Introduction – The Mediterranean Diet for Beginners

The Mediterranean diet is often championed as a heart healthy diet. Recent studies link the Mediterranean diet with lower risk factors for heart disease, such as high cholesterol and high blood pressure. Given its benefits, the Mediterranean diet is one of the healthy eating plans that American nutrition experts recommend. It’s also recognized by the World Health Organization as a healthy-eating pattern. Given all the accolades, it seemed like a great idea to pen this post, “The Mediterranean Diet for Beginners”.

So, why is a heart healthy diet so important…I went to the experts to find out. “Our study shows us that you have the control and power to change the trajectory of your health and life,” says lead study author and Johns Hopkins expert Haitham Ahmed, M.D., M.P.H. “With a healthier diet, exercise, weight maintenance and smoking avoidance, thousands of our participants were able to live longer and free of cardiovascular disease. You can too!”

Mediterranean-style eating aids your heart in four ways, according to Ahmed:

• It helps keep cholesterol levels healthy.
• It enhances your body’s ability to absorb blood sugar (diabetes and pre-diabetes threaten your heart’s health).
• It cools off damaging inflammation, an immune system response triggered when the body fights perceived intruders. Acute, or one-time, inflammation is helpful in fighting viruses and bacteria, but people who are overweight, consume high levels of refined foods, and lead a sedentary lifestyle have chronic, or ongoing, inflammation, which may lead to diabetes and liver and heart disease.
• It helps arteries stay flexible and resist plaque buildups [3].

What Is the Mediterranean Diet?

The heritage diets of countries bordering the Mediterranean Sea vary slightly so there are several versions of the Mediterranean diet. In 1993, the Mediterranean Diet Pyramid and nutrition guide was developed by the Oldways Preservation Trust, the Harvard School of Public Health, and the World Health Organization. It summarizes the Mediterranean Diet pattern of eating, suggesting the types and frequency of foods that can be eaten every day. More and more, I see academia using the term eating pattern in lieu of diet. The Mediterranean Diet Pyramid follows this thought as it is an eating pattern and not a strict diet plan. The pyramid focuses upon certain foods based on the dietary traditions of several Mediterranean countries during the mid-20th century. Studies show that during this time, these countries displayed low rates of chronic disease and higher than average adult life expectancy despite having limited access to quality healthcare. It was believed that their diet, mainly fruits and vegetables, beans, nuts, whole grains, fish, olive oil, small amounts of dairy, and red wine, contributed to their exceptional health. The guide also emphasizes daily exercise and the beneficial social aspects of eating meals together. The social aspect of eating is something I will highlight in future posts.

How It Works

The Mediterranean diet is a primarily plant-based eating plan that includes daily intake of whole grains, olive oil, fruits, vegetables, beans and other legumes, nuts, herbs, and spices. The diet incorporates animal proteins eaten in smaller quantities than the traditional American diet. The primary protein used is fish and seafood. Sadly, I have never been a seafood eater. However, I believe retirement is a great time to try new things, so I plan to do my best to experiment and incorporate seafood into my diet. I anticipate I will have to use chicken as an alternative until my tastes change. You can read below why this is not an optimal solution.

Whereas the pyramid shape does suggest that you eat more fruits and vegetables and less dairy foods, it does not specify portion sizes. There are additional characteristics that make this eating plan unique:

• An emphasis on healthy fats. Olive oil is recommended as the primary added fat, replacing other oils and fats (butter, margarine). Other foods that naturally contain healthy fats and included in the Mediterranean diet are nuts, avocados, and oily fish like tuna, salmon, herring and sardines; among these, walnuts and fish are high in omega-3 fatty acids.
• The diet chooses fish as the preferred animal protein at least twice weekly. and other animal proteins of poultry, eggs, and dairy (cheese or yogurt) in smaller portions either daily or a few times a week.
  • Fish may not have as much protein as other meats, but it makes up for that with its Omega 3 fatty-acids, a nutrient most people are deficient in. Omega 3 helps reduce inflammation, improve cognitive function and prevent heart disease, heart attack and stroke.
  • Red meat is limited to a few times per month.
  • Be sure to choose fish low in mercury.
• Water is the consistent beverage of choice, but the diet does include a moderate intake of wine with meals, about one to two glasses a day for men and one glass a day for women. Red wine is preferable due to its content of more polyphenols, which are thought to benefit heart health. That said, both blueberries and dark chocolate have more of this than red wine, so they can be good sources as well.
• Like with all health guidelines, emphasis is also on daily physical activity through enjoyable activities.

Some Research Findings

• One interesting feature of the Mediterranean diet is that it incorporates a healthy amount of fat. Evidently, which types of fats are consumed is very important; the total percentage of calories from fat is less of an issue. The PREDIMED study, a primary prevention trial including thousands of people with diabetes or other risk factors for heart disease found that a Mediterranean diet supplemented with extra virgin olive oil or nuts and without any specific fat and calorie restrictions reduced the rates of death from stroke by roughly 30% [6]. Characteristic of the Mediterranean diet, most dietary fats were healthy fats, such as those from fatty fish, olive oil, and nuts. Interestingly, total fat intake was a generous 39-42% of total daily calories, which is much higher than the 20-35% fat guideline as stated by the Institute of Medicine. Risk of type 2 diabetes was also reduced in the PREDIMED trial.

• As with any diet, there is the potential to overeat and add weight. Therefore, It is recommended you use the Diet Pyramid and Guide, which gives guidance on specific types of foods to incorporate as well as a balanced plate guide such as the Healthy Eating Plate [5], which gives a better indication of healthy proportions of food to eat per meal. However, it is important to note that, probably in part due to the higher intake of olive oil and less processed foods, the Mediterranean dietary pattern seems to satisfy hunger, which reduces the likelihood of overeating. In one of the most successful weight loss trials to date, those assigned to the Mediterranean diet maintained weight loss over a period of six years.

• Research indicates that the health benefits of a Mediterranean-style eating pattern have a synergistic component. The plan includes several foods…and it is the combination of these foods that seems to be beneficial. The effect is not as strong when looking at single foods or nutrients included in the Mediterranean diet. Therefore, it is important to note that simply adding olive oil or fish to your current diet, but not fully adopting the plan, will not result in nearly as much benefit.

Conclusion

The Mediterranean diet doesn’t require any special boutique foods or expensive diet plans. To start eating according to the Mediterranean diet, just take a quick trip to the grocery store to stock up on the recommended foods. These tips will help you get started:

• Eat more fruits and vegetables. Each day, strive for 2 to 3 servings of fruit and four or more servings of vegetables. One serving of fruit equals a medium piece of whole fruit or one cup of chopped. One serving of vegetables equals two cups of leafy produce, one cup of raw veggies, or half a cup of cooked vegetables.
• Choose whole grains. Eat whole-grain bread, cereal and pasta. You also can try other whole grains, such as rye, bulgur, barley and farro. If you eat about 2,000 calories a day, aim to have at least 3 ounces of whole grains. You can get 1 ounce from a slice of bread, a cup of ready-made cereal, or half a cup of cooked rice or pasta.
• Use unsaturated fats from plants. Replacing saturated fats with unsaturated fats may help lower the risk of heart disease. You can replace butter with olive, canola, or safflower or sunflower oil in cooking or at the table. And instead of putting butter or margarine on bread, try Smart Balance, which is a product I use. You can also try nut or seed spreads on your toast, fruit or other favorites.
• Eat more seafood. Eat fish or shellfish 2 to 3 times a week. Children and people who are pregnant or breastfeeding may want to limit certain types of fish due to mercury levels. One serving of fish is around 3 to 5 ounces for adults. The U.S. Food and Drug Administration recommends smaller servings for children twice a week.
  • Fresh or water-packed tuna, salmon, trout, mackerel and herring are healthy choices.
  • Be sure to choose fish low in mercury.
• Get nuts. Each week, aim to eat four servings of raw, unsalted nuts. One serving is a quarter of a cup.
• Enjoy some dairy. Skim or 1% milk, low-fat cottage cheese, and low-fat Greek or plain yogurt. Limit how much cheese you eat. One serving is about the size of four cherries. Reduce higher fat dairy, which includes whole and 2% milk, butter, margarine, and ice cream.
• Reduce red and processed meat. Eat more fish, poultry or beans instead.
• Spice it up. Herbs and spices boost flavor and lessen the need for salt.

The Mediterranean diet has a lot of flexibility, so you can make it a delicious and nutritious way to a heart healthy life style.

Resources

• Mediterranean Diet Shopping List
• Oldways Cultural Food Traditions
• Super Easy Mediterranean Diet Cookbook for Beginners
• The Mediterranean Slow Cooker Cookbook

And check out my post “Heart Healthy Cookbooks for Seniors”, which highlights healthy diets and books beyond just the Mediterranean diet.

 

Sources

1. Oldways Cultural Food Traditions

2. Mediterranean diet for heart health – Mayo Clinic

3. Take Your Diet to the Mediterranean – Johns Hopkins

4. Diet Review: Mediterranean Diet- Harvard School of Public Health

5. Healthy Eating Plate – Univ. of Minnesota

6. The Predimed Study – New England Journal of Medicine

 

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