The Mediterranean Zone (2 page)

T
he Zone is not some mystical place or a clever marketing term. It is a real physiological state in your body that can be measured in clinical tests that are routinely used at Harvard Medical School. If you are in the Zone, you have optimized your ability to control inflammation. Inflammation is the reason you gain weight, become sick, and age faster. By reducing inflammation we lose excess body fat, return to wellness, and slow the aging process.

The only way to reach the Zone and stay there for a lifetime is by your diet. The Zone Diet is not a diet but a blueprint for how to balance a meal to optimize your hormonal response for the next five hours, thus allowing you to control the levels of inflammation in your body. All you need is a hand, an eye, and a watch to follow this blueprint for life and to dramatically reduce your risk of obesity and the other major health scourges of today.

Following the Zone Diet blueprint is easy. At every meal, divide your plate into three equal sections. (You need an eye for that.) On one-third of the plate put some low-fat protein that is no larger or thicker than the palm of your hand (that’s because some hands are larger than others). This doesn’t have to be animal protein, but it has to be protein-rich. For vegans this means either extra-firm tofu or soy imitation-meat products. For lacto-ovo vegetarians, it can also include dairy and egg protein-rich sources in addition to vegan sources of protein. For omnivores, the choice of proteins is even wider.

To start controlling inflammation for a lifetime, just follow the figures below to start building your plate to generate an anti-inflammatory meal every time you eat.

Next, fill the other two-thirds of your plate with colorful carbohydrates, primarily non-starchy vegetables and small amounts of fruits to balance the protein as shown below.

Here are two very practical hints when it comes to carbohydrates. First, the more white (white bread, white pasta, white rice, and white potatoes) you put on your plate, the more inflammation you are going to create. Second, the more non-starchy vegetables you consume and the fewer grains and starches you eat (ideally none), the better the results. Scientifically, it’s called lowering the glycemic load of the meal. Finally, you add a dash of fat (a small amount). The fat I’m talking about is primarily monounsaturated fat, and low in omega-6 and saturated fats. This could be olive oil, guacamole, or nuts.

Now, why do you need the watch? If you have balanced your plate correctly, then for five hours after the meal, you will not be hungry because you have stabilized blood sugar levels. Because of those stable blood sugar levels, you will also have peak mental acuity for the same time period. The lack of hunger and improved mental focus also indicate that you have been successful in reducing inflammation in your body during that same five-hour period.

That’s it. It seems easy enough, except you have to do it every five hours for the rest of your life to maintain hormonal balance and the resulting control of inflammation. That’s a small price to pay for a longer and better life. And if you have a bad meal (and we all will), don’t worry, since you are only one meal away from getting back into the Zone.

Since the Zone concept is simply a blueprint to balance your plate, this makes it compatible with all dietary philosophies, ranging from vegan to paleo. The balance on the plate doesn’t change, only the food ingredients you use to fill in the Zone blueprint. Welcome to the Zone.

M
edicine is not as complicated as we are led to believe. Conversely, nutrition is not as simple as we are often told. But they are both intimately linked through inflammation.

We often think of inflammation as harmful, yet it is our primary defense in our endless struggle against microbes. Without inflammation our injuries would never heal.

Inflammation is actually a two-part process. The initial phase is an aggressive pro-inflammatory response that can turn on otherwise silent inflammatory genes to respond to injury or microbial attack. This starts with the activation of the most primitive part of our immune system to cause otherwise benign white cells in the blood to become powerful killing machines to stop the damage caused by physical injury or microbial invasion. The second phase is driven by a totally different set of protective anti-inflammatory responses, to turn off these molecular warfare mechanisms and return the body to equilibrium. Hormones ultimately determine the turning on and off of these inflammatory genes in the body.

The good news is these key hormones can be controlled by your diet. The bad news is these key hormones can become unbalanced by your diet. If these two powerful phases of inflammation are balanced, we remain in a
state of wellness. If they become unbalanced, we begin a slow, steady descent into chronic disease and premature aging.

Although inflammation is a finely defined system of checks and balances that have evolved over millions of years, it can also be turned very quickly against us by our diet. Unfortunately for us, there has been a fundamental shift in the balance of these two powerful opposing inflammatory processes due to the industrialization of our food in the past fifty years, and it is only with advances in modern molecular biology that we are realizing the metabolic and genetic consequences of this change to our diet. We see this in our increased obesity, the development of chronic disease at an earlier age, and the acceleration of the aging process—especially in brain aging—and we seem to be powerless to stop them. But what if obesity, chronic disease, and aging have a common point of origin that we have overlooked?

I have spent most of my research career seeking the connections between diet and inflammation. It’s a complex story that continues to rapidly evolve. But when you make a complex story too simple, the truth within the story is often the first casualty. There is no single dietary villain in this story; rather it is the complex interactions of the various changes of the American diet that have disrupted this carefully crafted balance in our inflammatory responses. More ominously, these disruptions in our inflammatory genes appear to have the ability to be transmitted and amplified from one generation to the next.

There is a coming global tsunami of the most dreaded disease of aging: Alzheimer’s disease. It has been gathering strength for more than fifty years, first starting with our obesity crisis, followed by our growing diabetes epidemic, and now beginning its next manifestation as the incidence of Alzheimer’s climbs.

The inflammation-to-Alzheimer’s progression is shown in the following simple flow chart.

It’s helpful to think of this progression as a champagne fountain: It takes about fifteen to twenty years for one condition to reach a critical mass before its effects spill over into the next “bowl” and precipitate another more devastating chronic disease condition. Our obesity epidemic began to rise in the mid-1970s, but it was fueled by the beginnings of diet-induced inflammation in the early 1960s with the increasing industrialization of our food supply. The rate of diabetes was relatively constant until 1995, when it started to rise dramatically. We are now on the cusp of a new epidemic rise of Alzheimer’s.

There is no known treatment to stop the progression of Alzheimer’s, let alone a cure for the condition. In fact, the only thing we know about Alzheimer’s is that it appears to involve inflammation. The death rates for most major diseases of the twentieth century (heart disease, cancer, stroke) have been decreasing in the past decade, but the death rate for Alzheimer’s in the same period has increased by 68 percent and it is now the sixth leading cause of death in America. This suggests that as we live longer and become more inflamed by our diet, more and more of us will be victims of dementia. Not a very pleasant vision of the future.

All of these conditions—obesity, diabetes, and Alzheimer’s—have a common origin: diet-induced inflammation. Keeping this type of inflammation under control means constantly keeping the hormones—generated by the food we eat—within a zone that is not too high but not too low. This is no different from taking a prescription drug. The key is keeping that
drug in a therapeutic zone. If you give a patient too little of the drug, it doesn’t work. If you give the patient too much of the drug, it becomes toxic. The same is true of hormones such as insulin that are critical to our metabolism and eicosanoids that control inflammation, except these hormones are hundreds of times more powerful than any drug. That was the message of
The Zone
twenty years ago, and it remains the same today. Simply stated, if you want to live a longer and better life, you have to manage diet-induced inflammation for a lifetime.

The Zone is not some mystical place. Being in the Zone is defined by rigorous clinical markers, and virtually every leading medical researcher would agree that reaching the clinical goals that define the Zone is necessary for a longer and better life. The Zone has never been an unattainable destination. However, the only way to get there is through the diet.

The Mediterranean Zone
describes how we got into this health-care crisis, and it explains the potential way out of it: by following an anti-inflammatory diet that allows you to retake control of the expression of ancient inflammatory genes. If we don’t do this, we can begin to prepare ourselves for World War A (A as in
Alzheimer’s
).

This is why the heightened attention around traditional Mediterranean diets offers us an opportunity to retake control of our future. New advances in molecular biology and genetics now allow us to understand how certain nutrients in the Mediterranean diet can take the classic Zone Diet to an even higher level of inflammation control. In particular, it is the role of a unique group of chemicals known as polyphenols—the chemicals that give fruits and vegetables their color—to manage both the master genetic switches that control inflammation and the metabolism that offers us the greatest hope. Foods containing high levels of polyphenols have been the foundation of the Mediterranean diet for more than two thousand years and are integral dietary components for the Mediterranean Zone, which may be our best “drug” for treating obesity, chronic disease, and aging (especially in the brain) in the future.

O
ne of the great mysteries of life is how metabolism works. Food containing protein, carbohydrates, and fat (as well as vitamins, minerals, and phytochemicals) goes into our mouths, gets broken down to its most basic components for absorption, and then those components are reassembled as complex biological molecules needed to sustain life. Metabolism not only provides the continuous source of energy required for us to function, but it also allows us to continually renew every cell in our body, to defend ourselves from constant microbial invasions, repair our injuries, and finally to reproduce the next generation.

The word
metabolism
comes from the Greek root
meta,
meaning “change.” That’s far too simple a word to describe what actually takes place during metabolism. Metabolism can either create energy from biological matter or build complex biological molecules from simple dietary components. What is important is the fact that when your metabolism doesn’t work properly, you begin to gain weight, develop chronic disease, and age at a faster rate.

Consider the complexity of trying to keep 10 trillion cells in your body in constant communication. The reason your metabolism works as smoothly as it does is because it uses a biological Internet, one vastly more
complex than anyone at Google can fantasize about in the future. Unlike the simple flow of electrons that drives the computer-based Internet, your biological Internet runs on hormones, and like any good engineering system, hormones operate best when maintained within an optimal zone.