Vitamin E, Heart Disease and Olive Oil
1.6mg, or 2.3 IU (International Units) of Vitamin E, a natural antioxidant, is present in one tablespoon of olive oil. One tablespoon of olive oil would provide 8% of the recommended daily allotment for vitamin E.
Atherosclerosis is the process of plaque formation, thickening and blocking of the arteries which can lead to heart attacks and stroke. LDL cholesterol, the "bad" cholesterol is thought to be partially responsible for these changes when it oxidizes in the artery wall. It has been hoped that antioxidants in the diet would be found to decrease atherosclerosis. Studies show that people who eat antioxidant rich foods such as vegetable oils, fruits, vegetables, grains and nuts have a lower chance of getting heart disease and cancer. It was assumed that taking Vitamin E supplements would do the same but oddly enough newer studies show that this is not true.
In the American Journal of Clinical Nutrition, Iannuzzi and colleagues of Cardarelli Hospital in Naples found that women who consumed more vitamin E were less likely to get early signs of cardiovascular disease. They looked at ultrasound evidence of thickening in the carotid arteries, a marker for vascular disease throughout the body. Study participants were women from Southern Italy. They got most of their vitamin E from legumes, vegetables and olive oil.
Doctor Uannuzzi found that additional Vitamin E only helped those women whose levels started out low. Women with an adequate intake could not lower their risk of atherosclerosis by adding vitamin E to the diet.Other antioxidants such as Vitamin A and C did not seem to affect carotid thickening. SOURCE: American Journal of Clinical Nutrition 2002;76:582-587. 8/2002
More recently 10,000 patients at high risk for heart attack or stroke were followed for 4.5 years in the The Heart Outcomes Prevention Evaluation (HOPE) Study. People who received 265 mg (400) IU of vitamin E daily did not experience significantly fewer cardiovascular events or hospitalizations for heart failure or chest pain when compared to those who received placebo. It seems that you must eat the whole foods to get the benefit of Vitamin E, taking supplements doesn't help. 12/03/03
Designer Cooking Oils
Large food companies cannot depend on population growth to achieve revenue goals. The consumer must be compelled to buy more expensive (and profitable) items on the grocery shelf for health, flavor or convenience attributes.
Making a more healthy product will certainly differentiate it. Nutritional supplements and healthy sounding food additives are adding value to everything from breakfast cereal to dressings and spreads. Olive oil and other healthy fats can be just the ingredient to add value and profits. The ultimate example is Olivio, a spread made with olive oil.
Olive oil has gained market share over the seed oils because of its health aspects and in spite of its price is seen advertised as a "healthy" ingredient in some products. Olive oil may be seeing some competition.
There is a new generation of "healthy fats". Some are combinations of plant fats which pool their salubrious attributes. Others are genetically modified oils with enhanced antioxidant and nutrient content.
Olive oil and canola are primarily mono-saturated fats and have been shown to have heart healthy and anti-inflammatory properties. Olive oil can satiate quickly, leading to lower total calories ingested and has antioxidants which have a variety of beneficial effects. Fish oils are high in omega-3 lipids and have been shown to lower cardiac disease. Mustard oil, hemp oil, grape seed oil and many other vegetable oils have been shown to be healthy. Combinations of these oils could offer multiple benefits.
Forbes Medi-Tech Inc. has announced the results of its latest designer cooking oil clinical trial. While fats and oils usually contribute to body weight gain, Dr. Peter Jones, one of the researchers, said the oil will actually cause weight loss. Forbes' designer oil is formulated with medium chain triglycerides, plant phytosterols, omega-3 and omega-6 fatty acids.
McGill University in Montreal researchers placed 24 obese males on a diet of the "designer" cooking oil or olive oil for 28 days. The designer oil group showed a significant decrease in total body weight - about 1 pound in 28 days. The designer oil diet also lead to a 16.3 percent drop in LDL or "bad" cholesterol.
"These oils are oxidized very quickly and burned as energy rather than stored as body fat" Jones said. The company is stressing the health benefits and says little about flavor. The oil is for cooking, not to be used as a condiment as some high end olive oils are.
Other companies are in this market. Japan-based Kao Corp. has developed "Healthy Econa Cooking Oil" which it claims lowers cholesterol. The main ingredient is diacylglycerol, a vegetable sterol, which slows the increase of blood triglycerides to help prevent obesity. Take Control, Flora pro.activ and Benecol all contain plant sterols extracted from soybeans or other sources which have shown to lower LDL cholesterol in several studies.
Another "healthy oil", Soyola, is made from specially bred soybeans with reduced levels of both linolenic and palmitic acid and increased levels of oleic acid, a monosaturated fat found at high levels in olive and canola oils. Soyola was being pushed as a food ingredient.
So if olive oil isn't the cheapest oil and isn't the healthiest oil, what marketing angle still exists? Olive oil has cultural and historical appeal which the new oils can't match. Extra virgin olive oil is not refined, a selling point with some consumers. And of course olive oil actually has a flavor - something the industry could do more to promote. 11/30/02
Can Olive Oil Help Prevent Heart Attacks?
A recent study looked at the basic disease process behind heart attacks; the development of blood clots which block the coronary arteries. Several studies in Mediterranean countries have shown that the incidence of heart disease is lower than would be expected by blood cholesterol levels. Many feel that this discrepancy can be explained by the high amount of olive oil in the diet in this region. But what is it in olive oil which lowers heart attack risk? Researchers Larsen LF, Jespersen J, and Marckmann P at the Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg, Denmark decided to see if it was due to olive oil affecting the blood's basic ability to form clots. Less effective clotting would mean fewer heart attacks. The researchers compared the effects of virgin olive oil with those of rapeseed and sunflower oils on blood coagulation factor VII, which is a key factor in blood clot formation. In this study eighteen healthy young men consumed diets enriched with olive oil, sunflower oil, or rapeseed oil for a period of 3 wks. Levels of Factor VII were significantly lower in those who ate olive oil compared to sunflower or rapeseed (canola) oil. The study's conclusion was that olive oil may lower the procoagulant tendency of fatty meals which could explain the low incidence of heart attacks in Mediterranean countries. 3/2000
Atherosclerosis - Comparison of Coconut Oil and Olive Oil
Coconut oils if one of the few vegetable fats that are saturated. The vast majority of nutritionists and doctors advise that saturated fats raise cholesterol levels and should be avoided in the diet.
Recently, promoters of coconut oil have touted it as a weight loss miracle despite the fact that no large scale dietary studies support this. The Golden hamster has been used in many studies to observe the development of atherosclerosis and study the effects of various type so fats. In a recent study by Mangiapane et al at the University of Nottingham, Loughborough, UK, hamsters were fed a diet high in cholesterol and either coconut oil or olive oil. The hamsters in the olive oil group had less atherosclerosis. In a second study the researchers stopped the high cholesterol diet but continued either coconut or olive oil. Atherosclerosis lesions in the large arteries actually continued to increase in size in the coconut oil group but stabilized or shrank in the olive oil group. Studies have not yet been designed to see if olive oil would shrink atherosclerosis and "cure" heart and vascular disease in humans. 12/08/03
Which is the Best Cholesterol Buster: Canola, Sunflower or Olive Oil?
San Rafael - Some recent studies have suggested that not all monounsaturated fats are the same in their ability to lower cholesterol. Scientists at the Institute of Human Nutrition and Food Science in Germany fed hamsters a moderate amount of canola, olive, sunflower, or polyunsaturated palm oil. All the monounsaturated fats did better than the palm oil in lowering cholesterol and weren't significantly different from each other. This is good news for olive oil lovers if we can assume that similar effects would be found in humans. In a separate study, hamsters fed corn oil had significantly lower LDL and VLDL cholesterol concentrations than those fed olive oil. Unfortunately, HDL cholesterol, the "good" cholesterol, also dropped. 12/1999
Olive Oil and Heart Disease - Is Any Fat Good Fat?
John Deane M.D.
Greenbrae, Ca - A web visitor recently asked about the value of olive oil for persons recently diagnosed with atherosclerotic heart disease. There is still a great difference of opinion about oils and health. What people agree on is that less fat is better and unsaturated fats are better than saturated ones. The question is, how low do you go and which oil is better than others.
The truth may be that everyone is different and fats may or may not be a risk factor depending on one's genes. The Mediterranean diet has been shown to lower heart disease but Mediterranean countries people eat as much as 40% of their calories as fats (mostly olive oil). How much of the benefit is from the oil and how much is from the large quantity of nuts, fruits, and vegetables that are consumed? Studies are in progress to try to find out. For patients with low HDL levels and high triglycerides, the Mediterranean diet may lower heart disease best.
Dr. Dean Ornish has risen to national prominence with a diet and lifestyle program which advocates as little as 10% calories from fat. This has been shown to actually reverse atherosclerosis in some studies. Dr. Ornish says high triglycerides and low HDL are risky only for people on high-fat diets. With a lower fat diet your HDL level is less important. But there are a few critics who argue that a diet too low in fat may actually lower the good HDL cholesterol and cause worse damage to arteries. There are plenty of places in the world where heart disease is unheard of, as in rural China where the diet is heavy with complex carbohydrates such as rice and greens and very light in meat and no dairy. That would tend to support Dr. Ornish.
Now what about the different oils? Animal fats have cholesterol so there is a consensus we should avoid them. Plant oils never contain cholesterol but those which are deliberately saturated to stay solid at room temperature cause oxidative damage with resulting accelerated heart disease. Monosaturated fats such as olive oil are best. There is new research that shows that nut oils such as almond oil can lower cholesterol and raise HDL better than olive oil.
As you can see, the jury is still out, there is still controversy about diet and heart disease. My cardiology colleges all agree though, that lower fat is better. Remember, sopping your bread with olive oil may make you feel like you are doing the healthy thing, but 2 tablespoons of oil is equivalent to 2 scoops of Ben and Jerry's when it comes to total fat.
Recent Studies Suggest Margarine as Bad as Animal Fats in Artery Clogging Potential
John Deane M.D.
Greenbrae, Ca. - What is a person to do about conflicting diet advice on avoiding heart disease? Recent studies suggest margarine is worse than animal fats in its artery clogging potential. Doctors have known for some time that saturated fats, the ones that stay solid at room temperature, are not as good for you as unsaturated fats such as vegetable oils. Americans like spreading solid fats on their toast and bread rather than using liquid oils as the Mediterranean cultures have done with olive oil for centuries. To produce vegetable oils which stay solid at room temperature, they are hydrogenated, a process whereby hydrogen gas is bubbled through the oil, "saturating" it with hydrogen. Both saturated animal fats (butter) and plant oils (margarine) have been shown to be unhealthy for the heart. The solution? Use one of the new olive oil spreads which are in a tub or which have been mixed with water and other natural stabilizers to make them semi-solid at room temperature. what about Olivio, an olive oil containing spread promoted by former Chrysler head Lee Iacocca. Unfortunately it still has some possibly harmful trans-fatty soybean. Smart Balance, another olive oil containing spread, has no trans-fatty acids but contains some saturated palm oil. Your best bet? Dip or drizzle unsaturated or monosaturated oils like olive oil! Or, with pump spray gadgets like Misto you can spray your toast with your favorite oil instead of spreading margarine.
Can Pouring On The Salad Dressing Reduce Your Risk of Heart Attacks?
John Deane M.D.
San Rafael - Researchers at Harvard think so. As reported in the American Journal of Clinical Nutrition, dietary intake of alpha-linolenic acid is protective against fatal heart attacks in women. The study looked at a 116 item food questionnaire given to 76,283 women in 1984. 10 years later, women who reported a higher intake of oil and vinegar salad dressing, an important source of alpha-linolenic acid, had a lower rate of fatal heart attacks. The study confirms findings of previous lab studies in animals and humans. The primary fatty acids in olive oil are oleic, linoleic and linolenic acid. Oleic acid is monosaturated and makes up 55-85% of olive oil. Linoleic is polyunsaturated and makes up about 9%. Linolenic, which is polyunsaturated, makes up 0-1.5%. Warning: Don't pour on the creamy ranch or gorgonzola dressing, they probably have the opposite effect as they are high in saturated fats.
Olive Oil for Blood Pressure Reduction
Saturated fat diets are associated with higher blood pressure but there have been few good studies on whether the reverse is true; can unsaturated fats lower blood pressure? And are some unsaturated fats better than others? The answer is yes according to a well designed study published by researchers from the University of Naples, Italy. They fed 23 subjects a diet rich either in monosaturated fatty acids (MUFA) (olive oil) or polyunsaturated fatty acids (PUFA) (sunflower oil) for one year. In their words "the main result of our investigation was a straightforward reduction in antihypertensive tablet consumption when patients were given olive oil, whereas drug consumption was only mildly affected by sunflower oil." Need for common blood pressure drugs such as atenolol, HCTZ and nifedipine was cut in half after just 4 months on the olive oil diet whereas drug consumption was only mildly affected by sunflower oil. Cholesterol and triglyceride levels were also slightly lower while on the olive oil diet. There are as many as 5 mg of antioxidant polyphenols (absent in sunflower oil) in every 10 grams of olive oil. Polyphenols have been shown to reduce coronary artery disease and may be the substance lowering blood pressure. Antioxidants reduce nitric acid levels, a substance in the body known to raise blood pressure. At 26.6% of calories from fat the experimental diet was also low in total fat. The study was double blinded with neither subjects nor researchers aware of which oil was being used. Subjects were told to cook with given oil and men were told to add 40 g (about 4 spoonfuls) and women to add 30 g (about 3 spoonfuls) of oil after cooking. The study participants experienced no change in weight during the year. For readers with high blood pressure thinking of doing their own olive oil study: please get the participation of your doctor before changing medication doses.
From the Departments of Clinical and Experimental Medicine (Drs Ferrara, Raimondi, Guida, and Marotta, and Ms d'Episcopo) and Biochemistry and Medical Biotechnologies (Mr Dello Russo), Federico II University of Naples, Naples, Italy.
Reprints: L. Aldo Ferrara, MD, Department of Clinical and Experimental Medicine, Federico II University of Naples, Via S Pansini 5, 80131, Naples, Italy (e-mail: ferrara@unina.it).
Questions from the Mail bag
D. Jones asks: I heard the other night on David Letterman that Mel Gibson had been drinking 1 oz of olive oil every day and that he had cleared his arteries completely out. Is this true. My chol. is 211 and my LDL is very high. Would this help me. Please let me know at your convenience Thank You
Dr. Deane Replies: Several studies show that substituting animal fats with olive oil will lower your chance of a heart attack. Note that we are substituting, not adding fats to the diet. There is still some controversy over whether a diet extremely low in all fats or one which has a moderate amount of monosaturated or other "good" fats is better.
Extremely low fat diets are the only ones which have been shown in well designed preliminary scientific studies to cause a reversal of plaque in the coronary arteries. There are larger studies currently under way using a " Pritikin" or "Dr. Dean Ornish" type low fat diet which should shed some more light on this controversy.
Most Americans eat way too much fat and too many calories. Simply adding more fat to the diet is very unlikely to melt away clogged arteries.
Omega-3 Fatty Acid Oils
Greg asks: I have recently switched to a vegetarian (but not vegan) diet for health and ecological reasons. This includes eliminating fish from my diet. I understand, however, that fish are an excellent source of "omega-3" fatty acids and that I should have a healthy portion of such acids in my diet.
I've also heard that consuming olive oil on a regular basis can make up for this loss. But I've also heard that other vegetable oils contain these acids in higher quantities than olive oil, and still other reports that suggest that fish are the only true source of omega-3's.
My question is therefore multi-faceted: As a vegetarian, what is the best way for me to ensure that I am getting an adequate supply of omega-3 fatty acids in my diet? Do vegetable oils in fact contain omega-3 fatty acids? Are there any other fruits or vegetables that contain such acids? And are omega-3's really essential to a healthy diet?
Dr. Deane Replies: When we talk about fatty acids there are two considerations. The first is whether it is essential for life, one of the "essential fatty acids". The second consideration is whether it may prevent disease and prolong life. Omega-3 fatty acids have been in the spotlight recently because they may help prevent stroke and heart attacks. The FDA has said "Consumption of omega-3 fatty acids may reduce the risk of coronary heart disease" (2/2002), and the American Heart Association AHA states: "We recommend eating fish two times per week." Omega-3s exert their health benefits by blocking inflammatory substances made by the body and disrupting the function of platelets, a part of the blood clotting machinery. Olive Oil does not have high levels of omega-3 fatty acids but it does have substances, the flavenoids, which exert some of the same effects. The ratio of Omega-3 to other acids is very good in olive oil and it may be that the ratio of these fatty acids is what's most important. There are studies which show that diets rich in olive oil help prevent heart attacks and stroke.
If your personal convictions prevent you from eating fish or fish products, such as fish oil pills and capsules, I think olive oil can help with some of your concerns. A vegetarian diet is generally regarded as one of the healthiest, especially if it includes eggs, fish and dairy. Remember, you don't need to choose one oil to eat for the rest of your life. A nutritious diet would include oils high in omega-3, oils high in flavenoids, and other healthy oils. 9/27/02
Bonnie asks: I am very interested in the apparent benefits of olive oil and since I was told by my own doctor that my blood cholesterol levels were a bit over the average I have taken a keen interest in eating a very healthy diet as well as continuing the medication of one 10mg statin tablet per day, which has reduced my cholesterol to below the average for the part of Scotland I live in! However, I am confused if eating a source of omega3 found in oily fish such as herring, mackeral, sardines etc marinated in olive oil is good or bad for you, as a recent article I read suggested that such a combination was in fact full of fat. Talk about being confused!!!
Dr. Deane replies: The food we eat can be categorized as protein, carbohydrate or fat. All oils are fats. Olive oil and omega3 fatty acids are healthier types of fat than animal fats (which contain cholesterol) and the plant fats which are highly saturated (such as margarines and palm oil). Its best to reduce the total amount of fat in your diet and make sure that what fat you do eat is the healthy kind found in fish and olives.
Shana asks: I am writing to you in reference to my mother who is 54. Has always had High Cholesterol. Last year she had a Bypass surgery. Now she is taking both Lipitor and Niaspan. She is now a vegetarian, exercises regularly. Also takes medication regularly. (Before the Bypass surgery, she never took her Cholesterol Medication regularly, always on and off) Anyway, she is now scared to put any kind of oil in her food. She only eats salads, boiled Veges and steamed Fish. Is olive oil safe for her? Does it not contain Saturated Fat that may be harmful for her?
OOS Replies:
Olive oil is mono-saturated so has no saturated fat. There is a controversy over which is better, an extremely low fat diet such as Dean Ornish's or a diet which has a reasonable amount of "healthy oil" such as olive oil. Most cardiologists agree that the lower the total amount of fat in the diet, the better, but remember that there are some essential fatty acids and many vitamins are only fat soluble. Plant sterol spreads such as Benecol have been shown to reduce cholesterol when added to Lipitor and Niaspan. Many studies have shown that adding a small amount of olive oil to a low fat diet will not raise cholesterol and has other beneficial cardiac effects. Your mother should go along with the recommendations of her cardiologist but I would personally say that there is no danger in adding a small amount of olive oil to the diet.
And for those of you with pets and heart disease:
Jim asks: I have an 4 month old miniature schnauzer with a heart murmur that we started giving a tsp. of olive oil to ( at 8 weeks ) each morning with her kibble. We have been told that cod liver oil would be better.
OOS Replies: Are pets the next growth area for olive oil sales? Cod liver oil is an excellent health additive as far as vitamins. It is higher than olive oil in Vit. A. Fish oils are high in polyunsaturated fatty acids known as the omega-3 or n-3 fatty acids which some studies have shown prevent heart disease in humans. Fish oils are also high in the precursors of thromboxanes and prostacyclins, which are important for platelet and vessel wall physiology and may inhibit the formation of blood clots in the coronary arteries. In spite of all this the American Heart Association (AHA) does not recommend general usage of fish oil supplements until more compelling evidence is at hand. (Note that heart murmurs are usually valvular problems and are unrelated to coronary artery disease and clots which are affected by diet.) The AHA does currently recommend a "Mediterranean diet" which predominates in polyunsaturated or monosaturated fats such as is found in olive oil, canola oil, nuts and fish. Olive oil has polyphenols and other antioxidants as well as monosaturated fats which have a salubrious effect on the heart and blood pressure. I am not a veterinarian but I would guess that for the dog, its a toss-up which oil to use. The calories for both are the same. We haven't discussed taste which we are assuming is not a factor for a dog. Although fish oils are healthy, they would be a hard sell for human consumption as a table spread, salad dressing, baking ingredient, etc. due to taste.
Olive Oil and Cardiac Disease References
"Can a Mediterranean-Style Diet Reduce Heart Disease?"
Rose Marie Robertson, MD; and Lynn Smaha, MD, PhD
Circulation. 3 April 2001: 1821(2).
Web Version: http://circ.ahajournals.org/cgi/content/full/103/13/1821
Summary: Editorial discusses a scientific advisory by the American Heart Association that states a Mediterranean-style diet pattern may have a positive effect on prevention of cardiovascular disease.
"Mediterranean Diet After MI (Myocardial Infarction, or Heart Attack)."
Rebecca Voelker
Journal of the American Medical Association, 13 December 2000: 2863(1).
Web Version: http://jama.ama-assn.org/issues/v284n22/ffull/jwm00010-2.html
Summary: Brief article discusses findings on the benefits of a Mediterranean-style diet for patients after a heart attack.
"A Mediterranean Mixed Bag."
Jayne Hurley and Bonnie Liebman
Nutrition Action Health Letter, November 2000.
Web Version: http://www.cspinet.org/nah/11_00/greekfood.html
Summary: This article from Center for Science in the Public Interest (CSPI) reminds us that not all Mediterranean food is healthy. Typical restaurant menu items are reviewed for sodium, fat content and calories.
"Savory Diet That's Good for Heart? Let's Eat."
Jane E Brody
The New York Times, 23 March 1999: F6(1).
Summary: Article gives a broad overview of the Mediterranean diet and recent research.
Lyon Diet Heart Study
http://www.americanheart.org/presenter.jhtml?identifier=4655
Summary: This fact sheet from the American Heart Association explains about the primary study used as a basis to suggest the health benefits of a Mediterranean diet.
Olive Oil and Health
Olive oil is very healthy oil. A correct and balanced nutrition necessarily contains olive oil on a daily basis. The essence and taste, which gives to all foods, is unique. Just like all oils, olive oil as well, must be used in moderation. The oils contain fatty acids, which can be separated in three kinds: saturated, monounsaturated and polyunsaturated. The animal fats contain mostly saturated fat acids, the seed oils polyunsaturated, while the olive oil contains mostly monounsaturated fat acids up to 83%. The oleic acid, the main component of olive oil, comprises such a monounsaturated fat acid.
As the main source of monounsaturated fat acids, the olive oil helps:
The lower of "bad" cholesterol (LDL) in blood.
The maintenance in the blood of "good" cholesterol (HDL).
The good function of the intestine.
The prevention of cardiovascular diseases and the protection of the organism from the coronary disease due to the strong antioxidants it contains.
The cure of gastric and duodenum ulcer, as it eases the digestion.
The decline of the gastric juices.
The best immersion of calcium by the organism.
The correct metabolism of diabetics and consequently the balance of the diabetes rates.
The prevention from cancer.
While last but not least … it revitalizes the skin.
Olive Oil
Olive oil is the oil, which is collected by the fruits of the olive tree with mechanical means and natural process, while the temperature and the light do not degrade its characteristics. The olive oil is a product, which is natural and can be consumed as soon as the procedure of its collection has been completed. It is absorbed by the organism in 98% while it gives the same number of calories as all the other natural oils, which are 9,3 for each gram.
It comprises the basic source of fats in Mediterranean Nutrition. The sources of fats are all kinds of greases and butters of animal and vegetable origin. The fats of vegetable origin contain more polyunsaturated and monounsaturated fat acids and are considered friendly for the organism (body) and health, while they do not contain any cholesterol. In contrast to the animal fats which contain a large number of saturated fat acids and cholesterol and are dangerous for our health.
The Mediterranean Nutrition
The Mediterranean Nutrition, one of the most widespread diets in the world, is based on the consumption of olive oil as the main source of fats. During the last 50 years some researches which have been done in some areas of the Mediterranean, including Crete and south Italy have shown that the Mediterranean model of nutrition is responsible for the longevity of the inhabitants and the absence of diseases such as cardiovascular and that of the digestive system.
The Mediterranean Diet rich in vegetable fibers is based on the consumption of vegetable foods, which are healthy for the organism. Vegetables, pasta, rice, legumes and fruit are its main components, while the foods of animal origin are consumed in small quantities.
The olive oil, especially the raw olive oil, is used in salads, and is added at the end of cooking. Also, in this model of nutrition the consumption of small quantities of wine during the meals is used.
Variety of plenty fresh fruits and vegetables, consumed many times a week.
Olive oil it consists the main source of fats
Legumes, plenty of bread, pasta and other starchy foods, such as rice, potatoes and other cereals in variety but in moderation in daily consumption, but at least twice a week.
Fish, rich in fats, poultry and lean meat at least twice a week
When alcohol is consumed, it should be wine accompanying the meal
Dairy products, especially yogurt and cheese
2006-09-01 23:50:10
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