The Mediterranean Diet: Delicious, Nutritious, and Heart-Healthy

by Diane, M.P.H, M.S.

The Mediterranean diet, one of the “healthiest and most scientifically researched eating patterns in the world (7),”  is based on the traditional diet and life style of countries bordering the Mediterranean Sea, in particular southern Italy, the island of Crete, and much of the rest of Greece in the 1960s. Like most healthy diets, the traditional Mediterranean diet emphasizes the importance of fruits, vegetables, whole grains, legumes, nuts, seeds, and fish, and limits unhealthy fats.
Health benefits of the Mediterranean diet consistently demonstrated by 50 years of research, as well as a recent analysis of more than 1.5 million healthy adults:
  • Lengthen your life
  • Lower your risk of heart disease and high blood pressure (hypertension)
  • Reduce morbidity and mortality from cardiovascular and cerebrovascular disease
  • Reduce your risk of asthma
  • Reduce your risk of certain cancers
  • Reduce your risk of diabetes and it’s complications
  • Keep depression away
  • Improve brain function
  • Prevent or reduce the risk of chronic diseases
  • Reduce symptoms of arthritis and fibromyalgia
  • Reduce the risk of dental disease
  • Improve fertility, as well as, the health of children
  • Reduce your risk of Alzheimer’s and Parkinson disease
  • Aid your weight loss and management efforts

For this reason, most, if not all, major scientific organizations encourage healthy adults to adapt a style of eating like that of the Mediterranean diet for the prevention of major chronic diseases.

The Mediterranean diet emphasizes:

  • Getting plenty of exercise
  • Eating primarily plant-based foods, such as fruits, vegetables, whole grains, legumes, nuts and seeds
  • Replacing butter with healthy fats such as olive oil and canola oil
  • Using herbs, spices, and citrus juices, instead of salt, to flavor foods
  • Limiting red meat to no more than a few times a month
  • Eating fish and poultry at least twice a week
  • Drinking red wine in moderation or not at all
  • The importance of enjoying healthy meals with family and friends.
Oldways Mediterranean Diet Pyramid
The Oldways Mediterranean Diet Pyramid (12, 18):

Oldways, the Harvard School of Public Health, and the European Office of the World Health Organization introduced the classic Mediterranean Diet and a Mediterranean Diet Pyramid design at a conference in Cambridge, MA, in 1993.
The pyramid illustrates what is now universally recognized as the “gold standard” eating pattern that promotes lifelong good health and has been used for years by consumers, educators, and health professionals alike to promote healthier eating habits. This pyramid describes a healthy, traditional Mediterranean diet, based on the dietary traditions of Crete, Greece and southern Italy in 1960 at a time when the rates of chronic disease among populations there were among the lowest in the world, and adult life expectancy was among the highest, even though medical services were limited.
The key to this longevity is a diet that successfully resisted the last 50 years of “modernizing” foods and drinks in industrialized countries. These modern trends led to more meat (mostly beef) and other animal products, fewer fresh fruits and vegetables, and more processed convenience foods high in salt, sugar, fat, preservatives, artificial colorings and flavorings. Ironically, this diet of “prosperity” was responsible for increasing the risk of heart disease, obesity, diabetes, and other chronic diseases.

The “poor” diet of the people of the southern Mediterranean, consisting mainly of fruits and vegetables, beans and nuts, healthy grains, fish, olive oil, small amounts of dairy and red wine, proved to be much more likely to lead to lifelong good health.

The science behind the Mediterranean Diet provided by Dr. Ancel Keys and the Seven Countries Study (6):

For decades the Mediterranean diet pattern of southern Italy, the island of Crete, and much of the rest of Greece in the 1960s has been recognized as one of the healthiest eating patterns on earth, promoting a longer, healthier life.

The Mediterranean diet is based on what mainstream nutrition considers a paradox: although people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found.But why is the traditional Mediterranean diet so healthy?

On November 17, 2010, UNESCO recognized this diet pattern as an “Intangible Cultural Heritage of Italy, Greece, Spain, and Morocco,” not only as a significant part of their history and background, but also as a great contribution to the world (13). However, the diet is not typical of all Mediterranean cuisine. In Northern Italy, lard and butter are often used in cooking, and olive oil is reserved for dressing salads and cooked vegetables (1). In North Africa, wine is traditionally avoided by Muslims. In both North Africa and the Levant, along with olive oil, sheep’s tail fat and rendered butter (samna) are the traditional dietary fats (9).

The Mediterranean Diet was first publicized in 1945 by the American doctor and researcher, Ancel Keys, while stationed in Salerno, Italy. However, the diet failed to gain widespread recognition until the 1990s. During the 1940s, Keys had postulated a correlation between increased cholesterol (hypercholesterolemia) and coronary heart disease. To test his hypothesis, he completed a longitudinal study of businessmen in Minnesota, USA.The study was unique for it’s time, since it was a “prospective study” which followed study participants for 15 years.

Keys was eventually able to persuade many researchers to join him in a similar, but much larger, research project, the “Seven Countries Study.” Objective data showing that the Mediterranean diet is healthy first originated from the Seven Countries Study. The Seven Countries Study began in 1958. A total of 12,763 men, 40-59 years of age, were enrolled. The study included 16 cohorts in seven countries, in four regions of the world (United States, Northern Europe, Southern Europe, Japan). One cohort is in the United States, two cohorts are in Finland, one in the Netherlands, three in Italy, five in the former country of Yugoslavia (today, two in Croatia, and three in Serbia), two in Greece, and two in Japan. The entry examinations into the study were performed between 1958 and 1964. The average participation rate was 90%. The lowest participation rate was in the USA, with 75%. The highest participation rate was in one of the Japanese cohorts, with 100% (13). The Seven Countries Study has been continued for more than 50 years.

The Seven Countries Study demonstrated that:

  • Increased cholesterol (hypercholesterolemia) increases cardiovascular risk at both the population level and individual level.
  • The association between increased cholesterol and coronary heart disease (CHD) is homogeneous across different cultures.
  • Increased cholesterol and being overweight or obese increases mortality from cancer (1, 9).
  • Coronary deaths in the United States and Northern Europe greatly exceed those in Southern Europe, even when controlled for age, cholesterol, blood pressure, smoking, physical activity, and weight. When these factors were investigated by various research groups, the Mediterranean diet’s significance and benefits were revealed and published (2, 3, 4, 15, 16, 17).
  • The slowly changing habits of a population in the Mediterranean region, from a healthy, active lifestyle and diet, to a not so healthy, less active lifestyle and a diet slowly influenced by the Western pattern diet, significantly increases risk of heart disease.
  • There is an inverse association between adherence to the Mediterranean diet and the incidence of fatal and non fatal heart disease in initially healthy middle aged adults in the Mediterranean region.

The Seven Countries Study, along with other important large studies, e.g., the Framingham Heart Study, Nurses’ Health Study, Women’s Health Initiative, confirmed the following:

  • The importance of a healthy diet, not being overweight or obese, and regular exercise, in maintaining good general health.
  • Regular exercise and dietary fiber strongly influence body fat levels.
  • Elevated blood pressure (hypertension) increases the risk of coronary heart disease and stroke.
  • The mortality rate after a coronary heart disease event or stroke can be influenced by the level of hypertension.
  • Differences in overall mortality between the different regions of the world are largely accounted for by the variation in cardiovascular mortality.
  • Cigarette smoking is a highly significant risk factor in the development of coronary heart disease, leading to angina pectoris, myocardial infarction (MI), and coronary death.  (Other important studies which support this correlation include the Framingham Heart Study and the British Doctors Study.
  • The importance of good cardiovascular health in avoiding dementia in the general population.
  • Cardiovascular risk factors in mid life are significantly associated with increased risk of dementia death later in life.

Numerous medical papers have been published regarding the Seven Countries Study which have confirmed the above findings. An additional study of the “whole diet” approach was published in 1995 by Antonia Trichopoulou, Walter Willett, Frank Sacks, and others, in which the original Oldways Mediterranean Diet Pyramid was evaluated. The study documented the health benefits of the Mediterranean eating pattern and lifestyle.

Dietary data from parts of the Mediterranean region that in the recent past enjoyed the lowest recorded rates of chronic diseases and the highest adult life expectancy are characterized by a pattern similar to the one listed below. The healthfulness of this pattern is supported by more than 50 years of epidemiological and experimental nutrition research. The frequency and amounts suggested are in most cases intentionally nonspecific, since variation was considerable:

  • Abundant plant foods (fruits, vegetables, potatoes, beans, nuts, seeds, whole grains, and breads).
  • Emphasis on a variety of minimally processed and seasonally fresh and locally grown foods to maximize the health-promoting micronutrient and antioxidant content of these foods.
  • Fresh fruit as the typical daily dessert: Sweets with a significant amount of sugar (often as honey) and saturated fat consumed not more than a few times per week.
  • Olive oil as the principal fat, replacing other fats and oils (including butter and margarine).
  • Total fat ranging from less than 25 percent to over 35 percent of energy, with saturated fat no more than 7 to 8 percent of energy (calories).
  • Dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts: Low-fat and non-fat dairy foods may be preferable.
  • Zero to four eggs consumed weekly: No more than 7 eggs per week including those used in cooking and baking.
  • Twice-weekly consumption of low to moderate amounts of fish and poultry, with fish somewhat favored over poultry.
  • Red meat consumed in low amounts: If red meat is eaten, consumption should be limited to a maximum of 12 to 16 ounces (340 to 450 grams) per month; where the flavor is acceptable, lean versions are preferable.
  • Regular physical activity at a level which promotes a healthy weight, fitness, and well-being.
  • Low to moderate consumption of wine, normally with meals: No more than one to two glasses per day for men and one glass per day for women. From a contemporary public health perspective, wine should be considered optional and avoided when consumption would put the individual or others at risk.
Sources of calories consumed, by percentage. Crete, Greece and United States, 1948 (7)
Food Group Crete  Fall 1948 Greece  1948-1949 USA  1948-1949
Cereals 39 61 25
Potatoes 4 2 3
Sugar and honey 2 4 15
Pulses and nuts 7 6 3
Vegetables and fruits 11 5 6
Meat, fish and eggs 4 3 19
Dairy products 3 4 14
Oils and fats 29 15 15
Wine, beer & spirits 1 not given not given
Total calories per person per day 2,547 2,477 3,129
Sources of protein in the diet, by percentage
Animal protein 24 19 66
Vegetable protein 76 81 34

 

Updating the Mediterranean Diet Pyramid:

During the 15th Anniversary Mediterranean Diet Conference in November 2008, the Classic Mediterranean Diet Pyramid was updated by the Scientific Advisory Board. The changes focused on grouping plant foods (fruits, vegetables, grains, nuts, legumes, seeds, herbs, spices, olives and olive oil) in a single category to visually emphasize their health benefits. The scientific committee made this change to emphacize the key role of these delicious and healthy plant foods in this health-promoting eating pattern.

A new feature on the Mediterranean Diet Pyramid is the addition of herbs and spices, for reasons of both health and taste. Also, herbs and spices contribute to the national identities of various Mediterranean cuisines. The committee changed the placement of fish and shellfish on the pyramid, recognizing the benefits of eating fish and shellfish at least two times per week.

Heart-healthy fats:

The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease and cancer risk. Instead, the Mediterranean diet features olive oil as the primary source of fat. Olive oil provides monounsaturated fat, a form of fat that helps to reduce LDL cholesterol levels when used in place of saturated or trans fats. “Extra-virgin” and “virgin” olive oils, the least processed forms, also contain the highest levels of the protective plant compounds that provide antioxidant effects. Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain beneficial linolenic acid, a type of omega-3 fatty acid. Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure.

Olive oil consumption has also been correlated with a reduction in cancer risk. This may be due to the oil’s antioxidant properties attributable to oleic acid and/or the presence of other nutrients, such as vitamin E and polyphenols, or because olive oil is largely consumed with vegetables and pulses.

Steps to help you begin the Mediterranean diet (12, 18):

  • Eat lots of vegetables and fruits: An abundance and variety of plant foods should make up the majority of your meals. Half of your plate at each meal should contain fruits and/or vegetables. Try to purchase them when they are in season, and aim for 7 to 10 servings a day. Keep baby carrots, celery, kale, spinach, sugar snap peas, sweet potatoes, apples, bananas, berries, oranges, and pears available for quick, satisfying meals and snacks. Many of these are rich in fiber, antioxidents, vitamins, minerals, and other phytonutrients. Fruit salads are a wonderful way to eat a variety of healthy fruit and can be enjoyed at any meal and in place of rich desserts. Residents of Greece typically eat about 9 servings a day of antioxidant-rich fruits and vegetables, but very little meat. Therefore, the Mediterranean diet has been associated with lower blood levels of oxidized low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol which contributes to fatty deposits in your arteries.
  • Switch to unrefined, whole grain bread, cereal, and pasta: Bread is an important part of the Mediterranean diet. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil, rather than with butter or margarine which contain saturated and trans fats. Whole grain foods should be minimally processed (unrefined) and not contain unhealthy trans fats. Replace white foods (white rice, pasta, and bread) with brown foods (brown rice, whole-wheat pasta, whole grains [e.g., quinoa, wheat, wheat berries], and whole-wheat or whole grain breads).
  • Snack on unsalted nuts and seeds: Keep almonds, cashews, peanuts, pistachios, walnuts, pumpkin, sesame, and sunflower seeds on hand for a quick snack. Choose natural almond or peanut butter, rather than the kind with hydrogenated fat and salt added. Try tahini (blended sesame seeds) or hummus (blended chickpeas) as a dip for vegetables or spread for bread, but avoid versions containing preservatives. Since nuts tend to be high in fat (approximately 80% of their calories come from fat, although most of it is unsaturated) and calories, they should not be eaten in large amounts, generally no more than a handful a day. Avoid candied, honey-roasted, and heavily salted nuts.
  • Use heart-healthy fats: The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease. Instead, the Mediterranean diet features olive oil as the primary source of fat. Olive oil provides monounsaturated fat, a form of fat that helps to reduce LDL cholesterol levels when used in place of saturated or trans fats. “Extra-virgin” and “virgin” olive oils, the least processed forms, also contain the highest levels of the protective plant compounds that provide antioxidant effects. Monounsaturated fats and polyunsaturated fats, such as canola oil and some nuts, contain beneficial linolenic acid, a type of omega-3 fatty acid. Omega-3 fatty acids lower triglycerides, decrease blood clotting, are associated with decreased sudden heart attack, improve the health of your blood vessels, and help moderate blood pressure. Avocados and olives also provide heart-healthy fats.
  • Avoid butter and margarine: Olive or canola oil are healthy replacements for butter or margarine and can be used in cooking. After cooking pasta, add a bit of olive oil, garlic, and green onions for flavoring. Dip bread in olive oil flavored with herbs or lightly spread it on whole-grain bread for a tasty alternative to butter.
  • Season your meals with herbs and spices, rather than salt: Herbs and salt-free spices enhance the flavor of food and are also rich in health-promoting phytonutrients.
  • Always eat a healthy breakfast: Include fiber-rich fresh or frozen unsweetened fruit, yogurt, and whole grain bread, granola, oatmeal, quinoa, or shredded wheat, or mash half an avocado with a fork and spread it on a slice of whole grain toast, to keep you satisfied for hours.
  • Eat seafood twice a week: Fish is eaten on a regular basis in the Mediterranean diet. Fish such as Arctic Char, herring, mackerel, wild Alaskan salmon, sardines, lake trout, and fresh or water-packed light tuna, are healthy choices rich in omega-3 fatty acids which are important for brain and cardiovascular health. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it’s sauteed in a small amount of canola oil.
  • Limit red meat: Substitute fish and poultry for red meat. When eaten, make sure red meat is lean, and keep portions small (about the size of a deck of cards). Avoid bacon, salami, sausage, and other high-fat or cured meats.
  • Choose low-fat or non-fat dairy products: Reduce your intake of higher fat dairy products such as whole or 2% milk, cheese, and ice cream. Switch to skim milk, low- or non-fat Greek or plain yogurt, kefir, and low-fat cheese.
  • Drink alcohol in moderation with food, or not at all: The Mediterranean diet typically includes some wine occasionally, since grape-growing has been a part of the region’s culture for centuries. This means no more than 5 ounces (148 milliliters) of wine daily for women (or men over age 65), and no more than 10 ounces (296 milliliters) of wine daily for men under age 65. More than this may increase the risk of many health problems, including certain types of cancer, diabetes, hypertension, kidney ailments, and osteoporosis. If you cannot limit your alcohol intake to the amounts defined above, have a personal or family history of alcohol abuse, heart or liver disease, refrain from drinking wine or any other alcohol. Also keep in mind that red wine may trigger migraines in some people. If your doctor approves, enjoy a glass of wine at dinner. However, if you don’t drink alcohol, you don’t need to start. Drinking purple grape juice may be an alternative to wine.
  • Avoid artificial sweeteners and processed foods containing chemicals. 
  • Choose water and fresh fruit, instead of sugary drinks, soda, excessive amounts of juice, candy, chips, or other unhealthy, calorie-laden snack foods.

Traditional Mediterranean meals include (18):

  1. Grains, vegetables, and fruits:Eat these at most meals, since they provide vitamins, minerals, energy, antioxidants, and fiber, and promote good health and weight control.
    • Grains: Choose whole, minimally-processed grains, such as wheat, oats,rice,barley,and corn, since refining and processing often remove many nutrients, including vitamins, minerals, and fiber.
    • Vegetables: An important staple throughout the Mediterranean. Usually eaten cooked or drizzled with olive oil, and sometimes raw.
    • Fruits: Choose whole fresh fruit in season. Note that no-sugar-added fruit juices provide less nutrients and often more calories per serving than whole fresh fruit. Avoid “fruit drinks.”
  2. Olives and olive oil: Olives are universally eaten whole, and widely used for cooking and flavoring in the countries that border the Mediterranean Sea. Olive oil is the principal source of dietary fat used for cooking, baking, and for dressing salads and vegetables. Extra virgin olive oil is highest in health-promoting fats, phytonutrients and other important micronutrients.
  3. Nuts, beans, legumes, and seeds: Good sources of healthy fats, protein, and fiber, and add flavor and texture to Mediterranean dishes.
  4. Herbs and spices: Provide flavors and aromas to foods, reducing the need to add salt or fat when cooking.  These provide several health-promoting antioxidants, are used frequently in Mediterranean foods, and contribute to the national identities of the various Mediterranean cuisines.
  5. Cheese and yogurt: Eaten regularly in the traditional Mediterranean diet, but in low to moderate amounts.  Provide calcium which is important for bone and heart health. Choose lowfat and nonfat dairy products.
  6. Fish and shellfish: Important sources of healthy protein. Fish such as tuna, herring, sardines, wild Alaskan salmon and bream are rich in essential heart-healthy omega-3 fatty acids, and shellfish and crustaceans including mussels, clams and shrimp have similar benefits. Fish and shellfish are not typically battered and fried in Mediterranean countries.
  7. Eggs: A good source of high-quality protein, and especially beneficial for people who do not eat meat. Eggs are regularly used in baking in Mediterranean countries.
  8. Meats: Eaten in small portions by Mediterranean peoples, who prefer lean cuts. Poultry is a good source of lean protein without the high levels of saturated fat found in some cuts of red meat. With ground meats, 90 percent lean/10 percent fat is a good choice.
  9. Sweets: Consumed in small portions in the Mediterranean. Fruits are ever-present on Mediterranean tables, and are a normal way to end a meal. Gelato and sorbet are consumed a few times a week, in small portions.
  10. Wine: Consumed regularly but moderately. “Moderately” means up to one five-ounce glass of wine per day for women and up to two five-ounce glasses for men. Only drink wine if you are medically able to do so and have your doctor’s approval.
  11. Water: Consumed regularly
  12. Portion size: Because foods in the bottom section of the pyramid may be eaten in larger amounts and more frequently, portion sizes and frequency of consumption decline in the pyramid’s upper sections.
  13. Moderation is a wise approach: A balanced and healthy diet accommodates most foods and drinks, so long as moderation and wise choices are the key characteristics. For example, enjoying a small piece of birthday cake, savoring a few slices of grilled steak, or relaxing with family and friends with a glass or two of wine or beer are important aspects of being human. As always, moderation is the wise watchword.
  14. Healthy lifestyle habits: Daily physical activity is important for overall good health. This includes strenuous exercise like running and aerobics, as well as more leisurely activities such as walking and housework or yard-work, or taking the stairs instead of the elevator.
  15. Meals in the company of others: The Mediterranean Diet is grounded on the principles of enjoyment and pleasure. Foods, drinks and meals are best eaten with others, when possible, and savored.
Note that weight control is very important for good health. Establish your healthy weight range with your doctor or from reputable web sites, and let this healthy weight range be your guide. If you are above this range, cut back on the food and drink you consume, add more exercise, or both. For most people, counting calories obsessively not only detracts from enjoying foods, drinks, and meals, but also doesn’t work very well in the long term. These recommendations and the updated Mediterranean Diet Pyramid are reliable for most adults. However, children and pregnant women and others with special dietary needs may require dietary supplementation. These needs can be accommodated within the Mediterranean Diet in most circumstances.
Tips for families (18):
  • Plan meals in advance: Make a shopping list and buy most of what you need in one trip to the store per week. Keep wholesome ingredients in your pantry, such as unsalted nuts and seeds, olive oil, canned tomatoes, tomato paste, whole grain pasta, shredded wheat, quinoa, and canned wild Alaskan salmon. Buy additional fresh produce and seafood a few times a week.
  • Offer nutritious snacks: When kids need an after-school snack, offer dips like hummus, tahini, tzatziki, or baba ghannouj with fresh vegetables and whole grain pita bread for dipping.
  • Set a good example by following the Mediterranean Diet Pyramid yourself, and encourage your children to eat vegetables every day: Add vegetables to foods your kids already like. If pancakes are popular, add some grated carrots or shredded zucchini to the batter. Toss frozen diced carrots, peas, and corn with whole grain pasta or macaroni and cheese. Add diced sautéed onions, mushrooms, peppers, and feta to scrambled eggs.
  • Make fruit part of your family’s daily diet: Provide sliced or whole apples, clementines, grapes, melon, pears, oranges, and strawberries at meals and as snacks after school, or add blueberries to breakfast cereal or yogurt. Encourage kids to eat fresh fruit rather than drinking fruit juice, for a better source of fiber which is often lacking in their diets.
  • Mediterranean vegetables are very versatile, so experiment with different cooking methods: Kids often prefer a raw or roasted carrot to a steamed one. Eggplant that is sliced, brushed with olive oil and lightly browned on both sides under the broiler may have more appeal than when it is sautéed – and soft.  Try serving sweet potatoes (A superfood!) baked and caramelized whole, or as healthy, oven-baked fries, rather than white potatoes mashed with butter, cream, and salt.
  • Eat fish twice a week: Serve small helpings of mild-flavored mahi-mahi, cod, tilapia, or wild Alaskan salmon, and experiment with flavorful Mediterranean marinades using oregano, garlic, lemon juice, pepper, and basil.
  • If hamburgers are popular with your family, prepare several varieties of veggie burgers, or Mediterranean wraps with spicy hummus, or pittas stuffed with tabbouli and falafel, and ask your family to choose their favorite.
  • Make your own trail mix: Eat small amounts of nuts in order to benefit from their healthy protein, fat, and fiber. In a large bowl, combine peanuts, chopped walnuts, almonds, raisins, dried cranberries or blueberries, and whole grain cereal. Package the mix in “snack-size” zip-lock bags to have on hand for car trips and lunch boxes.
  • Occasionally prepare heart-healthy international recipes: Plan Mediterranean theme nights with the family, such as “A Night in Crete,” and make a hearty soup with beans, herbs, and vegetables, to serve with whole grains. Experiment with different natural flavors, encourage your children to try new, wholesome dishes, and let them help prepare the meals. If your children don’t learn basic kitchen skills when young, they’ll regret it later in life and won’t have a legacy to pass on to their children.
Tips to help seniors find the best foods for good health(18): The Mediterranean Diet promotes increased mental acuteness, higher energy levels, improves disease resistance and immunity, and provides a way to lose weight and prevent weight gain when paired with a routine of weight-bearing exercise, such as walking. Therefore, seniors should:
  • Shop for fiber-rich foods which help to maintain digestive regularity: Instead of supplements, laxatives, and pills, the Mediterranean Diet recommends plenty of fruits, vegetables, beans, nuts and seeds, which are great sources of fiber, vitamins, minerals, and enzymes to aid digestion.
  • Shop at stores that sell fresh fish and can cut small pieces to feed one or two people: Eat fish twice a week, especially fatty fish like wild salmon which is rich in omega-3 fatty acids that reduce blood pressure and lower the risk of heart disease.
  • Choose products naturally high in calcium, to reduce the risk of developing osteoporosis: Beans, dairy products, bok choy, kale, mustard greens, spinach, and swiss chard lead the list. Greek yogurt is an excellent choice, since it’s rich in calcium and vitamin D and contains twice the protein of regular yogurt. Low-fat and non-fat milk, “Stoneyfield” organic yogurt, and “Lifeway Kefir” come supplemented with vitamin D which promotes the absorption of calcium. Note that fresh, natural yogurt and kefir also contain live active probiotic cultures which promote a healthy immune system and digestive tract.
  • Think of meat as a condiment or side dish, rather than the main event at a meal: Mediterranean fruits, vegetables and whole grains with their unique flavors and textures can easily serve as a satisfying main feature. Add only small amounts of lean meats such as grilled chicken strips, roast turkey, or beef round, loin, or sirloin. Open the package as soon as you get home, and cut it up into small serving amounts. Individually wrap and freeze portions for later use.
  • Meet the Mediterranean Diet’s quota of daily fruits and vegetables by shopping in the store’s deli section and salad bar where they can purchase small amounts of raw and cooked vegetables, salads, and olives: That way, you can take what you need and do not have to worry about spoilage.
  • Buy fruits and vegetables in the frozen food isle: Buy them in bags, to make it easy to take out small amounts at a time and reseal. Add them to soups and stews, or toss with pasta or rice.
  • Learn about the supermarket’s delivery service in case of inclement weather: Can your market provide you with food when the weather is bad or if you can’t get out of the house? Also, contact the store to learn what special programs or services they offer to seniors.
  • Many supermarket chains have registered dietitians on staff ready to help: Ask them about ways to integrate the Mediterranean Diet into your meals, or ask for a few Mediterranean recipes to get you on your way.

Scientific evidence supporting the healthfulness of the traditional Mediterranean Diet continues to grow. Read all the latest studies at www.oldwayspt.org/med-diet-news (20).

References:

  1. Alberini, Massimo; Mistretta, Giorgio. Guida all’Italia gastronomica. Touring Club Italiano. 1984.
  2. Fung, T.T.; Rexrode, K.M.; Mantzoros, C.S.; Manson, J.E.; Willett, W.C.; Hu, F.B. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation: 119 (8): 1093-100. 03/03/09.
  3. Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products. Kushi, L.H.; Lenart, E.B.; Willett, W.C. American Journal Clinical Nutrition: 61(6 Suppl): 1407S-1415S. June 1995.
  4. Health implications of Mediterranean diets in light of contemporary knowledge. 2. Meat, wine, fats, and oils. Kushi, L.H.; Lenart, E.B.; Willett, W.C. American Journal Clinical Nutrition: 61(6 Suppl): 1416S-1427S. June 1995.
  5. Keys, Ancel; Menotti, A.; Karvonen, M.J.; et al. “The diet and 15-year death rate in the seven countries study.” American Journal Epidemiology: 124 (6): 903–15. December 1986.
  6. “Mediterranean Diet.” Wikipedia: the free encyclopedia. 11/28/11. (Source: en.wikipedia.org/wiki/Mediterranean_diet)
  7. Sales, Francesca. “The Mediterranean Diet: Eat Better, Save Money, Live Longer.” 2011.
  8. Simopoulos, Artemis P. “What is so special about the diet of Greece? The scientific evidence.” Nutrition and Fitness: Mental Health, Aging, and the Implementation of a Healthy Diet and Physical Activity Lifestyle. Karger Publishers. pp. 80-91. 2005. (ISBN 3805579454)
  9. Tapper, Richard; Zubaida, Sami. A Taste of Thyme: Culinary Cultures of the Middle East. Tauris Parke Paperbacks. (ISBN 1-86064-603-4)
  10. Tenzer-Iglesias, Penny. “For Fibromyalgia Patients-Tips for Healthy Living: Eating Healthy.” FibroTogether: Believing, Connecting, Supporting. Forest Pharmaceuticals, Inc. p. 14. August 2011.
  11. “The Mediterranean diet is a heart-healthy eating plan combining elements of Mediterranean-style cooking.” Mayo Clinic Staff. (Source: www.mayoclinic.
  12. “The Oldways Mediterranean Diet Pyramid.” (Source: www.oldwayspt.org/mediterranean-diet-pyramid)
  13. Unesco. “The Mediterranean Diet.”
  14. “What is the Mediterranean Diet?” Information regarding the Mediterranean Pyramid and Traditional Mediterranean Diet. (Source: www.oldwayspt.org/mediterraneandiet)
  15. Willet, Walter C. “Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating.” Free Press. 2005. (ISBN 0743266420)
  16. Willet, Walter C. “The Mediterranean diet: science and practice.” Public Health Nutrition: (1A). pp.105-10. 02/09/06.
  17. Willett, Walter C; Sacks, F.; Trichopoulou, A.; Drescher, G.; Ferro-Luzzi, A.; Helsing, E.; Trichopoulos, D. “Mediterranean diet pyramid: a cultural model for healthy eating.”  American Journal of Clinical Nutrition: 61 (6): 1402S–6S. 06/01/95. 06/01/95. (PMID 7754995)
  18. www.oldways.com
  19. www.oldwayspt.org (For recipes and details on the latest scientific studies about the Mediterranean Diet, refer to this world-renowned source of Med Diet information)
  20. www.oldwayspt.org/med-diet-news

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