What Can I Eat on the Mediterranean Diet?

The Mediterranean diet is based on the traditional diets of the countries surrounding the Mediterranean sea, among them Greece, Italy and Spain. The diet emphasizes fresh fruit and vegetables, olive oil, fish and red wine in moderation. Several studies have shown the diet to be beneficial for the heart and overall health.

History

• Dr. Ancel Keys and his team at the University of Minnesota were the first to compare coronary disease incidence across countries, and to compare diet and lifestyle factors and their correlations to heart disease rates. The "Seven Countries Study" lasted from 1959 to 1970. Among its findings: the people of Crete had the lowest mortality from heart disease, though their diet was relatively high in calories and among the highest in fat. However, the fat was drawn from monounsaturated sources---mainly olive oil---rather than from red meat. Meals were eaten with friends and family, and physical exercise levels were high. All of these factors were thought to contribute to a lower incidence of disease. Several studies in the intervening years have collaborated these results. A 2009 study by Antonia Trichopoulou, Christina Bamia and Dimitrios Trichopoulos showed that adherence to a Mediterranean diet was associated with a reduction in total mortality.

Fruits and Vegetables

• Since 2005, the Centers for Disease Control and Prevention (CDC) have recommended that adults eat four to 13 servings of fruits and vegetables daily. It has been estimated that adults in Greece eat about nine servings daily; in contrast, a 2005 study by the CDC found that 60 to 80 percent of Americans consume less than five servings daily. Fruits and vegetables provide vitamins and minerals in abundance, and they are excellent sources of fiber and antioxidants. Consumption of fruits and vegetables has been repeatedly associated with a lower risk of heart disease and cancer.

Olive Oil

• Olive oil is a monounsaturated fat. Its use in cooking, baking and as a condiment is prevalent throughout the Mediterranean countries. Monounsaturated fats are healthy substitutes for saturated fats, such as those found in animal products, since they do not contribute to atherosclerosis and other forms of heart disease. In fact, olive oil lowers the levels of LDL ("bad" cholesterol) in the blood. Extra virgin olive oil is also high in polyphenols, a potent antioxidant. At least 2 tbsp. a day of olive oil are recommended for better heart health.

Fish

• The benefits of fish for a healthy diet are well-known. Fish oil is rich in omega-3 fatty acids, which reduce inflammation in the body. Omega-3s contribute to healthy skin cells, nerve cells and joints. When fish is eaten instead of red meat, the impact on heart health is even greater. At least two servings of fatty fish a week is recommended for reducing cardiovascular risk. The fish should be caught in waters that are low in mercury, PCBs and other toxins.

Red Wine

• Red wine is an important beverage in the Mediterranean countries, where grape vines thrive and wine-making originated. A moderate amount of red wine (5 oz. daily for women, 10 oz. daily for men) may help lower the risk of heart disease. Red wine is particularly high in antioxidants and reduces blood clotting. However, pregnant women and anyone with a history of alcoholism or liver disease should avoid wine. Alcohol should be avoided while taking certain medications. Alcohol in excess can raise the risk of several cancers and other diseases. Consult your doctor if you have concerns about whether a moderate amount of wine is safe for you.