Introduction

Chronic diseases are easy to ignore.

Bear with me for a second - I'm not suggesting one can ignore having a heart attack, but rather the decades it takes for atherosclerosis to silently build up until it blocks an artery. For the most part, this process is symptomless - or at least, the symptoms are subtle enough to dismiss. Most people can shrug off a slightly elevated blood pressure for years. 

Now, contrast this with acute diseases - a cold, for example - which are hard to ignore and have a short half-life. It's a shame it works this way, especially given that the vast majority of people die from chronic, not acute diseases (1). Hard to believe? Consider this: under the umbrella of chronic disease fall cancer, cardiovascular and neurodegenerative diseases (e.g. Alzheimer's), metabolic (e.g. diabetes) disorders, and autoimmune conditions. 

US Health Statistics

Although chronic diseases are a global health problem, some populations are clearly doing worse than others.

In America, for example, we struggle to fend them off - while populations, like those of the Mediterranean, seem to do so naturally, enjoying both longer lifespans and longer healthspans. 

According to the CDC, about 845,000 Americans die from cardiovascular diseases every year - roughly 2 per minute. These diseases begin early (sometimes as early as age 16; see our related blog post) and take decades progress into heart attacks and strokes. Cancer claims 615,000 American lives annually, Alzheimer's 115,000 and Diabetes 95,000.

Chronic diseases also fuel each other: having diabetes, for example, significantly increases the risk of developing Alzheimer's. And the same lifestyle risk factors tend to underlie them all - factors that us Americans, unfortunately, excel at accumulating:

• About 120 million Americans meet three or more of the criteria for metabolic syndrome, with 9 out of 10 meeting at least one (2).
• 7 out of 10 are overweight or obese.
• 6 out of 10 are chronically inflamed.
• Only 1 out of 4 meet the minimum guidelines for physical activity.
• Over 90% of Americans fail to meet basic dietary recommendations.
• About 1 in 3 adults sleep fewer than 7 hours of sleep per night, with older adults sleeping even less.
• Nealy 60 million Americans suffer from mental health conditions such as anxiety and depression - both diseases in their own right and risk factors for chronic diseases.
• 1 in 5 adults smoke an average of 13 cigarettes a day, amounting to a staggering 1.6 trillion cigarettes (80 billion packs) per year.
• According to the NIH, about 100 million adults in the US reported binge drinking (more than four drinks in two hours) or heavy alcohol use (five or more drinks per day, or over fifteen per week) in the last month (3).

These statistics are summarized in Figure 1 below.

Figure 1: Chronic disease risk factor demographics in the United States.

Comparative Chronic Disease Demographics: Americans vs Mediterraneans

How do Mediterraneans compare?

Well, for starters, it's widely recognized that Mediterraneans are among the healthiest people on the planet - perhaps making this an unfair comparison, but provides motivation for improvement and perhaps even surpassing. 

Greece, Spain, and Italy, consistently rank among the top ten longest-living nations, while the US ranks around 50th. Across nearly every metric, Mediterraneans come out ahead:

• Life expectancy: Mediterraneans live to an average of 84 years, versus 78 in the US.
• Healthy years: Mediterraneans enjoy 74 disease-free years, compared to 62 for Americans.
• Premature mortality: Americans are three times more likely to die before the age of 70.
• Obesity: Three times more prevalent in Americans.
• Type 2 diabetes: Three times more likely in Americans.
• Cancer mortality: Twice as high in Americans.
• Dementia: Four times more likely in Americans.
• Loneliness: Three times higher rates of social isolation and loneliness reports in Americans.
• Healthcare cost: The US spends roughly seven times more per person on healthcare than Mediterranean nations.

These comparisons are summarized in Figure 2.

Figure 2: Comparative health and disease-related demographics between Mediterraneans and Americans.

Clearly, Mediterraneans are healthier - but why?

Over 200,000 studies have explored this question. A good proportion of them point toward lifelong exposure to the ingredients and nutritional elements of the Mediterranean lifestyle. For example:

• Diet Quality Score: The Standard American Diet scores about four times lower than the Mediterranean Diet.
• Dietary Inflammatory Index (DII): On the DII scale, American Diets are pro-inflammatory, whereas Mediterranean patterns are all highly anti-inflammatory.
• Omega-6 to Omega-3 ratio: The ideal for health is between 1:1 and 4:1. Americans average 20:1, Mediterraneans ~2:1.
• Marine Omega-3 intake: Mediterraneans consume nine times more healthy marine-based Omega-3s.
• Fruit and vegetable intake: Only 10% of Americans meet daily recommendations, compared to 75% of Mediterraneans.
• Ultra-processed foods: Americans consume four times more of their daily calories from them.
• Polyphenol intake: Mediterraneans consume more than six times more polyphenols per day than Americans.
• Olive Oil consumption: Mediterraneans consume eleven times more olive oil per day than Americans.

A clear correlation is evident here between the consumption of Mediterranean ingredients and nutritional elements and the capacity to fight chronic diseases.

Lessons for Choosing the Right Food Supplements

How do these data translate to selecting food supplements that work? Clearly, the evidence points strongly in one direction: food supplements founded on Mediterranean ingredients and nutritional elements are among the most effective tools for improving health and combating chronic disease.

References

1) https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

2) Hirode G, Wong RJ. Trends in the Prevalence of Metabolic Syndrome in the United States, 2011-2016. JAMA. 2020 Jun 23;323(24):2526-2528. doi: 10.1001/jama.2020.4501. PMID: 32573660; PMCID: PMC7312413.

3) https://www.niaaa.nih.gov/sites/default/files/publications/NIAAA_Alcohol_Facts_and_Stats_0.pdf