What goes into a Mediterranean diet, and how to get started

If you’re into healthy eating, you’ve probably heard that the benefits of Mediterranean cuisine are as clear as the crystal clear seas of a Greek island getaway.

But for someone just testing the waters of the heart-healthy diet, the ins and outs of such a diet can get a little murky. That’s because its definition can vary.

Mediterranean eating isn’t necessarily about eating as many servings of a particular food at each meal, said Catherine M. Champagne, professor of nutritional epidemiology and nutritional assessment and nutritional counseling at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge. “It’s more of a pattern.”

In general, this pattern includes:

– Fresh fruits and vegetables.

– Nuts, beans and whole grains.

‒ Olive oil as the most important source of fat in contrast to butter or margarine.

– Fish and other seafood.

– Limit consumption of red and processed meats, sugary sweets, processed foods and some dairy products.

It’s a dietary pattern ingrained in the traditional habits of people in Mediterranean countries, where rates of heart disease tend to be lower and life expectancy after age 45 is among the highest in the world.

The details of what constitutes a Mediterranean diet can change from country to country, Champagne said. But repeated studies have linked it to lower cardiovascular risk. A 2018 study published in the JAMA Network Open found that among nearly 26,000 U.S. women who had been followed for up to 12 years, adherence to such a diet was associated with a one-quarter reduced risk of one of four cardiovascular events, including heart attack. connected was stroking.

Mediterranean-style eating has been included in the recent update of an American Heart Association’s heart health assessment tool. The Life’s Essential 8 tool creates a score based on eight easily measurable assessments: diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids (cholesterol and other fats), blood sugar, and blood pressure. easily measurable assessments: diet, physical activity, nicotine exposure, sleep health, body weight, blood lipids (cholesterol and other fats), blood sugar and blood pressure.

The experts behind Life’s Essential 8 endorsed both Mediterranean Eating Habits and DASH, or Dietary Approaches to Stop Hypertension, which have many similar components. For individuals, Life’s Essential 8 evaluates diet based on a screening tool for what is known as the Mediterranean Eating Patterns for Americans.

Christy Tangney, Professor of Clinical Nutrition and Preventive Medicine at Rush University Medical Center in Chicago, helped develop this 16-question screening tool.

One of the hallmarks of Mediterranean food is its flexibility, she said. For example, research on Mediterranean cuisine conducted in Spain includes sofrito, a sauce made from olive oil and vegetables that is commonly eaten there. Tangney’s “Americanized” screener omits sofrito because it’s rare in US diets, but adds berries.

Mediterranean food works, Champagne said, in part because of its effects on bloodstream cholesterol levels. The Mediterranean diet lowers “bad” LDL cholesterol, and research suggests it either doesn’t affect “good” HDL or raises it slightly, she said.

The bottom line, Champagne says, is simple: “We’ve seen many heart health benefits from a Mediterranean diet.”

That doesn’t mean it’s perfect. People who want to lose weight still need to reduce calories. And Tangney said it can be challenging for Americans to accept whole grains, steer clear of processed foods, and cut back on dairy products like cheese.

Access to fresh fruits, vegetables and other foods in a Mediterranean diet can also be a challenge for people on low incomes, said Dr. Annabelle Santos Volgman, Professor of Medicine at Rush University Medical Center and Medical Director of the Rush Heart Center for Women.

It can also be difficult to understand the role of wine. Moderate wine consumption—one to two drinks a day—was considered part of the diet. But Volgman, who worked with Tangney to develop the screening tool, said the potential benefits of wine are outweighed by the potential harms. Federal guidelines recommend that people who don’t drink alcohol shouldn’t start, and for those who drink alcohol, less is better for health.

Such caveats aside, it can be easy to adopt aspects of Mediterranean cuisine.

Embracing extra virgin olive oil in cooking or in salad dressings is a start, Tangney said. Eat leafy greens daily. “When you look at your plate, most of your plate should be made up of vegetables,” she said.

For protein, a Mediterranean eating plan would narrow you down to red meat, so try fatty fish — like anchovies, salmon, mackerel, tuna, or sardines — once or twice a week. Beans are also a good source of protein; Tangney suggests having them three times a week. For dessert, eat nuts or fresh fruit instead of sweets.

According to Champagne, breakfast could include an olive oil spread on whole wheat toast and possibly an egg. A dinner of salmon with pilaf and a big helping of roasted vegetables might work, she said. Pasta should be whole grain. And those who don’t like big olive oil can find healthy fats in nuts or avocados instead.

Diet is not the only part of the Mediterranean lifestyle that is important for heart health. Eating behavior is historically associated with lifestyles that involve exercise and social activities.

But the flexibility that makes Mediterranean-style dining difficult to define can make it easy to embrace.

“People love choice,” Tangney said. “No one wants to be dictated to.”

If you have any questions or comments about this American Heart Association News story, please email [email protected].