Mediterranean-Style Diet May Equal Taking 4,000 More Steps

  • New research is suggesting that what we eat can also help contribute to our daily step goals by as much as 4,000 additional steps.
  • People who have a healthier diet were found to have better physical fitness.
  • Eating healthily was associated with better metabolic health, as well.

For many people getting enough “steps in” has become part of a daily fitness goal.

So much so that everything from Google Maps to Apple Watches helps us keep track of how many steps we’ve taken in a day. But new research is suggesting that what we eat can also help contribute to our daily step goals by as much as 4,000 additional steps.

The study, published in the European Journal of Preventive Cardiology, suggests that a healthy diet is associated with greater physical fitness in middle-aged adults. Study authorDr. Michael Mi box Beth Israel Deaconess Medical Center in Boston says that the study shows strong data that supports the connection between a good diet and higher fitness.

“This is an amazing community-based study design that did the most accurate way to quantify one’s [cardiorespiratory fitness] to a healthy diet via metabolite testing,” said Dr. Christopher Tanayan, Lenox Hill Hospital’s director of sports cardiology. “This is probably the most objective way to establish the association between diet and cardiorespiratory fitness. The investigators did extensive measures to remove confounding factors and adjust for biases.”

The study included 2,380 adults with an average age of 54 years. The group was split nearly down the middle between men and women. Participants underwent a cardiopulmonary exercise test on a cycle ergometer to measure peak VO2, the maximum rate of oxygen consumption attainable during physical activity.

“Peak VO2 is obtained by having a person perform a maximal effort cardiopulmonary exercise test (CPET). This is not the only data we can derive from a CPET. One of the other parameters we look at during this test is the resting RER, or respiratory exchange ratio,” said Tanayan. “It has been shown to reflect the dietary consumption of one’s last meal prior to undergoing the test.”

The participants also completed the Harvard semiquantitative food frequency questionnaire to determine their intake of 126 different dietary items and their frequency, which helped to score their diet quality on the Alternative Healthy Eating Index and the Mediterranean-style Diet Score. Higher scores showed a better quality diet of vegetables, fruits, whole grains, nuts, legumes, fish and healthy fats, and limited red meat and alcohol.

Tanayan pointed out that the type of fuel used on the test day was another data point they used in analyzing peak VO2 to confirm their dietary indicators. Some metabolites were directly linked to better cardio performance.

What the study found was those with higher dietary scores on the Alternative Healthy Eating Index and the Mediterranean-style Diet Score achieved a 5.2% and 4.5% greater peak VO2, respectively.

Further analysis showed that eating healthily was associated with better metabolic health, as well.

“This study provides some of the strongest and most rigorous data thus far to support the connection that better diets may lead to higher fitness,” study author Dr. Michael Mi of Beth Israel Deaconess Medical Center, Boston, said 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 study authors note that this is an observational study and it cannot be concluded that eating well causes better fitness, nor does it exclude the possibility of a reverse relationship.

“It’s an interesting study,” said Dr. Sean Heffron, director of fitness-focused cardiology in the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart. “We’ll leave it at that. With any observational analysis, there are a lot of unmeasured confounders that are likely to play some type of role here. I would say a healthy diet and exercise are very broadly important, but how specifically a diet would contribute to improving synthesis of metabolic-related enzymes and other tissues that we know determine fitness, that I don’t know. People who eat well tend to have other good behaviors, and while the study measures a lot of different things, it doesn’t measure everything.”

But the authors of the study were able to control for some factors by having individuals use wearable devices with step counters.

Tanayan said, “As with any other observational study that involved exercise quantification using self-reported physical activity questionnaires, there is very little one can do to remove the subjectivity of a subject’s perceived daily level of activity. To lessen the effect of this, the investigators also utilized data derived from wearable devices with step counters worn for up to eight days after the test. This allows for accurate analysis of data factoring in baseline fitness derived from exercise.”

Overall, this is not the first time diet and heart health have been connected. In fact, it’s now considered a hard rule that a good diet is an important part of a healthy heart and contributes to overall better fitness quality.

Heffron recommends three things to his patients with respect to diet and heart health.

“I asked them to minimize land animals because they are the major source of saturated fat, which plays a big role in LDL cholesterol levels,” Heffron said. “I tell them to put a rainbow in their tummy every day, filling their bodies with fruit, vegetables and whole grains. And I asked them to eat foods that their grandparents would recognize as foods to avoid any hidden ingredients.”

“Eating a healthy diet must complement exercise, and in this case it can improve performance,” said Tanayan. “Adaptations in the way our heart utilizes fuel and the availability of a certain type of fuel based on one’s diet both contribute to fitness.”

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