The Mediterranean Zone

No book can replace the diagnostic expertise and medical advice of a trusted physician. Please be certain to consult with your doctor before making any decisions that affect your health or extreme changes in your diet, particularly if you suffer from any medical condition or have any symptom that may require treatment.

Copyright © 2014 by Zone Enterprises, Inc.

All rights reserved.

Published in the United States by Zinc Ink, an imprint of Random House, a division of Random House LLC, a Penguin Random House Company, New York.

B
ALLANTINE
and the H
OUSE
colophon are registered trademarks of Random House LLC.
Z
INC
I
NK
is a trademark of David Zinczenko.

L
IBRARY OF
C
ONGRESS
C
ATALOGING-IN
-P
UBLICATION
D
ATA
Sears, Barry.
The Mediterranean zone : unleash the power of the world’s healthiest diet for superior weight loss, health, and longevity / Barry Sears, Ph.D.
pages cm
Includes bibliographical references.
ISBN 978-0-8041-7917-1
eBook ISBN 978-0-8041-7919-5
1. Reducing diets. 2. Diet—Mediterranean Region. 3. Diet therapy—Mediterranean Region. 4. Inflammation—Diet therapy. 5. Weight loss. 6. Longevity. 7. Nutrition. 8. Health. I. Title.
RM222.2.S3893 2014
613.2′5—dc23         2014026641

www.ballantinebooks.com

eBook design adapted from print book design by Caroline Cunningham

v3.1_r2

a + prh

To Hippocrates, who was right when he said,
“Let food be your medicine, and let medicine be your food.”

T
he United Nations has declared the Mediterranean diet a historical treasure. The Mayo Clinic recommends it as a way to combat heart disease and Alzheimer’s. The
New England Journal of Medicine
has reported time and again on the medical benefits of the Mediterranean diet. Health and beauty magazines constantly tout the Mediterranean diet’s effectiveness.

Yet, somehow, no one can really describe it. How many calories a day do you need to maintain your weight on the Mediterranean diet? No one knows. How much protein per day do you need to be on the Mediterranean diet? No one knows. What is the right balance of protein to carbohydrate on the Mediterranean diet? No one knows. Why does it really work? No one knows.

This fuzzy thinking is what passes for nutritional knowledge in America today. A lot of talk, a lot of hype, but with very little true understanding behind those words. Nutrition is complex, but complex doesn’t attract page views or sell magazines. What actually gains public attention are simple solutions (especially concerning the elimination of “evil” foods) easily put into sound bytes that resonate on TV but have little scientific basis.

But the Mediterranean diet can’t be reduced to simple rules such as “don’t eat red meat” or “drink red wine.” And for that reason, many people believe that having a glass of wine with their pasta means they’re following the Mediterranean diet.

If you can unlock the true nature of the Mediterranean diet—if you can identify the factors that make it work—you can begin to make an enormous impact on your health starting today. And if you understand how this traditional diet works, you can refine it and take it to a much higher level to generate even greater health benefits, including the most elusive of them all for most Americans: permanent weight control.

The Mediterranean Zone represents the evolution of the Mediterranean diet into a cohesive dietary program that provides not only the structure needed for maximum health benefits, but also offers the simple rules that make it easy to use in your daily life. The Mediterranean Zone also represents a return to the past to bring the accumulated folklore of the Mediterranean diet into the twenty-first century. In many ways, the preface of
The Mediterranean Zone
could have easily been written by Hippocrates 2,500 years ago when he said, “Let food be your medicine, and let medicine be your food.” Yet to truly understand his wisdom requires an understanding of the recent advances in molecular biology (gene transcription factors, epigenetics, and so on) that explain why the Mediterranean diet has such a powerful impact on one’s health.

Although the science behind the Mediterranean Zone is robust, most people only care about (1) what’s it in for them and (2) how easily it can be incorporated into their hassled life. So let’s go right to the bottom line: What’s in it for you is an extraordinary litany of life-altering benefits, including freedom from heart disease, diabetes, and other modern scourges; a dramatic reduction in your risk of Alzheimer’s and other diseases of aging; younger, healthier-looking skin; and permanent weight control. And as far as its ease of use, this book breaks it all down into a plan that’s so simple, all you need is one hand, one eye, and a watch. If you have those three things, you can reap the benefits of the Mediterranean Zone for a lifetime.

W
hen I wrote my first book,
The Zone
, in 1995, I was careful not to use the word
diet
in the title. In fact, the book was written for cardiologists to alert them to the power of food to alter hormonal responses, especially those hormones involved in inflammation. The book was meant as a clarion call to the medical community that the low-fat, high-carbohydrate diet being recommended to the American public by the medical establishment was going to lead to epidemics of obesity and diabetes driven by increased inflammation. Not inflammation caused by a microbe or an injury, but inflammation caused by what we were eating.

The focus of
The Zone
was on a little known group of hormones called eicosanoids. Even though the 1982 Nobel Prize in Medicine was awarded for understanding the importance of these hormones in driving inflammation, outside of a few in academic medicine, by 1995 still virtually no one knew anything about them.

I knew that getting attention for the book was going to be a challenge, and my publisher readily agreed. So neither of us was surprised that the initial sales of
The Zone
were modest and quickly petered out. I was convinced that the right message wasn’t getting across, and that the media were looking at this book as just another fad diet book. Recklessly (without telling my wife), I went in search of a publicity firm that could help reposition the message of
The Zone
.

Since I grew up in Los Angeles, I figured if you could publicize films, you probably could do the same for books—even technical books on diet-induced inflammation. (Talk about being naïve.) So I went to the top PR firm in Hollywood and asked them if they had ever publicized a book. Their answer was no, but they were not willing turn a client away, so Michael Keaton’s press agent became the head of their new book publicity department with me as their first client.

I told them the only way I could judge their efforts was by any increase in book sales (which wouldn’t be too hard). Not much happened at first, but with only about four more weeks to go before my money ran out, I caught a break when Dennis Prager, a prominent LA radio talk show host, agreed to have me on his program because we both shared the same publisher. Although he liked the book, he made it clear that if there weren’t any callers in the first fifteen minutes, he would have to take me off the air. I told him I was just happy to get a chance to discuss the book. Three hours later, the phone lines were still jammed with callers, and I was still on the show. The book became the #1 best seller in Los Angeles the next week and a month later the #1 best seller on the
New York Times
book list. This only confirms the old saying, “Given the choice of being good or being lucky, always opt for being lucky.”

Of course, with this new success my two most dreaded words—
fad diet
—were immediately attached to the book. Although the word
diet
comes from the ancient Greek root meaning “way of life,” it has been corrupted to imply a short-term period of hunger and deprivation to try to look good in a swimsuit. A fad is a short-term phenomenon without substance that will soon fade. Put these two words together, and you have
fad diet
. Some fad diets are simply ridiculous, such as the Drinking Man’s Diet. Other fad diets, unfortunately, gain substantial credence, such as the low-fat, high-carbohydrate (rich in grains and starches) diet supported by the USDA in the early 1990s. This fad had the initial support of the government and the medical establishment, but it’s clear today that this policy led to an explosion of obesity in America.

That’s why I developed the concept of the Zone—not as a diet or a weight-loss program, but as a dietary road map for reaching and maintaining a constant hormonal balance that allows the body to operate at peak efficiency. The Zone is a real physiological state that can be measured in the body—a metabolic state that, once you reach it, works quickly to dramatically diminish your risk of obesity, diabetes, heart disease, and many other chronic health issues. Reaching the Zone and staying there requires a dietary lifestyle change that has to be followed for a lifetime, but it is one that will allow us to look, feel, and live healthier for many years to come.

For several years after the publication of
The Zone,
I spent my time like any good politician pressing the flesh trying to explain the mysterious world of hormones and inflammation. Now, nearly twenty years later, the once radical concept of the Zone seems almost old-fashioned, because today most diet books stress that hormones are involved in weight gain—excess insulin makes you fat and keeps you fat. Likewise, most diet books tell you if you eat too many white carbohydrates (bread, pasta, and pizza), you are going to gain weight.

But very few of today’s diet books talk about inflammation as the underlying cause of why these things happen, and why it’s so critical to control.

The reason the Zone concept went from being labeled a fad diet to mainstream nutrition is the science. When
The Zone
was first published, one of the few people who actually bought the book was David Ludwig, then a young Harvard Medical School instructor. (He is now a full professor at Harvard and one of the leading researchers in the study of obesity.) Actually, David first read the book with an academic’s skeptical eye, concerned about pseudoscience lurking behind another fad diet. After reading the book and seeing the early scientific support (it was the first diet book to actually contain scientific references), he asked me to give a seminar to his colleagues in the division of endocrinology at Boston Children’s Hospital at Harvard.

So I gave my seminar, and at the end I asked if there were any obvious fallacies to my concepts. The answer was no, since everyone seemed to be satisfied that everything I said was theoretically reasonable. Intrigued by my presentation, David decided to test my Zone concept in a controlled-feeding study. He used internal funds at Children’s Hospital, because his initial attempts to get government funding for this “radical” idea were rejected.

Sure enough, David and his group found my predictions about the ability of the Zone Diet (and in particular just a single meal put together based on the Zone principles) to alter hormonal responses were true. Since then, one carefully controlled study after another has confirmed what I hypothesized twenty years ago about the power of food to control hormonal responses and reduce inflammation.

Has anything changed in my thinking about the Zone over the years? Well, yes and no.
The Zone
was the first book to describe anti-inflammatory diets and how the hormonal response to diet could either increase or decrease the levels of inflammation in the body. The Zone Diet provides a dietary blueprint for balancing food ingredients on your plate for optimal hormonal, inflammatory, and genetic control for a lifetime (as opposed to being “on a diet” and constantly hungry and fatigued in order to lose a few pounds). Nothing has changed about that basic concept. But new research continues to demonstrate just how critical it is that we act now to bring inflammation under control and how certain food ingredients can enhance the process.

Breakthroughs in molecular biology and genetics have greatly expanded our understanding of the importance of the diet in turning on and off our genes. In particular, it involves new insights in understanding how the most primitive part of our immune system responds to certain nutrients. Even more important is how our diet can further alter the expression of our genes for several generations through the new knowledge of “epigenetics.” Epigenetics is like the cloud in the world of computers. It controls the expression of our genes and is strongly influenced by our environment, in particular our diet. More important, epigenetics explains how chemical markers can be left on our genes that can be amplified and transmitted to the next generation.

The Zone idea remains at the cutting edge of nutritional science because new discoveries keep adding depth to my basic concept. I first described the use of high-dose omega-3 fatty acids for anti-inflammatory control in
The OmegaRx Zone,
published in 2002.
The Mediterranean Zone
extends my basic Zone concept by describing the power of polyphenols—the chemicals that give fruits and vegetables their color—to further enhance the metabolic control of our genes and also to slow down the aging process.

The title of this book,
The Mediterranean Zone
, might suggest it will cater to those who simply want to hear that eating pasta with a little more Parmesan cheese, drinking a little more red wine, adding some olive oil to your meals, or sipping a cappuccino with a piece of dark chocolate are the essence of the dietary program. In fact, the key feature of the diets in virtually every region that borders the Mediterranean Sea is not pasta but colorful carbohydrates rich in polyphenols. We finally have enough scientific sophistication to realize it is the high levels of colorful polyphenols that make the Mediterranean diet uniquely protective against aging, not the white pasta.

This book is divided into four parts.
Part I
puts the useful stuff right up front as it describes how to master the Mediterranean Zone.
Part II
describes the science of polyphenols.
Part III
describes how the industrialization of food led to an epidemic of inflammation in America that is now spreading worldwide due to globalization. Finally,
Part IV
describes the future that makes the concepts of the Mediterranean Zone more important than ever in reversing our current health-care crisis.

I know that after reading this book, you will agree that the continued evolution of my Zone concept is more relevant today than when it was first presented nearly twenty years ago. And with the Mediterranean Zone, it gets even more delicious!