Tuesday, May 21, 2013

Make Each Day Mediterranean!

When I hear the word "Mediterranean," my mind conjures up visions of a coastal countryside and wonderful Italian and Greek-style food. My mouth almost starts watering just thinking about pasta dishes, breads, vegetables, herbs, olives, oils and nuts. The simplicity of the cooking and wholesome, natural ingredients might be what I like the best. Not only is the Mediterranean way of eating delicious, it's also very healthy and has received a lot of attention over recent years for its benefits to weight management and heart health.

May just happens to be Mediterranean Diet month. Even though we're reaching the end of the month, it's a great time to make some adjustments to your diet for good. Don’t get too concerned about the word “diet” in the title – the Mediterranean Diet is more so a lifestyle change and a shift in the types and amounts of foods typically consumed, as well as other lifestyle modifications. It's a healthy way of eating and a healthy way of life.

Why, you ask?

First, the research. There have been many studies on the Mediterranean Diet. One study of interest, The Seven Countries Study, which was initiated shortly after World War II, examined the idea that Mediterranean-style eating patterns contributed directly to improved health outcomes. This study ran from 1947-1981 (wow!) and examined the health of nearly 13,000  middle-aged men in the United States, Japan, Italy, Greece, the Netherlands, Finland and then-Yugoslavia. What they found was that adherence to a Mediterranean diet is associated with a significant improvement in health status; specifically, a reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson's disease and Alzheimer's disease (13%).

The benefits of a plant-based diet and unsaturated fats such as those found in olive oil, olives, avocados and nuts, are also well documented. Visit the American Heart Association for more information on the connection between dietary fats and cardiovascular health.


Use the Pyramid above to get an overview of the following cornerstones of Mediterranean Diet.
  • Being active and enjoying meals with others is a foundational component of the Mediterranean lifestyle. These lifestyle aspects help keep our bodies and minds active.
  • The largest layer of the pyramid contains fruits, vegetables, whole grains, and healthy fats and proteins from olive oil (replacing margarine or butter), beans, nuts, legumes and seeds. It emphasizes the use of herbs and spices (not salt) for flavor. These more plant-based recommendations are in keeping with the Dietary Guidelines for Americans too. {Visit ChooseMyPlate.gov for more information.}
  • Fish and seafood compose the next tier. It is recommended that these foods be consumed twice weekly.  Not only are fish and seafood typically lower in saturated fat than meats and poultry, but they contain omega-3 fatty acids, which can reduce inflammation throughout the body and delay or prevent atherosclerosis and heart disease. Omega-3s can also aid with fetal, infant, and child brain and neurological development. Keep in mind that if you are pregnant or nursing to check the mercury content of seafood prior to consumption.
  • The fourth tier contains poultry, eggs, cheese, and yogurt, which with moderate portions can be consumed daily to weekly. Although "moderate” consumption of dairy is in strong contrast to the US suggestions of 3 servings of low-fat dairy each day, research shows that the Mediterranean diet pattern, particularly when combined with additional olive oil, can improve bone markers.
  • The top tier of the pyramid contains red meat and sweets, which are recommended to be consumed less than any other foods. Red meats, if not from a very lean cut, contain excess fat and cholesterol. Added sugar gives calories with virtually no nutritional value, which can lead to weight gain if consumed in excess (and they displace other healthy foods!).
  • Beverages are found on the side of the pyramid.  Water is highly emphasized and red wine is suggested in moderation.  *Of course, if you are pregnant, have dependency issues or are taking certain medications, alcohol may not be appropriate to incorporate into your diet. Check with your physician before making changes.

Are you interested in a Mediterranean way of life? Try incorporating some of these tips from www.oldways.com:
  1. Eat lots of vegetables. From a simple plate of sliced, fresh tomatoes drizzled with olive oil and crumbled feta cheese to stunning salads, garlicky greens, fragrant soups and stews, healthy pizzas or oven-roasted medleys, vegetables are vitally important to the fresh tastes and delicious flavors of the Med Diet.
  2. Change the way you think about meat. If you eat meat, have smaller amounts – small strips of sirloin in a vegetable sauté, or a dish of pasta with diced prosciutto. Try thinking of meat as a garnish rather than the main part of your meal.
  3. Always eat breakfast. Start your day with fiber-rich foods such as fruit and whole grains to keep you pleasantly full for hours. Layer granola, yogurt, and fruit or mash half an avocado with a fork and spread it on a slice of whole grain toast.
  4. Eat seafood twice a week. Fish such as tuna, herring, salmon and sardines are rich in omega-3 fatty acids. Shellfish including mussels, oysters and clams have similar benefits for brain and heart health.
  5. Eat a meatless meal once a week (join the Meatless Monday movement). Build meals around beans, whole grains and vegetables instead of meat. Heighten the flavor with fragrant herbs and spices. Down the road, incorporate meatless meals more often to decrease the amount of saturated fats you consume.
  6. Use good fats. Include sources of healthy fats in daily meals, especially extra-virgin olive oil, nuts, peanuts, sunflower seeds, olives and avocados.
  7. Enjoy some dairy products. Eat Greek or plain yogurt, and try small amounts of a variety of cheeses.
  8. Eat fresh fruit for dessert. Choose from a wide range of delicious fresh fruits — from fresh figs and oranges to pomegranates, grapes and apples. Instead of daily ice cream or cookies, save sweets for a special treat or celebration.

To determine if a food product meets the Mediterranean Diet criteria, you can look for this symbol on packages. It's called the "Med Mark."

Med_Mark_StampTo use the Med Mark, products must meet these health thresholds per serving:
  1. Artificial trans fats: limit of zero grams (no added trans fats in any amount).
  2. Saturated fat: limit of 8 percent of total calories from saturated fat.
  3. Sodium: limit of 480 milligrams (for individual food) or 600 milligrams of sodium (for meal-type products).
  4. Added sugars: limit of 4 grams (or about 1 teaspoon).

Make each day Mediterranean! Get healthy and in shape by incorporating some of these Med-inspired tips as part of your routine lifestyle.

Download this handy Mediterranean Diet diet guide here (courtesy of Oldways.com).

Contributions to this article by: Kelly Houston, St. Louis University Dietetic Intern
Photos: Oldways.com

Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: meta-analysis.
British Medical Journal. 2008;337:a1344-50.
Fernández-Real, J., Bulló, M., Moreno-Navarrete, J., Ricart, W., Ros, E., Estruch, R., & Salas-Salvadó, J. (2012). A mediterranean diet enriched with olive oil is associated with higher serum total osteocalcin levels in elderly men at high cardiovascular risk. Journal Of Clinical Endocrinology & Metabolism97(10), 3792-3798. doi:10.1210/jc.2012-2221