The equivalent of 4,000 extra steps per day

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Fruits and vegetables are staples of a Mediterranean-style diet. Jenna Maslovska/Stocksy

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  • Researchers say adopting a Mediterranean-style diet produces the same benefits as walking 4,000 extra steps per day.
  • Experts say you can adjust to this type of eating plan by eating more fruits and vegetables, consuming less red meat, and preparing your own meals from scratch.
  • They also note it’s still important to exercise regularly even if you are on a healthy diet plan.

A healthy diet can be the physical equivalent of taking 4,000 extra steps per day for middle-aged adults.

That’s according to a new study published this week in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

“This study provides some of the strongest and most rigorous data thus far to support the connection that better diets maylead to higher fitness,” said Dr. Michael Mi, a study author and cardiologist at the Beth Israel Deaconess Medical Center in Boston, in a statement. “The improvement in fitness we observed in participants with better diets was similar to the effect of taking 4,000 more steps each day.”

The researchers pointed out cardiorespiratory fitness reflects the body’s ability to provide and use oxygen for exercise.

It also integrates the health of multiple organ systems, such as the heart, lungs, blood vessels and muscles.

The researchers said these are a “powerful predictors of longevity and health.”

They also said even with people who exercise the same amount, there are still differences in fitness, suggesting that additional factors like diet contribute.

The study looked at the link between a healthy Mediterranean diet and physical fitness in community-dwelling adults.

Researchers studied 2,380 people in the Framingham Heart Study. The average age was 54 and 54% of the participants were women.

Participants did a maximum effort cardiopulmonary exercise test on a cycle ergometer to measure peak VO2 (the maximum rate of oxygen someone uses during exercise).

They also completed the Harvard semi-quantitative food frequency questionnaire, which quantified intake during the last year of 126 dietary items ranging from never or less than once per month to ≥6 servings/day. Dietary quality was assessed by the Alternative Healthy Eating Index (AHEI; 0 to 110) and Mediterranean-style Diet Score (MDS; 0 to 25), which are both associated with good heart health.

The researchers also quantified the fasting blood concentrations of 201 metabolites.

Higher scores indicated a better-quality diet including fruits, vegetables, nuts, whole grains, legumes, fish and healthy fats, and limited red meat and alcohol.

Researchers examined the link between diet and fitness after considering other factors such as age, sex, total daily energy intake, body mass index, smoking status, cholesterol levels, blood pressure, diabetes and routine physical activity level.

The average AHEI was about 67, while the average MDS was about 12. Compared with the average score, an increase of 13 points on the AHEI and nearly 5 on the MDS was associated with a 5% and 4% percent greater peak VO2, respectively.

“In middle-aged adults, healthy dietary patterns were strongly and favorably associated with fitness even after taking habitual activity levels into account, Mi said. “The relationship was similar in women and men, and more pronounced in those under 54 years of age compared to older adults.”

Researchers examined the relationship between diet quality, fitness, and metabolites, which are substances produced during digestion and released into the blood during exercise.

They found 201 metabolites (amino acids) in blood samples collected from a subset of 1,154 participants, with 24 metabolites associated with either poor diet and fitness or with favorable diet and fitness.

“Our metabolite data suggest that eating healthily is associated with better metabolic health, which could be one possible way that it leads to improved fitness and ability to exercise,” Mi said.

“This was an observational study and we cannot conclude that eating well causes better fitness, or exclude the possibility of a reverse relationship, i.e., that fit individuals choose to eat healthily,” he added.

Mi said the study provided another reason to eat better.

“A Mediterranean-style diet with fresh, whole foods and minimal processed foods, red meat, and alcohol is a great place to start,” he said,

Jack Craig is a certified personal trainer for Inside Bodybuilding, a health clinic for professional athletes. Craig told Medical News Today that 4,000 steps are about the average amount of activity most sedentary people in the United States get during the day.

“With such a low amount of activity, it’s important to have a healthy diet,” Craig said. “Mediterranean diets are among some of the most notorious heart-healthy diets, which is why they can market benefits like those you’d get from 4,000 steps a day.”

Craig added that a Mediterranean diet is “rich in ingredients” that can help reduce risk of dementia and cardiovascular disease such as heart failure or stroke.

Craig did note that it’s important not to see diet as an alternative for physical activity.

“Walking regularly throughout the day, even in short, five-minute breaks throughout the day, can reduce blood pressure and blood sugar, as well as elevate your mood and help you think more clearly,” Craig said. “Walking also provides important stimulus which can help improve balance, muscle development, and bone density in the lower limbs, which is essential as we age.”

Dr. Theodore Strange, the chair of medicine at Staten Island University Hospital in New York, told Medical News Today there’s “very good” evidence linking healthy diet with better fitness, whatever a person’s fitness goals.

“Eating a good diet can provide one with the energy needed to perform better in daily tasks and to just enjoy casual or more rigorous activity,” Strange said. “As a marathon runner, it’s very important to have a healthy diet to achieve the goal of finishing; but one does not need to run marathons but just be active with at least 4,000 steps daily with a healthy diet to feel and perform better.”

Strange added the Mediterranean diet improves health, especially for people predisposed to hypertension, diabetes, or heart disease.

“Eating smart and healthy and being active reduces the risk of chronic diseases, prevents weight gain, and promotes weight loss, while improving one’s overall well-being,” he said.

Dr. Daniel Atkinson, the clinical lead at online medical clinic Treated, told Medical News Today there are easy ways to convert one’s eating habits to more of a Mediterranean-style diet.

“Switch to olive oil,” Atkinson said. “The obvious one is swapping butter – or lard if you use it – vegetable oil or rapeseed oil for olive oil when you’re cooking. Olive oil is easier on blood pressure and cholesterol than other types of cooking fat.”

Atkinson said cooking from scratch helps, meaning using basic and fresh ingredients, instead of processed foods.

“Another staple of a Mediterranean diet is fish – for example salmon or white fish – with boiled or roasted potatoes and a boiled vegetable like broccoli,” he said. “The main advantage of cooking meals yourself from scratch is that you’ve got more control over the salt and sugar content because you add it yourself. Salt is a major contributor to high blood pressure while eating a lot of sugar can increase your diabetes risk.”

Atkinson also said it’s worth it to pay a bit more for higher quality ingredients.

“Plum tomatoes and passata will taste better than chopped tomatoes in a tin for example,” he said.

Atkinson also said cook in bulk to avoid quick and easy processed meals and to use fresh herbs for taste and grill meat, rather than frying it.

“Turkish and Greek dishes tend to use grilled rather than fried meat and fish — and there are a couple of reasons why this is healthier,” Atkinson said.

“First of all, fried or deep-fried meat or fish soaks up more oil, which increases the saturated fat content,” he said. “Secondly, when you grill meat, you’ll tend to go for leaner cuts like chicken breast, because it stays together better on the grill – and these cuts don’t contain as much fat in the meat itself.”

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