A recent study evaluated six different clinical trials involving 2650 overweight and obese patients around the world. The Mediterranean Diet was found to be more effective in reducing weight, body mass index, blood pressure, fasting sugar and total cholesterol than a low fat diet.
The Mediterranean Diet is known as a moderate fat diet, because a higher percentage of calories comes from fat than in a standard heart healthy diet where less than 30% of calories are from fat. However, the secret of the Mediterranean diet is not the percentage of fat but the type of fat consumed. Olive, canola, sunflower, safflower, soybean and peanut oil commonly eaten in the Mediterranean regions are all mono and poly unsaturated oils, which are healthier than saturated and trans (partially hydrogenated vegetable oils). Monounsaturated fatty acids (commonly abbreviated MUFA) are healthier than saturated fats, which are found in animal fat products such as butter and tropical oils. Avocados are another source of MUFA.
Nuts, another integral food consumed in Mediterranean countries, provide heart-healthy omega 3 fatty acids.
Fish, a leaner protein than red meat, is a major component of the Mediterranean Diet. Fatty fish like salmon, halibut, herring, black cod and sardines have high levels of omega 3 fatty acids, which support healthy memory and aging, and prevent heart disease. Interestingly, omega 3 fatty acids modestly increase LDL ( bad cholesterol), but they are beneficial in preventing heart disease and stroke because they prevent platelet stickiness and help lower blood triglyceride levels. Omega 3 fatty acids also reduce the risk of sudden death by preventing heart dangerous types of heart rhythm abnormalities.
The Standard American Diet or SAD (pun intended) has large amounts of red meat, fried foods, processed grains, cured meats, and sugary sweets and beverages. In contrast, the Mediterranean Diet is plant-based, with up to 10 servings of fruits and vegetables daily.
Whole grains are another important feature of the Mediterranean Diet. Bread is eaten plain or dipped in olive oil. Avoid butter, which has saturated fat, and margerine, which contains trans fat made by partially hydrogenating vegetable oils. Whole grains take longer to digest so they prevent sharp increases in blood sugar after meals.
Americans more commonly eat processed grains, which have the outer covering of the grain removed. Remember that whole wheat bread is not made of whole grain; instead it is made out of processed wheat flour (but still has more fiber than white bread). Whole grains have more fiber and are healthier for the colon than processed grains. A high fiber diet can reduce the risk of diverticulosis and colon cancer. It takes more calories to digest whole grains than to digest processed grains. A diet high in fiber can also lower blood cholesterol levels. The Mediterranean Diet have high amounts of soluble (beans, legumes, cracked wheat) and insoluble (fruits, vegetables, oat bran) fiber.
Substitute a whole wheat version of your favorite pasta, and remember to cook it al dente (not soft) in order to prevent increases in blood sugar after eating.
Red wine in moderation is acceptable in the Mediterranean Diet. However, if more than 5 ounces per day in women or 10 ounces a day in men is consumed, the benefits of the red wine are lost. Women at risk for breast cancer or breast cancer
recurrence should consider restricting alcohol intake since this factor has been associated with breast cancer occurrence. It is believed that the benefits of red wine to the heart are through the antioxidant action of the phytonutrient resveratrol, which is found in the skins of grapes. So the same benefits of wine can be achieved by eating red grapes or drinking pure red grape juice.
Dr. Ancel Keyes and his colleagues (including Dr. Paul Dudley White, who later served as President Eisenhower’s heart doctor) developed the Seven Countries Study after World War II to evaluate the health of almost thirteen thousand middle-aged men in the United States, Greece, Italy, the Netherlands, Finland, Yugoslavia and Japan. They discovered that people who ate a diet high in vegetables, fruits, legumes (beans, lentils), fish and whole grains were the healthiest. The healthiest men were the residents of Crete, who lived longer and had less heart disease than Americans in the post World War II era. Dr. Keyes and his associates hypothesized that it was the Mediterranean diet that the Cretans ate which contributed to their longevity and good health. The residents of Crete ate up to 10 servings of fruits and vegetables daily!
Studies have shown that the Mediterranean Diet decreases the risk of heart attack, stroke, Parkinson’s disease, Alzheimer’s disease and death from all causes. Although there have not been any prospective randomized, double blind, placebo controlled trials (the gold standard for evidence based medicine) comparing the Mediterranean diet to the standard American diet or weight loss programs, a number of studies have shown that people who follow the Mediterranean diet are leaner than people who follow other diets.
Cruciferous vegetables (shaped like a cross when cut) such as broccoli, cauliflower, kale, cabbage and Brussels sprouts have antioxidants which prevent several kinds of cancer including breast and prostate. Tomatoes have lycopene, an antioxidant similar to vitamin A, which reduces the risk of cancers such as breast and prostate. Cooking tomatoes or cooking with olive oil, such as in tomato sauce, increases the lycopene content.
The low sodium Mediterranean diet combined with the high potassium content of fruits and vegetables such as various greens, legumes, potatoes and squash helps lower blood pressure. Spinach, almonds, lentils, broccoli, pumpkin and sunflower seeds are good sources of magnesium, another element essential to maintain good blood pressure.
The high fiber content of fruits, vegetables and whole grains stabilizes blood sugar and prevents diabetes. Another benefit of fiber in the diet is that it keeps maintains a feeling of fullness, decreasing the temptation for eating unhealthy snacks when ravished! Mono unsaturated fats from foods such as avocados, olive oil and nuts increase the body’s ability to use insulin, which also decreases the risk of diabetes.
Although nuts have healthy omega 3 fatty acids, they are composed of fat, so no more than a handful a day is recommended. Avoid salted or honey roasted nuts. Almonds, walnuts, hazelnuts, pine nuts, cashews and pistachios can be eaten as part of the Mediterranean diet.
Lean protein in the form of chicken and other poultry and fish (healthy portion is checkbook cover size) are important components of the Mediterranean diet, and are consumed weekly. Red meat and pork is rarely eaten, no more than a few times a month, and in small portions (about the size of a deck of cards). Food is prepared simply, using fresh ingredients, without sauces or gravies. Rosemary, garlic, thyme, basil and parsley are herbs commonly used in Mediterranean cuisine, and have been shown to have beneficial health effects.
Studies show that garlic decreases blood pressure and reduces risk of cardiovascular disease. Remember to allow cut garlic to sit out for at least 5 minutes before cooking, in order to retain its health benefits.
In the Mediterranean region, sweets are consumed infrequently (no more than twice weekly), and are usually made of natural sugars such as honey. Aiming for a 75 calorie dessert is ideal. Sorbets, fruit and dark chocolate are the best dessert choices.
Low fat Greek yogurt, feta cheese, sardines, beans, Brussels sprouts, broccoli, spinach and kale are good sources of calcium.
Lentils, spinach, almonds, and poultry are good sources of iron. Eating citrus fruit or peppers provides vitamin C, which helps the absorption of iron in a meal. Lentils and beans are also good sources of potassium, magnesium, folic acid and soluble fiber. Soak beans and change the soaking water several times in order to decrease the gas producing substances in beans. Remember that beans are not a complete protein, meaning they lack some essential amino acids that the body must get through the diet; adding lean poultry and eggs provides these essential amino acids. Egg yolks should be eaten no more than once a week due to the saturated fat content, but there is no limit to the amount of egg whites that can be consumed.
At least 30 minutes daily exercise or movement is a recommended part of the Mediterranean diet.
Finally, a very important component of the Mediterranean lifestyle is sharing food with friends and family. Enjoy the Mediterranean lifestyle, have a zest for life and improve health all at the same time!
Allain J. Nordmann, Katja Suter-Zimmerman, Heiner C. Bucher, Iris Shai, Katherine R. Tuttle, Ramon Estruch, Matthias Briel. Meta-Analysis Comparing Mediterranean to Low-Fat Diets for Modification of Cardiovascular Risk Factors. The American Journal of Medicine Volume 124, Issue 9, Pages 841-851.e2, September 2011.
Last updated on January 18, 2012 by Dr. Vee Photograph courtesy of epSos.de