk about that a lot, but what actually is a strain? Is it just the muscle tired, it is being stretched, is it fraying? Get in to that for me.

Dr. Congeni: Well, strain is such a general term, as you know.

I told you when you were down in Arizona, no injuries when you come back. The next day the closer’s out until the opener. So, good thing we got Vinnie Pestano and other things like that.

Horner: I agree.

Dr. Congeni: So, a grade one strain is kind of an overstretch of the muscle. A grade two is actually some tearing of the muscle tendon unit. So, remember, sprain injury to the ligaments — the ligaments that hold joints together.

Strain is an injury to the muscle and tendon unit: grade one, stretch injury; grade two, some fraying and tearing; grade three, a complete tear. They don’t go into a lot of detail in these things, but the injury is to the muscle tendon unit.

In pitchers, it is always a balance between the muscles in the front of the shoulder and those in the back of the shoulder. And what gives stability to the shoulder — a group of muscles called the scapular stabilizers — are the ones in the back of the shoulder.

You know, the strength coaches talk about the push muscles — the pecs and the deltoids — and the pull muscles. The pitchers and overhead athletes need to work a lot of those pull muscles — the stabilizers of the shoulder. And, unfortunately, when you overload those stabilizers and they tear and stretch, you can’t create the velocity, you can’t throw the ball where you want to, and it’s a real big deal for pitchers.

Horner: We’re gonna start getting these Little League practices and everything going, do we see strains at all with our young 9 through 13 year olds?

Dr. Congeni: Oh my gosh, if you think that we’re just getting started in baseball right about now, Ray, come on down to my office with me today. You know this ‘cause I know you have a son, Rocco, playing.

Horner: Yeah, we played all winter.

Dr. Congeni: It’s all winter long with these kids. So, I’ve been seeing them in January and February — and in the old days I didn’t see them then.

But, it’s different in kids, and thanks for asking because it’s not a strain, it’s not the muscle tendon unit. The weaker link in kids is the growth plates, the areas where the bones are growing. So what they get is this thing called, Little League shoulder, where the shoulder fails, or Little League elbow, where the elbow fails.

They have no strength anymore and they have to rest. You can see it on X-rays many times, it’s a stress fracture to the growing bones. The good news is if they will rest it, it will heal pretty good — in some ways maybe even better than the muscles and tendons of Chris Perez.

Horner: Dr. Joe Congeni with us from Sports Medicine Center at Akron Children’s Hospital.

I remember these growth plates. If you turn the clock back, Joe, probably about 7 or 8 years ago, remember I brought Elizabeth down to your office? She was playing volleyball and was having some problems in her back and shoulder area. You came in and you said, this is the growth plate thing and you see it a whole lot at that age.

Dr. Congeni: Much of the day, that’s what I’m chasing around is the overload to these growth plates. The runners get them in their knees, the basketball players get the Osgood-Schlatters, swelling of that growth plate, the soccer players get them in their feet, the overhead athletes get them in the shoulder and the elbow. So, these growth plates are not meant for that overload stress.

With that big Dr. Andrews’ article in The Plain Dealer last week, you may have heard about, [the key] is to reduce the load to these growth plates. But, it’s hard in this day and age. You know as a parent, sports is a year-round issue. We ask, “Can we get you to take 3 months off, one season of the year?” But, young kids do not take a season of the year off and they play year-round.

Horner: Yeah, I’ve made it a point. Rocco plays fall baseball, he does it in the winter a little bit and then spring. But after the spring season is done, he’s done for a couple months just to rest that a little bit.

What else do you have?

Dr. Congeni: Our big once-a-year conference is this weekend. It really is a sellout. We have a couple of overflow rooms, but every seat is already taken.

We have a great keynote speaker from Harvard, a physical therapist who is the director of the Spaulding National Running Center. I know for you as a runner, I’d like to get you the podcast of Irene Davis. She’s been on “Good Morning America,” she’s always in the Wall Street Journal and other journals. She’s one of the best-known speakers in the country on running injuries, talking a lot about barefoot running, injuries in running, running mechanics. She’s awesome and she’s giving 2 or 3 talks for us this weekend.

And then one of my old fellows is coming in from Milwaukee Children’s and he’s going to talk about injury prevention. So, our big conference is this weekend at Children’s Sports Medicine Center.

Horner: Alright, Joe, thanks for coming on in. We’ll see you maybe at a court nearby or for sure we’ll talk with you next week.

Dr. Congeni: Keep up with that Mediterranean diet [laughter].

Horner: I will [laughter].

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About Dr. Joe Congeni - Director of Sports Medicine

Dr. Joe Congeni is the Director, Sports Medicine; Clinical Co-Director, Center for Orthopedics and Sports Medicine at Akron Children's Hospital. For the past 25 years, Dr. Congeni has been the “go to” source for national and local media looking for information about pediatric sports medicine.

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