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What is The Mediterranean Diet?

 

The Mediterranean diet is a recommended way of eating that encompasses the culinary traditions of the countries that border the Mediterranean Sea, such as Greece, Italy, and Spain. This traditional way of eating is plant-based with an emphasis on vegetables, fruits, beans, nuts, whole grains, olive oil, and fish. The Mediterranean lifestyle is not only centered around delicious, rich-tasting, fresh foods but also embraces the pleasure of eating by sharing meals with friends and family and enjoying regular exercise.

Did you know US News and World Report named the Mediterranean diet the “best overall diet” for the past four years? It is of no surprise that their panel of health experts would agree that the Mediterranean diet is the best. Over the past five decades, there have been numerous evidence-based studies that have exemplified the many positive health benefits of the Mediterranean diet and a subsequent reduction in all-cause mortality. This diet is exploding with antioxidants and anti-inflammatory nutrients including polyphenols, fiber, and Omega-3 fatty acids which are likely responsible for the countless health benefits. 

 

 

If you want to learn more about the incredible health benefits of this eating pattern and discover easy ways to implement this diet in your life this article is for you. Adopting a Mediterranean-based diet can be helpful in maintaining optimal health and help treat many common health conditions.

It is important to discuss the definition of the word “diet” as this can help set the mindset for how one chooses to approach a new food pattern. A “diet” refers to the kind of foods a person eats and also refers to the adoption of certain dietary restrictions, such as the case with the low FODMAP diet aimed to help reduce unpleasant IBS symptoms. It is best to embrace the concept that the Mediterranean diet is a ‘lifestyle’, not a diet you try for a month or two. Adherence to this new eating style 100% of the time is not necessary to reap the many health benefits. Instead, focus on eating more of the main staple foods such as vegetables, whole grains, olive oil and fish. Shifting the attention on what to eat versus what not to eat often yields better outcomes. The Mediterranean diet is far from boring, as you can enjoy so many mouthwatering and flavorful foods such as whole-grain bread dipped in olive oil, fruit, cheese, nuts, and wine in moderation. No food group is really excluded from this eating plan. 

The Numerous Health Benefits of the Mediterranean Diet:

  • Improved Cardiovascular Health (1,2,3)
    Reduced risk of heart disease and heart attacks
    Lower LDL cholesterol levels (the bad cholesterol)
    Higher HDL cholesterol levels (the good cholesterol)
  • Stroke prevention
  • Improved blood pressure
  • Protection against developing Type 2 Diabetes (4)
  • Healthy weight loss and weight maintenance  (5,6)
  • Improved cognitive health and brain function (7)
  • Reduced risk of developing Alzheimer’s (8)
  • Prevention and treatment of non-alcoholic fatty liver disease (NAFLD) the most common liver disease in the world, and non-alcoholic steatohepatitis (NASH) (9)
  • Improved mental health including lower risk of depression (10)
  • Increased longevity (11)
  • Lower risk of developing COPD (chronic obstructive pulmonary disease) (12)
  • Lower risk of developing cancers (11)

Foods Encouraged on the Mediterranean Diet:

Vegetables are the main staple of this diet and one is encouraged to consume several servings of fresh vegetables each day. 

Tips: 

  • Aim for a vegetable with lunch and dinner.
  • Try to sneak in a few more by snacking on raw vegetables and hummus for a healthy snack option or toss a handful of spinach or kale into your smoothies or eggs at breakfast. 
  • Enjoy your vegetable raw, roasted, steamed, grilled, or sautéed in olive oil with herbs and spices. Fresh is best, however, frozen vegetables can work.


Fruit
is encouraged for desserts and snacks. All fruit fits in the Mediterranean diet, fresh or frozen. Aim for more seasonal fruit to help ensure better tasting fruit.


Whole Grains
- choose whole grains such as quinoa, brown and wild rice, oats, spelt, barley, bulgur, couscous, millet, kamut, teff, spelt, buckwheat, and whole-grain breads and pastas. Avoid refined grains found in baked goods, crackers, cold cereals, pastries, and other foods containing refined white flour, trans-fats, and added sugars. 

Tips: 

  • Choose products with words “whole grain” or “whole wheat” on the very top of the ingredient list when looking at the food label. 
  • Bulk bins are a great place to find whole grains. 
  • Here is a great cheat sheet for whole-grain cooking tips. 


Olive Oil
is the primary fat source of the Mediterranean diet; however, this diet also emphasizes nuts, seeds, olives, and avocados. Olive oil is encouraged for all of your cooking needs including salad dressings, marinades, and to add the finishing touch to meals. Try to incorporate olive oil or another healthy fat at every meal. The standard recommendation is 2 Tbsps per day. 


Legumes
including beans, lentils, tofu, and tempeh are encouraged three or more times per week. The mighty, humble bean is a super nutritious addition to any meal as it contains fiber, protein, folate, and really satisfies hunger.

Tips:

  • Enjoy black bean tacos, vegetarian chili, or add garbanzo beans to your salad or pasta to meet this goal. 
  • Feel free to cook your own pulses from scratch. Use an Instant Pot, or open up a can (opt for the unsalted variety or rinse under running water in a strainer to keep sodium intake low).
  • Explore more vegetarian recipes and work these into your weekly rotation or swap meat for your favorite veggie protein source.


Nuts and Seeds
add crunch and texture to your meals. Try tossing a few sliced almonds on your greek yogurt or salad or grab a small handful of pecans, walnuts, or peanuts for a quick and satisfying snack. 


Greek Yogurt and Cheese
are the main dairy sources and are encouraged in low to moderate servings, which translate to one serving up to seven times per week. Sorry, but extra cheese is not really the Mediterranean way as it is considered more of a condiment or way to add flavor. Look for plain, unsweetened Greek yogurts and add your own sliced fruits and nuts to add natural sweetness and crunch.


Fish and Seafood.
Try to include at least three servings of fish and seafood per week as these are frequently consumed on the Mediterranean diet. Cold-water fatty fishes such as salmon, sardine, cod, haddock, and mackerel are highest in Omega-3 fatty acids. This also includes shellfish such as mussels, clams, oysters, shrimp, crab, and lobster.

Tips: 

  • Try a classic Nicoise salad or a spruced-up tuna salad for lunch. 
  • Choose fish or seafood as your main protein source two times per week at dinnertime. 
  • Experiment with fish-based appetizers such as anchovies or lox paired with whole-grain crackers.


    Red wine.
    Up to one five-ounce glass per day for women or two glasses per day for men is the recommended upper limit and to be enjoyed at mealtime. If you do not enjoy wine, aim for several servings of red and purple fruits each week such as grapes, raspberries, blackberries and plums to get in those cancer-fighting polyphenols. 


    Poultry and Eggs
    are encouraged in low to moderate amounts. Feel free to enjoy one to two eggs for breakfast and chicken or turkey a few times each week. 


    Herbs & Spices
    . Try growing your own herbs to keep always on hand and make sure your pantry is well-stocked with fresh spices, as these really add warmth and enhance all the delicious flavors of your foods. 

    The Mediterranean diet encourages regular consumption of many plant-based foods preferably those grown locally and in season. Accessibility to fresh produce may be challenging for some based on your geographical area. However, frozen fruits and vegetables provide similar nutrition profiles. If possible, visit farmer’s markets and get involved in local CSA boxes as this connects you to your local farmers and you can experience incredibly fresh foods.

    What Foods are Limited on the Mediterranean Diet?

    • Sugar and sweets such as cookies, candy, baked goods, and sugar-sweetened beverages including soda. It is best to keep foods with added sugars to a minimum.
    • Refined grains such as crackers, chips, pretzels, cold cereals (those that are not whole grain), flour tortillas, white breads, buns, and more. 
    • Red meat including pork and lamb, processed meats such as bacon, sausage, and hot dogs. Try to keep red meat consumption to only a few times per month. 
    • Butter, margarine, and trans-fat. It is best to swap butter and these unhealthy fats with olive oil.

        Why Do Some People Struggle with Change?

        Changing our eating behaviors and lifestyles is not always easy. It can be challenging to find the time to grocery shop, plan, and prepare meals as these all require extra time. Other challenges some struggle with is lack of cooking skills, confidence to cook tasty meals, and lack of family buy-in to try new foods. 

        Many of us just want to take a break from the kitchen from time to time due to burnout or increased demands in other parts of our life. Quite often, I give my clients the permission to take short cuts, opt for meal services, and choose simple meals while not having guilt around these decisions. Sure, many of us would love to be able to grocery shop, plan fancy meals, shop at the local farmers market, and cook all of your meals from scratch; however, the reality is that this may not really be a reality or work for you at this moment. If you are looking for all the amazing health benefits of the Mediterranean diet without all the work, you are in luck. ModifyHealth is now offering a Mediterranean diet meal delivery

        Try Mediterranean Meal Delivery...

        The easiest way to get started with the Mediterranean diet is to sign up for the Mediterranean Program from ModifyHealth. Their exciting new, fully-prepared Mediterranean entrees deliver right to your door. Choose from a variety of dietitian and chef-created meals designed to help you feel your best. Enjoy them at home, at work or while traveling - simply heat and enjoy. It really couldn't be simpler!


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        References:

        1. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999 Feb 16;99(6):779-85. doi: 10.1161/01.cir.99.6.779. PMID: 9989963.

        2. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Fitó M, Gea A, Hernán MA, Martínez-González MA; PREDIMED Study Investigators. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389. Epub 2018 Jun 13. PMID: 29897866.

        3. De Pergola G, D'Alessandro A. Influence of Mediterranean Diet on Blood Pressure. Nutrients. 2018 Nov 7;10(11):1700. doi: 10.3390/nu10111700. PMID: 30405063; PMCID: PMC6266047.

        4. Salas-Salvadó J, Bulló M, Babio N, Martínez-González MÁ, Ibarrola-Jurado N, Basora J, Estruch R, Covas MI, Corella D, Arós F, Ruiz-Gutiérrez V, Ros E; PREDIMED Study Investigators. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care. 2011 Jan;34(1):14-9. doi: 10.2337/dc10-1288. Epub 2010 Oct 7. Erratum in: Diabetes Care. 2018 Oct;41(10):2259-2260. PMID: 20929998; PMCID: PMC3005482.

        5. Esposito K, Marfella R, Ciotola M, et al. Effect of a Mediterranean-Style Diet on Endothelial Dysfunction and Markers of Vascular Inflammation in the Metabolic Syndrome: A Randomized Trial. JAMA.2004;292(12):1440–1446. doi:10.1001/jama.292.12.1440

        6. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ; Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008 Jul 17;359(3):229-41. doi: 10.1056/NEJMoa0708681. Erratum in: N Engl J Med. 2009 Dec 31;361(27):2681. PMID: 18635428.

        7. Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martínez-González MÁ, Martínez-Lapiscina EH, Fitó M, Pérez-Heras A, Sala s-Salvadó J, Estruch R, Ros E. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA Intern Med. 2015 Jul;175(7):1094-1103. doi: 10.1001/jamainternmed.2015.1668. Erratum in: JAMA Intern Med. 2018 Dec 1;178(12):1731-1732. PMID: 25961184.

        8. Román GC, Jackson RE, Reis J, Román AN, Toledo JB, Toledo E. Extra-virgin olive oil for potential prevention of Alzheimer disease. Rev Neurol (Paris). 2019 Dec;175(10):705-723. doi: 10.1016/j.neurol.2019.07.017. Epub 2019 Sep 11. PMID: 31521394.

        9. Abenavoli L, Milic N, Peta V, Alfieri F, De Lorenzo A, Bellentani S. Alimentary regimen in non-alcoholic fatty liver disease: Mediterranean diet. World J Gastroenterol. 2014 Dec 7;20(45):16831-40. doi: 10.3748/wjg.v20.i45.16831. PMID: 25492997; PMCID: PMC4258553.

        10. Masana MF, Haro JM, Mariolis A, Piscopo S, Valacchi G, Bountziouka V, Anastasiou F, Zeimbekis A, Tyrovola D, Gotsis E, Metallinos G, Polystipioti A, Tur JA, Matalas AL, Lionis C, Polychronopoulos E, Sidossis LS, Tyrovolas S, Panagiotakos DB. Mediterranean diet and depression among older individuals: The multinational MEDIS study. Exp Gerontol. 2018 Sep;110:67-72. doi: 10.1016/j.exger.2018.05.012. Epub 2018 May 26. PMID: 29775747.

        11. Di Daniele N, Noce A, Vidiri MF, Moriconi E, Marrone G, Annicchiarico-Petruzzelli M, D'Urso G, Tesauro M, Rovella V, De Lorenzo A. Impact of Mediterranean diet on metabolic syndrome, cancer and longevity. Oncotarget. 2017 Jan 31;8(5):8947-8979. doi: 10.18632/oncotarget.13553. PMID: 27894098; PMCID: PMC5352455.

        12. Fischer A, Johansson I, Blomberg A, Sundström B. Adherence to a Mediterranean-like Diet as a Protective Factor Against COPD: A Nested Case-Control Study. COPD. 2019 Aug;16(3-4):272-277. doi: 10.1080/15412555.2019.1634039. Epub 2019 Aug 13. PMID: 31405301.