Mediterranean Diet

Drs. Caren and Urman have been recommending a Mediterranean-style diet to their patients for over the past decade based on an abundance of evidence showing its benefit in patients with known heart disease. Multiple studies have shown significant reduction of future heart attack in high risk patients adhering to a Mediterranean diet. If the Mediterranean diet could be captured in a pill, it would be a blockbuster drug. In addition, numerous studies had shown that adherence to a Mediterranean diet was associated with a smaller waist circumference, lower levels of triglycerides, blood sugar and blood pressure, and reduced risk of pre-diabetes.

Now that we can see the connection between a Mediterranean diet and a reduced incidence of major cardiovascular events, let’s take a closer look at what sets this eating plan apart. Common in countries such as Greece and Southern Italy, a Mediterranean diet is abundant in vegetables, fruits, whole grains and fish. Meats and sugary foods are eaten sparingly, and the diet is rich in nuts, legumes, olive oil and even a glass of red wine here and there. Real Mediterranean cuisine also can be found in the foods of Spain, provencal France, Turkey, Lebanon, Israel, Morocco and Tunisia. So very different tastes, from creamy and garlicky hummus to chewy calamari to sweet baklava can be part of a Mediterranean diet.

While not a “low fat” diet, understand that the fats consumed in a Mediterranean diet tend to be unsaturated fats, i.e., the “good” fat. Saturated fats on the other hand – like those found in cheese and red meat – can contribute to high levels of LDL cholesterol and other health issues. The value of the Mediterranean diet is also thought to be due to several other factors including anti-inflammatory effects, decreased oxidative stress, a reduction in insulin resistance (which can lead to type II diabetes), beneficial effects on arterial health (endothelial function and endothelial progenitor cells) and obesity.

It is also helpful to think of the Mediterranean diet more as a Mediterranean “lifestyle.” Beyond food choices, Mediterranean cultures tend to emphasize the importance of healthy physical activity and low stress – factors that both tend to contribute to a lifetime of heart health!

Click above for the Mediterranean Food Pyramid (courtesy of oldswayspt.org)

A Closer Look at the Mediterranean Diet

Where Other Diets Fail, Eating Mediterranean Style Succeeds

Eating lots of fresh vegetables, fruits and whole grains is great for your heart. Vegetables and fruit should fill half your plate; whole grains should fill one-quarter and one-quarter or less of your plate should be left for meat or fish.
Olive oil and nuts are loaded with heart-healthy monounsaturated fat and are a important part
Get most of your protein from fish, plant proteins, low-fat dairy and skinless poultry rather than red meat
The more physically active you are, the more you can benefit from a Mediterranean Diet

Click here for Tips for mediterranean-style Heart Healthy Meals from Oldways.

Click here for Tips for Mediterranean-style Heart Healthy Meals from Gaples Institute

The elements of the Mediterranean diet include:

PLANT FOODS EVERY DAY:

Meals should be centered around these ingredients including fresh vegetables, fruits, legumes and beans, nuts (not salted, preferably raw), seeds, whole (unrefined) grains, olive oil, herbs and spices.

FRESH FISH OFTEN:

At least twice a week, the more fatty the better or white fish (wild salmon, other salmon, trout, sardines, anchovies are the best and highest in omega-3s) but avoid high-mercury containing fish (less tuna, swordfish and mackerel). Bake or broil your fish using lemon, herbs and spices, don’t fry or use batter or rich sauces. Fish contains two oils, DHA and EPA which are known to lower blood pressure, reduce the risk of heart arrhythmia and to slow the growth of fatty plaques that block arteries.

POULTRY, EGGS, CHEESE AND YOGURT IN MODERATE CONSUMPTION:

Daily to weekly but limit eggs to no more than four a week.

WINE IN MODERATE AMOUNTS:

As part of a well-balanced heart-healthy diet and relaxed lifestyle.

Men should have up to two 3½ ounce glasses per day

Women should have up to one 3½ ounce glass per day

MEATS AND SWEETS VERY LITTLE:

Red meat and sweets can be eaten up to a few times a month or more often if consumed in tiny amounts. Dark chocolate might be a better choice than processed candies. Avoid processed sugar.

REGULAR PHYSICAL ACTIVITY

Click here for more information on exercise and the heart.

Which components of the Mediterranean diet are most beneficial?

Every study that has tried to find the “magic bullet” part of the Mediterranean diet has shown that it really takes the “whole package” to achieve the maximal health benefit. Many assume it is the olive oil although some studies have shown that high vegetable consumption, high fruit and nut intake, increased legume consumption, moderate alcohol consumption, and low intake of meats all seem to be stronger factors to longer life than the olive oil itself. Perhaps the olive oil is only as good as the green leafy vegetables you put it on.

What To Keep “In the Pantry” at home to follow a Mediterranean Diet:

Extra virgin olive oil: one can use a less expensive one for cooking and a cold-pressed, unfiltered, “gourmet” type for dressings and drizzling.
Whole Grains: Bulgur, barley, and brown rice (both long-grain and short-grain and “wild” rice)
Dried and canned beans: Chickpeas, lentils, red kidney beans, white Tuscan beans
Dried fruits: Dates, figs, raisins, cherries, apricots
Wine: Preferably red

The Basics:

Key components: Fresh vegetables and fruit, nuts, herbs and garlic
Primary protein source: Fresh fish / seafood and beans (legumes)
Main fat source: Olive oil (preferably extra-virgin)
Important limits: Red meat (once a week or even once a month); eggs (less than once or twice a week)
Bonus beverage: Wine (red possibly best), 1 – 2 glasses a day.

More Information and News about a Delicious, Practical and Heart-Healthy Mediterranean Diet

Click here for Heart Healthy Mediterranean Meal Ideas (Gaples Institute for Integrative Cardiology)

Reviewed by Mark K. Urman, MD

Last updated: 01/05/2019

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