Lindsay Marie Morris

Following a Mediterranean diet is associated with a lower risk of heart failure, particularly in women. So says a recent review published by a group of European scientists, including researchers at Sicily's University of Palermo and Kore University of Enna. 

The results suggest following such a diet could benefit women, who research shows tend to develop heart failure later in life than men. They are also more likely to experience heart failure with preserved ejection fraction (otherwise known as diastolic heart failure). 

While women with heart failure tend to live longer than men, they experience lower quality of life during those extended years. Perhaps eating more fruits, vegetables, seeds, nuts, and vegetable oils (and fewer meat and dairy products) can help women reduce their risk and avoid unnecessary suffering. 

For more information, I reached out to Saint Camillus International University of Health Sciences Associate Professor of Geriatrics and Internal Medicine Nicola Veronese. 

In his previous role as Senior Researcher of Geriatrics and Internal Medicine at the University of Palermo, Dr. Veronese was part of the team that performed this latest systematic review and meta-analysis of the effect of the Mediterranean diet on the incidence of heart failure. He shared more about heart failure and which components of the diet contribute to its heart-healthy benefits. 

 

 

Why did you and your colleagues embark on this review?

Heart failure is among the most common causes of hospitalization, particularly, but not only in older people. We have in mind other cardiovascular diseases, but very little is known about heart failure, particularly in terms of prevention. So, we started with the idea that the Mediterranean diet has a protective effect on several medical conditions. But, the knowledge of its effect on heart failure was limited, so we decided to do this work.

 

What is heart failure?

Heart failure is a common condition where your heart has difficulties regulating normal blood pressure or blood for your system and organs. It is a common cause of hospitalization. There are better medications compared to some years ago, but they're not able to solve the problem; they are only able to reduce the symptoms of heart failure.

 

How does heart failure affect women and men differently?

Our research tried to highlight this important topic because gender differences are highly supported in cardiovascular research. We don't have any reason for these epidemiological findings. You are told about this without being able to find a precise mechanism. However, the research suggests that, for example, the Mediterranean diet's effect was stronger in women than in men. This is probably due to hormonal changes or differences mediating the interaction between a Mediterranean diet and the risk of heart failure.

 

Women may also adhere to the Mediterranean diet more than men because, in Europe, they cook more frequently than men, particularly in families. They're probably better positioned to tailor foods to be more Mediterranean. 

 

What components of the Mediterranean diet contribute to its heart-health benefits?

First, olive oil is like gold in Italian kitchens. It has a lot of anti-inflammatory and antioxidant properties. Second is the fact that you limit practically all animal fats. Fish offers strong cardiovascular heart disease protection compared to meats like beef. Finally, the Mediterranean diet is a spiritual attitude to follow with your family. This is very important to decrease anxiety, depression, and your risk of heart failure or other cardiovascular diseases. 

 

What were the limitations of your review?

They are observational studies, so we did not put an intervention of, for example, one group with a randomized diet and the other with low fat. There is also somewhat of a selection bias. First, you are including people who are not adhering to your reality. Second, we observed that the Mediterranean diet sometimes was not reported. It is somewhat unrealistic to think that today, you'll have practically the same diet in 10 years. Maybe today, you will eat animals, and in 10 years, you will become vegan. This is an important limitation, of course, but it is related to the fact that these are observational studies. 

 

What do you hope people will take away from these findings?

I hope they gain some knowledge about how important the Mediterranean diet is for this disease. Unfortunately, heart failure is less known compared to other cardiovascular diseases, metabolic disease, or diabetes. However, it is a very important condition. Knowing that the Mediterranean diet can decrease your risk of heart failure is important not only from an epidemiological point of view but also as an attempt to try at least to follow a Mediterranean diet. 

 

 

 

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A classic Italian soup, traditionally made from vegetable scraps and paired with beans and sometimes pasta, minestrone is the perfect first course for a Sicilian supper. There are a variety of ways to prepare this meal starter, but I was drawn to a recipe by Nadia Fazio of Mangia Bedda.

 

Nadia's blog reflects her quest to transcribe all of her mother's classic recipes. It has an even deeper meaning for her now that their mother has passed. 

 

I sat down with Nadia to discuss her Sicilian-Canadian upbringing, the origin of Mangia Bedda (and its name), the right way to make minestrone, and the art of shelling your own beans.  

 

 

What's your background?

I'm Italian-Canadian. Both my parents, however, were born in Sicily. They are actually from the same little town in Sicily (Naso in the province of Messina). My father emigrated to Canada in 1954. My mom, after they got married, came here and joined in 1959.

 

What was it like growing up Sicilian Canadian?

My siblings and I grew up with all the typical Italian traditions that they brought over from Sicily. It's interesting because it appears that when people came here from Sicily, it was sort of like time froze. They maintained the exact same traditions, with regard to food and family, that they practiced in Sicily. 

 

I grew up with the typical Sicilian foods, all the traditional foods, all homemade from scratch, especially at this time of the year, all of the preserving, making the tomato sauce and all the different vegetables, the beans, and roasting the peppers and the eggplants and all of that.

 

I grew up surrounded by that, and I think my memories of my childhood and my parents are all, for the most part, actually centered around food, and I didn't appreciate it at the time. I really did not appreciate it.

 

I remember being dragged to a local farmers market in Montreal, and I found it so drab. I mean, I was a kid. It was boring, and it's one of my favorite places today.

 

Another memory that stands out is going to a farm outside of the city to get fresh milk (probably unpasteurized at the time) so that my mom could come home and make ricotta with it.

 

Tell us about your project, Mangia Bedda.

I started this blog almost 10 years ago as a little part-time hobby. It slowly grew and evolved, and I realized that my mission was really to transcribe all of my mom's recipes so that they wouldn't be lost. Most importantly, I wanted to write them down and get the correct quantities of ingredients because whenever you speak to an Italian nonna about how much flour goes into a recipe, it's as much as needed.

 

I started going to my mom's home to prepare one recipe at a time, watching her make it and stopping her at every step. "Wait, Mom, I've got to measure. I've got to weigh; I've got to write down how much it is." So that's what I did because I wanted to make sure that I had my favorite recipes. And that's even more dear to me now. I'm so grateful that I had the opportunity to do that.

 

I lost my mom a year ago, actually. So I am ever so grateful that I had that opportunity to do that because I have the recipes, not only for me, but I see how much they're appreciated by the types of comments and feedback I get from my readers, who are so happy that I took the time to document them. They share these memories of growing up with these recipes and are so happy that there's a place where they can get them.

 

Where does the name of your blog come from?

Bedda means my pretty one or beautiful one. And that's of significance to me because when I was little, I only met my nonna twice in my lifetime. She lived in Sicily, but I remember I was two years old when I met her, and apparently, I didn't want to eat. She always said those words to me, "Mangia, bedda," to coax me to eat.  

 

What does this minestrone remind you of?

The first thing that comes to mind is memories of this time of year, specifically because this was when my mom made huge batches of minestrone, and she had all the vegetables from my dad's garden. So, if I look at all the ingredients and the recipe, the celery came from the garden. The tomatoes came from the garden. The zucchini and the green beans came from the garden. Oh, and some of the greens, I put in fresh spinach that's easily accessible, but you can use any greens in the garden.

 

I remember my mom making huge batches. She would freeze it before adding pasta and put it into freezer bags. She had a freezer full; we used to have the deep-chest freezer that we had in the garage at the time. She would take out a bag at a time and cook it up for us.

 

So, what exactly is minestrone?

It's an Italian vegetable and bean soup. The key component is that it's vegetables and beans. The beans are always present. Usually, they're Romano beans, but they could be white beans. It's just a medley of vegetables cooked down with these beans. There's a tomato base, and in my mom's case, it was always fresh tomatoes from the garden.

 

Usually, pasta is added to it as well. It's usually a small shape, like a ditalini. It could be small shells or elbow macaroni. Another typical addition would be taking spaghetti and breaking it up into small pieces. We call this spaghetti "sminuzzati." That was very, very common. In fact, sometimes, my mom might've even mixed pasta.  

 

How do you flavor your minestrone?

Most minestrone soups are made with plain water, which is the classic way. But you could use chicken stock or vegetable broth if you want.

 

The herbs are also important—fresh basil, parsley, and thyme. You could add flavor with bay leaves. In just about any soup, I always add a couple of bay leaves.

 

I also add Parmesan rind. I think that makes such a big difference. If you want to stick to using plain water and not some kind of broth, just throw in a Parmesan rind, and I think it's fantastic. It gives a lot of flavor. And, of course, I always serve it with Parmesan cheese. Having minestrone or anything with pasta without cheese is hard for me.

 

Another thing you could add just before serving is a nice drizzle of olive oil. Olive oil on top adds tons of flavor.

 

What did your mother add that was unique to this recipe?

In our house, it was always made with freshly picked vegetables from our garden because, as I said, my mom made large batches. At this time of year, my parents often headed out to local farms and picked their own vegetables to supplement what we had. We could get more tomatoes, more zucchini, and so on.

 

I should add that the beans used were not dried beans that you just bought and soaked from the grocery store. They would always go out and get fresh beans. I actually did this recently. I went to a local farmers market and got a huge 20-pound bag of beans in their pods.

 

There was a lot of time spent shelling these beans at this time of year. They were the beans that we shelled ourselves. She also froze bags full of these beans to make pasta fagioli as well during the winter months.

 

What do you get out of that experience of shelling your own beans?

Oh, it connects me to my mom. When I was a kid, I was always trying to find a way to get away from these tasks. And my mom didn't force me. She let me go out and play and wouldn't hold me to these tasks. But for the last few years, I made sure to head out with my mom every year to get those beans. So we spent time the last few years sitting here, actually in my backyard, bonding while we were shelling the beans and chitchatting and talking about family and so on. So it's really special. I'm glad that I had the opportunity to do that. And now I do that with my husband and my daughter. It's just continuing that tradition.

 

What do you hope readers will take away from your recipe?

What I hope readers will take away is a few things. I think, first of all, the importance of preparing a simple, healthy meal from scratch with fresh ingredients for themselves and their family. I want to show them that it's really not that difficult to do so. Also, the importance of preserving family food traditions and passing them on to the next generation.

>>Get Nadia Fazio's minestrone recipe here.<<

 

 

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