5 March 2013 Eating More Mediterranean Style

Certain studies get a lot of play in the news and “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet” has gotten well-deserved attention. I am also thrilled to hear and read that doctors are also excited about this study. This study shows that there is more effective dietary guidance than simply recommending a low fat diet for patients with high risk of cardiovascular disease.

Low Fat Diets

Based upon strong evidence from earlier studies, major health organizations have traditionally advocated a lower fat diet to help lower risk of cardiovascular disease. That is, a lower fat diet is promoted to lower your risk of heart attack and stroke by lowering your “bad” blood cholesterol levels. The only problem is – people are not very compliant in following low fat diets. We like fat and we do not like eating low fat meals and snacks. It is also a problem if we go too low in fat and drag down our healthy HDL blood levels. And if we lower fat in our diet by replacing those foods with highly refined/low fiber starches and sugars, then we can end up increasing a “bad fat” in our blood – blood triglycerides.

Mediterranean Style Eating

It appears that shifting from a low fat to a healthier fat intake will more effectively reduce risk for cardiovascular disease in high risk people. And that is where Mediterranean style eating takes center stage. There really isn't a specific “Mediterranean Diet” since there are many cultures that live around the Mediterranean Sea. However, eating more “Mediterranean” style is defined and tracked in the study with a food frequency questionnaire. Based upon this questionnaire, I have created a hit list of food habits to help you eat more like the folks in the treatment groups of the study. Eating more Mediterranean style should help reduce your risk for cardiovascular disease. The content found below was adapted from Table S1 of the study appendix.

Daily Food Goals

  • Consume 4 or more tablespoons of extra virgin olive oil*.
  • Consume 2 or more large portions of vegetables. 1 serving = 200 g (7 oz)
  • Consume 3 or more servings of fruit.

Weekly Goals

  • 7 or more glasses of wine. 1 standard glass = 150 ml (5 fl oz)
  • 3 or more servings of legumes (dried beans/peas). 1 serving = 150 g (5 oz)
  • 3 or more servings of fish or shellfish.
  • 1 serving fish = 100-150 g (3.5-5 oz); 1 serving shellfish = 200 g (7 oz)
  • Less than 3 servings of store bought sweets, pastries, cakes, cookies, biscuits, or custard.
  • 3 or more servings of nuts*. 1 serving = 30 g (1 oz or 1/4 cup).
  • 2 or more servings of sofrito (sauce of tomato, onion/leek/garlic, cooked in olive oil)

Other Goals

  • Choose chicken, turkey, or rabbit over veal, pork, hamburger, or sausage.
  • Avoid daily – less than 1 serving of red meat, hamburger, or meat products. 1 serving = 100-150 g (3.5 – 5 oz)
  • Avoid daily – less than 12 g (1 tablespoon) of butter, margarine, or cream.
  • Avoid daily – less than 1 serving sweetened beverages.

Note: Extra virgin olive oil (EVOO) is very high in polyphenols and 4 tbsp of intake was used as one of the study treatment groups (instead of just refined olive oil). The other treatment group consumed the above diet but did not specifically use EVOO as the olive oil source. The nut treatment group consumed 1 serving of nuts daily in the form of 15 g walnuts + 7.5 g almonds + 7.5 g hazelnuts. This ensured a mixture of high alpha-linolenic acid (ALA or the plant form of omega-3 fat) and monounsaturated fats. Nuts were consumed in addition to the 4 tbsp of olive oil intake, they did not replace it. People in the daily EVOO or nuts treatment groups had lower rates of major cardiovascular events compared to people in the standard low fat diet group.

Enjoy experimenting with Mediterranean style eating. I think you will find the foods delicious while also helping you reduce your risk for cardiovascular disease. To your health and taste buds!

Katherine Isacks, MPS, RD, CDE
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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.

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Foods & Recipes/Fruit & Vegetables Meal Planning & Diets/Low Fat & High Fat Meal Planning & Diets/Mediterranean Style

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