Mediterranean Diet

The Mediterranean diet is a diet based on plant foods. It is high in N-3 fatty acids, antioxidants and phytochemicals.

Fat intake under the Mediterranean diet is moderate (up to 35% of total calories). It consists predominately of monounsaturated fats (e.g. olive oil) as opposed to polyunsaturated (e.g. canola oil) and saturated (e.g. animal) fats.

The diet is also low in cholesterol, salt and sugar. It has received a lot of attention in recent years because scientists have shown that following a Mediterranean diet is associated with a number of health benefits.

The Mediterranean diet comes from the Mediterranean region, which includes countries such as Greece, Turkey, Malta and Italy. Many of the foods eaten in the Mediterranean region?are also common in other parts of the world (e.g. fish), and, as a result of globalisation, immigration and the world food market, foods once considered to be?specialties of the Mediterranean region (e.g. olive oil, feta cheese) are now mass produced and available on the shelves of supermarkets throughout the world. As such, people in many parts of the world eat traditional Mediterranean foods.

The important combination of foods traditionally eaten in the Mediterranean is not necessarily adhered to by people who eat Mediterranean foods. However,?it is the combination of foods on which the diet is based, rather than the individuals foods it includes, which?is important in relation to the health benefits associated with the diet. For example, eating lots of olives and feta cheese without the whole grains and legumes, or in combination with saturated fats or sugary drinks, is unlikely to be beneficial to one's health, and is not a Mediterranean diet.

The Mediterranean diet combines a high intake of fresh vegetables, fruits, legumes (e.g. chick peas) and cereals (e.g. oats) with a relatively high fish intake and minimal saturated fats intake. Red meat is eaten on rare occasions, as are sweets and butter. Cheese, yoghurt, eggs and red wine are consumed most days, in moderation. Olive oil, which is a monounsaturated fat, is used in place of butter and oil containing saturated fats.

Two people following the Mediterranean diet can consume a different amount of energy (i.e. calories) and?still be following the diet. The total number of calories eaten will depend on whether one is trying to lose or gain weight, or simply maintain a healthy lifestyle.

For weight loss, a diet restricted to 1500 calories per day for women, and 1800 per day for men, is recommended. Many individuals will eat more than that;?in general, it is recommended that one does not eat more than 2400 calories per day.

It should be noted that even people who eat in excess and become overweight or obese still receive benefits from following a Mediterranean diet. Compared to obese people who follow other diets, they are less likely to suffer from metabolic syndrome, which often leads to diabetes and cardiovascular disease.

The Mediterranean diet offers health benefits because of the combination of foods consumed and the relative quantities in which they are consumed. A typical Mediterranean diet should include the following.

Less saturated fat and more monounsaturated fat

Fat should contribute 25–35% of total calories (roughly the same as a healthy, balanced diet). Less than 10% of total calorie intake should be from saturated fats.

Instead of saturated fats, olive oil is used for cooking and salad dressings. Low fat nuts (e.g. almonds) are consumed in moderate quantities. On a typical day, someone adhering to a traditional Mediterranean diet might derive fat from 30–45 grams of olive oil (1–2 tablespoons) and a handful of walnuts or almonds.

Small quantities of saturated fats are eaten every day in the form of yoghurt and cheese (low fat, natural varieties are best, particularly if weight loss is the goal. If fruit yoghurt is consumed, it should be low fat without added sugar).

Less meat, eggs and poultry

Poultry, and even more so red meat, are consumed only occasionally (e.g. either poultry or meat might be eaten once a week). Up to four eggs can be consumed per week.

More seafood

Seafood (e.g. fish, shellfish, fish eggs) is the predominate form of meat eaten be followers of the Mediterranean diet. It is eaten 2–3 times per week, in servings of 100 grams.

Dairy products

Different dairy products are consumed daily, but in moderation and usually in the form of cheese or yoghurt and not butter or milk. It is typical to eat the equivalent of a small tub of yoghurt?and a small piece of cheese every day.

More nuts and legumes

Legumes or nuts are usually eaten every day in moderate quantities (e.g. a small handful of nuts as a snack, or a serving of beans). Nuts are usually low fat varieties like almonds and walnuts, eaten as a snack or added to cooking. Legumes include chickpeas (the legume used to make hummus), peas and beans.

Cereals

Cereals have traditionally been mostly whole grains. They include home-made bread, pasta and polenta. They are eaten daily, at all meals, in moderate portions.

Fruits

Grapes, figs, tomatoes, cucumbers and melons are common and consumed several times every day. Tomatoes and cucumbers are eaten with most meals (e.g. on toast for breakfast, in salads), while melons and figs are common deserts.

Vegetables

Lots of leafy green vegetables, including lettuce and wild herbs, carrots, beetroot and onions, are eaten in large quantities every day.

Red wine

Red wine is the predominant form of alcohol. A glass of red wine can be consumed daily, although it should be consumed with meals.

The health benefits of a Mediterranean diet were first highlighted in the 1950s, when scientists noticed that the rates of coronary heart disease and other chronic conditions were low?in Italy. Since then, the lower rates of chronic diseases have been linked to the dietary patterns of people living in the Mediterranean region (i.e. adhering to a Mediterranean diet). Studies have shown that following a Mediterranean diet can:

Increase longevity: A European study showed that elderly people (older than 60 years) who followed a Mediterranean diet were less likely to die (i.e. they lived longer) than elderly people who did not follow a Mediterranean diet.Reduced risk of cardiovascular problems: Following a Mediterranean diet after having a heart attack can reduce the risk of both having and dying from a heart attack in the future.Reduced risk of metabolic syndrome: Individuals who follow a Mediterranean diet are less likely to develop metabolic syndrome. Many individuals who already have the syndrome can reverse the metabolic alterations associated with it by following a Mediterranean diet.Reduced risk of type 2 diabetes mellitus: Following a Mediterranean diet reduces the risk of developing diabetes for healthy people and for people who are obese (and therefore have a high risk of developing diabetes).Reduced risk of cancer: A European study showed that following a Mediterranean diet reduced the risk of developing cancer.Increased weight loss: Obese individuals who follow a Mediterranean diet lose more weight than those following similar diets matched for total calorie and fat intake.

The nutritional balance of a diet (i.e. the combination of fats, cereals, sugars, vitamins and other nutrients), and particularly the types of fats consumed, have different effects on the body. For example, monounsaturated fats are associated with less abdominal obesity (instead, fat is stored around the hips and buttocks) than saturated fats. In terms of diabetes and cardiovascular disease, evidence suggests that abdominal fat poses greater health risks than fat which is stored around the buttocks. Saturated fats are also associated with endothelial dysfunction, which increases the risk of metabolic syndrome and diabetes.

Fish is a good source of long chain omega 3 fatty acids, which play an important role in fighting the metabolic imbalances that cause diabetes. Refined grains (which are largely excluded from traditional Mediterranean diets in favour of whole grains) are associated with increased glucose and triglyceride levels after eating, which increases the risk of cardiovascular problems and diabetes. Butter and full fat milk have a greater impact on cholesterol levels than other dairy foods like cheese and yoghurt, which are most common in Mediterranean diets.

The health benefits of the Mediterranean diet come from the combination of foods consumed. Combining components of the Mediterranean diet (e.g. fish and potatoes) with saturated fats (e.g. fried fish and chips), alcohol or excessive food consumption is not a healthy alternative.

When all components of the Mediterranean diet are consumed in the correct proportions, (and particularly when they are consumed in overall moderation), the diet is beneficial for one's health.

It is also important to remember that regular, moderate intensity exercise is necessary for good health. The Mediterranean diet is not a substitute for daily physical activity.

There are many ways that a diet can be modified to more closely resemble the important combination of nutrients found in a typical Mediterranean diet. To begin, try:

Replacing animal fats and butter with olive oilReplacing red meat with fish and lean poultryGrilling meat, fish and poultry rather than frying itDrinking red wine with meals instead of without food and instead of beer or mixersEating low fat nuts like almonds and walnuts instead of potato chips, pretzels, peanuts, cashews and other snacks which are high in fatWhen cooking, using yoghurt or olive oil instead of cream or butterLooking for tasty new recipes?For more information on nutrition, including information on?types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition.?For more healthy and tasty recipes, including recipes for breakfast, snacks, parties, dinner and dessert, as well as recipes for kids, see Recipes.Esposito K, Ceriello A, Giugliano D. Diet and the metabolic syndrome. Metabolic Syndrome and Related Disorders. 2007; 5(4): 291–6.Shai I, Schwarzfuchs D, Henkin Y. Weight loss with a low-carbohydrate, Mediterranean, or low fat diet. NEJM. 2008; 359(3): 229–41.Trichopoulou A, Orfanos P, Norat T, Bueno-de-Mesquita B, Ocke MC, Peeters PH, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005; 330: 991.Willet WC. The Mediterranean diet: Science and practice. Pub Health Nutr. 2006; 9(1a): 105–10.de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors and the rate of cardiovascular complications following myocardial infarction: Final reports of the Lion Heart Study. Circ. 1999; 99: 779–85.Esposito K, Marfella M, Ciotola M, Di Palo C, Giugliano F, Giugliano G,?et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: A randomised trial. JAMA. 2004;?292(12): 1440–6.Blaha MJ, Bansal S, Rouf R, Golden SH, Blumenthal RS, Defelippis AP. A practical "ABCDE" approach to the metabolic syndrome.?Mayo Clin Proc. 2008; 83(8): 932–43.Martinez-Gonzalez MA, de la Fuente-Arrillaga C, Nunez-Cordoba JM, Basterra-Gortari FJ, Buenza JJ, Vazquez Z, et al. Adherence to Mediterranean diet and risk of developing diabetes: Prospective cohort study. BMJ. 2008; 336: 1348–51.Benetou V,. Trichopoulou A, Orfanos P, Naska A, Lagiou P, Bofetta P, et al. Conformity to traditional Mediterranean diet and cancer incidence: The Greek EPIC cohort.?Brit J Cancer. 2008; 99(1): 191–5.Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity and risk of cardiovascular disease: 13 year follow up of participants in a study of men born in 1913. BMJ. 1984; 288: 1401–04.Jakulj F, Zernicke K, Bacon SL, van Wielingen LE, Key BL, West SG,?et al. A high fat meal increases cardiovascular reactivity to psychological stress in healthy young adults. J Nutr. 2007; 137(4): 935–9. O'Keefe JH, Gheewala NM, O'Keefe J. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008; 51(3): 249–55.Carpentier YA, Portois L, Mallaise WJ. N-3 fatty acids and the metabolic syndrome. Am J Clin Nutr. 2006; 83(6 Suppl): 1499S–1504S.Beulens JWJ, de Bruijne LM, Stolk RP, Peeters PHM, Bots ML, Grobbee DE,?et al. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women: A population-based follow-up study. J Am Coll Cardiol. 2007; 50: 14–21.Biong AS, Muller H, Seljefot I, Veierod MB, Pedersen JI. A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine.?Br J Nutr. 2004; 92(5): 791–7.

View the original article here