The Omega Diet: The Lifesaving Nutritional Program Based on the Diet of the Island of Crete

By Artemis P. Simopoulos and Jo Robinson

The medically proven diet that restores your body's essential nutritional balance

"Good fats"--essential fatty acids--influence every aspect of our being, from the beating of our hearts to our ability to learn to remember. There are two types of essential fatty acids (EFAs), omega-6 and omega-3. The problem with our modern diet is that it contains far more omega-6 fatty acids than omega-3s. This hidden imbalance makes us more vulnerable to heart disease, cancer, obesity, autoimmmune diseases, allergies, diabetes, and depression.

The Omega Diet is a natural, time-tested diet that balances the essential fatty acids in your diet. It is packed with delicious food that contain the "good" fats, including real salad dressing, cheese, eggs, fish--even the occasional chocolate dessert--and an abundance of antioxidant-rich fruits, vegetables, and legumes.

The Omega Diet provides:

• seven simple dietary guidelines for optimal physical and mental health
• a concise guide to the foods you need to restore your body's nutritional balance
• a diet plan that lets you eat fat as you lose fat
• fifty delicious recipes that are quick and easy to prepare
• a comprehensive three-week menu to help you get started

• Language: English
• Publisher: Open Road Integrated Media
• Release date: Feb 15, 2011
• ISBN: 9780062013118

Artemis P. Simopoulos

Artemis Simopoulos, M.D., is a world authority on essential fatty acids and was nutritional adviser to the Office of Consumer Affairs at the White House. She is the author of The Healing Diet and the editor in chief of World Review of Nutrition and Dietetics. She lives in Washington, DC.

Book preview

The Omega Diet

The Lifesaving Nutritional Program Based on the Best of the Mediterranean Diets

Artemis P. Simopoulos, M.D., and Jo Robinson

To my husband, Alan Lee Pinkerson, M.D., and my daughters, Daphne, Lee, and Alexandra Pinkerson, M.D., whose enthusiasm and support encouraged me to translate the latest nutrition knowledge and concepts into a book for the benefit of the general public

A.P.S.

Contents

Introduction

Part 1

Your Health Is in the Balance

1. Found: The Missing Ingredients for Optimal Health

2. The Skinny on Fat

3. Why We Eat the Wrong Fats

4. A Fatty Acid Primer

Part 2

Fighting Disease with The Omega Plan

5. The Genesis of a Heart Attack

6. Taming the Savage Cell

7. Defeating Syndrome-X, Obesity, and Diabetes

8. Food for Thought

9. How The Omega Plan Fine-tunes Your Immune System

Part 3

Putting The Omega Plan into Action

10. Your Health Is in the Balance

11. The Omega Shopper

12. The 3-Week Omega Plan

13. The Omega Weight-Loss Plan

14. In the Omega Kitchen

15. Shortcuts to Healthy Eating

Comments and Endnotes

Appendix

Grams of Fatty Acids per 100 Grams

Resource Section

Recommended Reading

Searchable Terms

Acknowledgments

Copyright

About the Publisher

Introduction

In this book, I have the privilege of presenting some lifesaving new discoveries about diet and health. Careful research conducted over the past fifteen years has shown that fat is more than fuel—it is an essential nutrient that influences every aspect of your being from your ability to learn to the beating of your heart. Whether fat enhances or undermines your health depends on its unique blend of fatty acids, the molecular building blocks of fats and oils. Eating a healthy balance of fatty acids will reduce your risk of a host of diseases, including cardiovascular disease, cancer, diabetes, obesity, arthritis, and asthma. It might even save your life.

In an ideal world, we should not have to know anything about fatty acids in order to eat a healthy diet; we should be able to shop at the local store, buy products that are readily available, and be confident that we are bringing home nutritionally balanced food. But we do not have this luxury. Unwittingly, we have allowed the food industry to make technological changes to our food supply without understanding the biological consequences. The net result is that our diet is so different from the natural human diet, the diet on which our species evolved, that it is at odds with our genetic makeup, increasing our risk of heart disease, cancer, diabetes, obesity, and immune disorders. The Omega Diet, the landmark medically proven program featured in this book, restores a healthy balance of essential nutrients to your diet. This simple and delicious program will help every cell and every system in your body function as nature intended.

As fortune would have it, I grew up eating a diet very similar to The Omega Diet. I was born in Greece, a country with a 5,000-year tradition of good nutrition. My mother made a great effort to give us fresh, wholesome food, a task made easier by the fact that we had a large estate that had been in her family for generations. Within the stone walls of the estate were chickens, goats, sheep, and hundreds of trees that gave us olives, pears, figs, plums, and pomegranates. The mild climate allowed fruits and vegetables to grow year round. Given this bounty, everything we ate was impeccably fresh. The eggs that went into the spinach pie had been laid by our hens that very morning. The milk was from the day’s first milking. The whole-wheat bread was freshly made, and the olive oil that anointed the bread had been pressed from our own olives. For lunch, we had charcoal-broiled fish that had been swimming in the Mediterranean Sea only the day before. One of my childhood delights was waking up in the morning and hurrying down to breakfast, knowing that I would be greeted by a bowl of ripe fruit. The fruit would be chilled—not because it had come from the refrigerator but because it had been picked before dawn.

Although the food was delicious and bountiful, it was eaten with restraint. As is true in most Greek households, a period of fasting preceded our holidays and feast days. During Lent, for example, we would go for several weeks without eating meat or dairy products. During Easter week, we would even forgo olive oil. It wasn’t unusual for adults to lose ten pounds before Easter, a reversal of the American tradition of feasting during the holidays and then going on a punishing diet. Exercise was an integral part of our lives. We would walk to market, to school, and to church. In church, everyone would stand except the old people. In school, we had a full hour of physical activity every day. People from the wealthiest families even had personal exercise trainers—decades before the practice became fashionable in the United States.

I was in for a rude shock when I came to the United States in 1949 to study chemistry at Barnard College. To put it bluntly, I found much of the food inedible. I can still remember the first breakfast I ate in the dorm. The only bread available was white bread, which, to me, tasted like cotton. There was one kind of cheese, an intensely orange, bland, and rubbery cheese. The fruit looked appetizing, but it had so little flavor that it was hard to believe it was the same kind of fruit that grew in Greece. There were three other Greek students at Barnard, and they viewed the American diet with equal dismay. Eventually, we discovered that white bread tastes better when it’s toasted, and that rye crackers are a reasonable stand-in for whole-grain bread.

The stark contrast between the American diet of the 1950s and the traditional Greek diet made such an impression on me that it helped shape my entire medical career. When I went to medical school, I specialized in pediatrics and focused much of my attention on infant and maternal nutrition. I began to realize that many of the children with serious diseases had been malnourished in the womb. This unfortunate start was made worse by the types of food eaten in the home—refined foods, lots of saturated fat and sugar, very few fruits and vegetables, and margarine with its hidden cargo of trans-fatty acids. My first job following my training was directing the newborn nursery at George Washington University, and I saw once again that diet and lifestyle can have dramatic effects on the health of the child. This observation made me interested in the interplay between genetics and nutrition as well. Which types of food were ideally suited for a child’s genetic background? How could diet help compensate for genetic defects? I found the answers to many of my questions when I went to study endocrinology and metabolism at the National Institutes of Health (NIH).

In the late 1970s and 1980s, I added another interest—food politics. Medical research alone cannot change what Americans eat. Vital research paid for with taxpayers’ money remains locked in the medical journals unless it is communicated to the public and implemented by government policy. To help shape that policy, I chaired the Nutrition Coordinating Committee at the NIH for nine consecutive years and co-chaired the Interagency Committee for Human Nutrition Research at the Office of Science and Technology Policy at the White House for five years. These committees influenced nutrition and food policy throughout the federal government.

While chairing the committees, I became aware of a number of new findings about essential fatty acids and, in 1985, helped organize the first international conference devoted exclusively to this topic. Following the conference, my colleagues and I wrote a comprehensive research program focusing on essential fatty acids that was adopted by ten separate institutes of the NIH.

One of the most important findings to come out of the research program is that our bodies function most efficiently when we eat fats that contain a balanced ratio of the two families of essential fatty acids—omega-6 and omega-3 fatty acids. The ratio in the typical American diet has been estimated to be as high as 20 to 1. One of the few diets in the world to have a balanced ratio of essential fatty acids is the traditional Greek diet. Ironically, I had spent much of my medical career gaining scientific insight into the very diet on which I was raised.

When you follow The Seven Dietary Guidelines of The Omega Diet, you will be fueling your body with a ratio of essential fatty acids ideally suited for your metabolism. You will also be enriching your diet with fresh fruit, vegetables, legumes, and oils high in omega-3 fatty acids. A study conducted in the 1990s (the Lyon Diet Heart Study) demonstrated convincingly that this type of diet protects your cardiovascular system more effectively than any other heart diet or drug.

Although this book is focused primarily on diet, I will also be stressing the importance of physical exercise. Regular physical activity enhances your health in many of the same ways as eating the right balance of nutrients. When you combine exercise with a healthy diet, you have what Hippocrates defined as Positive Health:

Positive health requires a knowledge of man’s primary constitution [what we now call genetics] and of the powers of various foods, both those natural to them and those resulting from human skill [today’s processed foods]. But eating alone is not enough for health. There must also be exercise, of which the effects must likewise be known. The combination of these two things makes regimen, when proper attention is given to the season of the year, the changes of the winds, the age of the individual, and the situation of his home. If there is any deficiency in food or exercise, the body will fall sick.

I have written this book with the hope that it will empower you to make healthier food choices, greatly increasing your chances of enjoying lifelong positive health.

PART 1

Your Health Is in the Balance

ONE

Found: The Missing Ingredients for Optimal Health

IN RECENT YEARS, medical research has shattered many of our simplistic notions about diet. For example, the popular ideas that fat makes you fat and that animal fat is bad and vegetable oil is good have been overturned by exciting new discoveries about fat that are helping to fight disease and promote optimal health. Similarly, the naïve notion that vitamin supplements can replace fruits and vegetables has given way to a new appreciation for the treasure trove of nutrients these wholesome foods contain, including antioxidants that are not vitamins, folate, and cancer-fighting nutrients called phytochemicals. This book translates these new findings into a simple, delicious dietary plan that will greatly increase your chances of living a long, lean, and healthy life.

One of the main conclusions to come from the medical labs is that you don’t have to give up fat to lose weight or enjoy better health. Most weight-loss diets and so-called healthy diets throw out the good fat with the bad fat, leaving you with dry, lackluster food. Very few people are able to stay on such a diet, resulting in a sense of frustration and failure. The Omega Plan, the breakthrough dietary plan featured in this book, replaces harmful fats with beneficial ones, allowing you to eat from 30 to 35 percent of your calories as fat—absolutely free of guilt! In fact, I will be urging you to eat more of certain kinds of fat. Yet studies show that you will be healthier on this new, moderate-fat program than if you were to submit yourself to a dreary succession of watery salad dressings, fat-free cheese, rice cakes, steamed vegetables, and skinless chicken breasts poached in broth.

And, no, you won’t gain weight. In fact, as you will learn in later chapters, when you combine The Omega Plan with a program of regular exercise, you will increase your chances of being fit and lean. If you have a substantial amount of weight to lose (ten pounds or more), this book can help you do that as well. Chapter 13 features two weight-loss versions of The Omega Plan—a fast burn program, and a more moderate weight-loss program. Both contain the same generous percentage of fat as the regular diet. Today, you can start losing up to two pounds a week as you reap all the health benefits of the regular program.

New Discoveries About Fatty Acids

Our new appraisal of fat comes from studying its molecular building blocks—fatty acids. When you pour vegetable oil into a measuring cup, it looks like one uniform substance, but on a submicroscopic level, it is composed of six or more different types of fatty acids. New studies show that the individual fatty acids can have remarkably different effects on your health. Some promote cancer growth; some block it. Some increase your risk of heart attack and stroke; some reduce it. Some are more likely to be stored as body fat; others are quickly burned as fuel. Some are linked with depression and other mental problems; some foster emotional well-being. The way a given fat influences your health depends on its unique blend of fatty acids.

Unfortunately, the typical Western diet is loaded with the types of fatty acids that are linked with some of our most serious health problems, while it is markedly deficient in some that are essential for optimal health. Even if you are well informed about nutrition and very careful about what you eat, you may still be fueling your body with the wrong ratio of fatty acids. Many of the physicians, medical researchers, and even dietitians who attend my lectures discover that they are eating the same unbalanced blend of fats as the general public.

The Bad Fats and the Good Fats

One type of fat—saturated fat—has lived up to its reputation of being a bad fat. Found in meat, dairy products, and some tropical oils, saturated fat increases your risk of coronary artery disease, diabetes, and obesity. Recently, another culprit has been identified—trans-fatty acids, manmade molecules that are produced during the hydrogenation of vegetable oil. New studies show that trans-fatty acids can be even worse for your cardiovascular system than saturated fat and may also increase the risk of breast cancer. Switching from butter to margarine was not such a good idea after all.

Some fatty acids, however, are actually good for your health. Monounsaturated fatty acids, the type found in olive oil and canola oil, help protect your cardiovascular system. They also reduce the risk of certain metabolic disorders such as insulin resistance and diabetes, and are linked with a lower rate of cancer. This good news is beginning to reach the general public, resulting in a newfound popularity for canola oil and olive oil, a healthy trend that is consistent with The Omega Plan.

But some of the most significant research about fatty acids has remained locked in the medical journals. In particular, few people know about the health benefits that come from eating the right balance of essential fatty acids, or EFAs. EFAs are fatty acids that are necessary for normal growth and development and cannot be manufactured in your body; you must get them from your diet. There are two families of EFAs, "omega-6 fatty acids and omega-3" fatty acids. Omega-6 fatty acids are most abundant in common vegetable oils such as corn, safflower, cottonseed, and sunflower oils. Omega-3 fatty acids are found primarily in seafood, green leafy vegetables, fish, canola oil, and walnuts. A critical finding is that your body functions best when your diet contains a balanced ratio of EFAs, yet the typical Western diet contains approximately fourteen to twenty times more omega-6 fatty acids than omega-3s.¹–⁷ This imbalance is now being linked with a long list of serious conditions and diseases including:

Heart attack

Stroke

Cancer

Obesity

Insulin resistance

Diabetes

Asthma

Arthritis

Lupus

Depression

Schizophrenia

Attention deficit hyperactivity disorder

Postpartum depression

Alzheimer’s disease

To learn more about EFAs, researchers have raised lab animals on diets similar to ours that are high in omega-6 fatty acids and low in omega-3 fatty acids. Invariably, the animals have suffered. When implanted with cancer cells, for example, their tumors have grown faster, larger, and more invasive. When allowed free access to food, the animals have gained weight and developed a common metabolic disorder called insulin resistance. When given psychological and mental tests, they’ve had a difficult time finding their way out of mazes, engaged in more random and self-destructive behavior, and been less willing to explore open spaces. Evidence that I will present throughout this book strongly suggests that eating an unbalanced ratio of essential fatty acids is causing the same havoc in our own bodies as well.

The Omega Plan fuels your body with an ideal balance of EFAs and other key nutrients, allowing every cell and system in your body to function more effectively. If you have a serious health problem, making these simple changes can relieve your symptoms, allow you to cut back on medications, or even save your life.

What Is the History of The Omega Plan?

Although The Omega Plan is supported by cutting-edge medical research, it has its roots deep in history. Indeed, it is based on the traditional diet of the Greek island of Crete, a diet that was virtually unchanged from 4,000 B.C. until modern times. The Crete diet first came to the attention of the medical community in the 1960s when an influential fifteen-year study revealed that the men from Crete were healthier than all the other 12,000 men surveyed in seven quite different countries—Greece, Italy, the Netherlands, Finland, Yugoslavia, Japan, and the United States.⁸

The difference in health between the men from Crete and the rest of the men was remarkable. Compared to the Americans, for example, they had half the cancer death rate and an astonishing one-twentieth of the mortality from coronary artery disease. Compared to the Japanese, they had half the overall death rate—even though the Crete diet was a 40 percent-fat diet that contained three times more fat than the Japanese diet. Surprisingly, the men from Crete also had half the overall death rate as men from Italy, even though both groups of men were eating Mediterranean-style diets that were rich in olive oil, legumes, fruits, and vegetables. There was something unique about the Crete diet, but at that time, medical science was unable to pinpoint what it was. (The educated guess was that it had something to do with its lower saturated fat and higher olive oil content.)

The Missing Clue

Two decades later, I was able to provide one of the missing clues: The traditional Crete diet has an ideal ratio of EFAs. I gathered this insight in a roundabout fashion while investigating the omega-3 fatty acid content of wild plants. As I had suspected, I found that certain wild plants contain far more omega-3 fatty acids than cultivated plants.⁹ This finding helped shed new light on the Crete diet because people from Crete eat large quantities of greens and wild plants, including purslane, the plant that was the subject of one of my studies. Perhaps this hidden bounty of omega-3 fatty acids was one of the reasons for their superb health.

My suspicions were confirmed by a landmark heart study conducted shortly thereafter by two French colleagues, Serge Renaud and Michel de Lorgeril. In a carefully designed study known as the Lyon Diet Heart Study, Renaud and de Lorgeril assigned 302 heart attack survivors to a traditional heart diet, the prudent heart diet recommended by the American Heart Association (AHA).¹⁰ A similar group was assigned to a slightly modified version of the Crete diet. This new diet was based on canola oil and olive oil, and it had a ratio of omega-6 to omega-3 fatty acids of 4 to 1, much lower than the AHA diet and the traditional Western diet. The diet was also lower in red meat and deli meats, but higher in fish, grains, fruits, and vegetables. Overall, it contained 35 percent fat, whereas the AHA diet is 30 percent.¹¹

Figure 1-1. Superior Heart Protection of the Crete Diet

This graph compares the number of patients in each diet group who survived and did not have additional heart attacks. As you can see, the patients on the modified Crete diet fared much better.¹³

The results of the study made medical history. Just four months into the clinical trial, the researchers discovered there had been significantly fewer deaths in the group on the modified Crete diet than on the AHA diet. This in itself is remarkable because no other heart diet or drug has ever shown a lifesaving benefit until patients have been treated for at least six months. The survival gap widened with each passing month. When the patients had been followed for about two years, the study was halted abruptly because the new diet was proving so superior it would have been unethical to continue the research. Compared to those on the AHA diet, the patients on the Crete diet had an unprecedented 76 percent lower risk of dying from cardiovascular disease or suffering heart failure, heart attack, or stroke! Remarkably, the new diet had proven more effective at saving lives than any other heart diet, drug, surgical technique, lifestyle program, or any combination of these elements. These results were deemed important enough to be published in three prestigious medical journals, The Lancet, ¹⁰ The American Journal of Clinical Nutrition,¹¹ and the Journal of the American College of Cardiology.¹²

The Omega Plan gives you the same balance of essential fatty acids and other nutrients that proved so beneficial for the French heart attack patients, allowing you to benefit from this lifesaving research for the very first time. So often you hear about a promising medical study, only to discover you can’t take advantage of it for years to come because more research needs to be done. Not so with the Lyon study. This book allows you to start profiting from this amazing heart research with your very next trip to the grocery store.

But The Omega Plan is far more than a heart diet. Studies show that this new program will also make you less vulnerable to inflammatory and autoimmune diseases. Your risk of cancer may go down by as much as 50 percent. You may even be less prone to mental disorders such as depression and Alzheimer’s disease. When you eat a diet that contains the right balance of fats and other essential nutrients, every system in your body will function more normally.

The Omega Plan Is Delicious and Easy to Follow

The Omega Plan is a very simple program to follow. Unlike some other popular diets, you won’t have to deprive yourself of fat, force yourself to eat abnormally high amounts of protein, or make sure that every bite that you eat conforms to a rigid ratio of fat, carbohydrates, and protein. Indeed, most of the work of the diet takes place at the grocery store. If you fill your shopping cart wisely, you will be well on your way to satisfying its Seven Dietary Guidelines.

The most important change you will be making is in eating a healthier balance of fat. A combination of olive oil and canola oil will become your primary oils. Just as important, you will be supplementing your diet with foods rich in omega-3 fatty acids while you limit your intake of omega-6 fatty acids, saturated fat, and trans-fatty acids. These changes are easier to make than you might expect. Simply using canola oil as your primary oil, for example, will satisfy most of these dietary requirements. You may be aware that canola oil is rich in monounsaturated fatty acids, but it is also an unheralded source of omega-3 fatty acids as well. The fact that it is low in saturated fat, trans-fatty acids, and lower in omega-6 fatty acids than many other oils makes it one of the healthiest foods in your kitchen.

Another change you will be making is eating more fruits, vegetables, and legumes. The current USDA guidelines recommend that you eat five or more servings of these wholesome foods every day. On The Omega Plan you will be eating seven or more servings a day, giving you added helpings of vitamins, fiber, minerals, antioxidants, and health-enhancing substances called phytochemicals.

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The Seven Dietary Guidelines of The Omega Plan

Eat foods rich in omega-3 fatty acids such as fatty fish (salmon, tuna, trout, herring, mackerel), walnuts, canola oil, flaxseeds, and green leafy vegetables. Or, if you prefer, take omega-3 supplements.

Use monounsaturated oils such as olive oil and canola oil as your primary fat.

Eat seven or more servings of fruits and vegetables every day.

Eat more vegetable protein, including peas, beans, and nuts.

Avoid saturated fat by choosing lean meat over fatty meat (if you eat meat) and low-fat over full-fat milk products.

Avoid oils that are high in omega-6 fatty acids, including corn, safflower, sunflower, soybean, and cottonseed oils.

Reduce your intake of trans-fatty acids by cutting back on margarine, vegetable shortening, commercial pastries, deep-fat fried food, and most prepared snacks, mixes, and convenience food.

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Medical Proof of The Omega Plan

Understandably, the public has grown weary of books that proclaim to reveal THE secret to health and fitness, especially when the advice is so contradictory. One year, the ultimate solution to good health is to strip all the visible fat from your diet. The next year, the revolutionary new program is very high in protein. Just when you think it’s safe to go to the store, someone tells you that you need to be eating a highly specific balance of fats, protein, and carbohydrates. What is even more confusing is that all of these diets are purported to be based on the latest medical science.

What assurance do you have that The Omega Plan is not just another fad diet? Fortunately, there are ways you can judge the validity of this program, or any other diet for that matter. The most important question to ask is whether a diet has been tested in a large-scale clinical trial. If the only proof of a diet is one small, unpublished study; or the testimony of a select group of clients; or, worse yet, the enthusiastic claims of a celebrity promoter—I was on this diet for three weeks and I feel terrific!—you have no assurance that the diet will work for you.

The Omega Plan stands up to this scrutiny because, as I have explained, its heart-protective properties were carefully tested in the Lyon Diet Heart Study. The Lyon study was a randomized clinical trial—the gold standard of medical studies. In such a study, a new therapy is compared with either a placebo or a commonly accepted form of treatment. The term randomized means that the patients are assigned by chance to the different study groups, which prevents the researchers from biasing the results by routing healthier or more treatable patients to a particular treatment. An added precaution of the Lyon Diet Heart Study is that it was blinded. This means that the physicians who evaluated the results did not know if a given patient had been on the Crete diet or the AHA diet, which helped them evaluate the results more objectively.

But