Eating Right - Mediterranean Style
by Dana Denis, MSPH., RD (topic expert: nutrition)

March is National Nutrition Month®, which the American Dietetic Association began in 1973 as a campaign to draw attention to and promote healthy eating and sound nutrition advice for the public.

This year's theme is Eat Right.

One way we can "eat right" is by following a Mediterranean Diet.

The Mediterranean diet describes the eating patterns of populations living in countries bordering the Mediterranean Sea, like Greece, Italy and Spain. They were observed to live healthier and longer lives, despite consuming high amounts of fat. This was first observed by researcher Ancel Keys in the 1950's and 1960's. Since then, the Mediterranean diet has been thoroughly studied and the results confirm increased longevity, lower incidence of heart disease and hypertension, improved blood sugar control, and a protective benefit from certain types of cancer, such as breast, stomach, colorectal and prostate. In addition, when compared with a low fat diet, the Mediterranean diet promotes greater weight loss and reduction in heart disease. Compared to the traditional low fat diet, the Mediterranean diet is very palatable and may be easier to follow. This may result in increased diet acceptance and compliance.

So what makes up the Mediterranean Diet?

1. Olive oil is the main fat consumed along the Mediterranean. Olive oil is high in monounsaturated fat, which is considered a "healthy fat" due to its ability to reduce risk of heart attack and heart disease and improve high blood pressure. Olive oil also contains antioxidants. It is important that the olive oil be cold pressed. The extra virgin olive oil has the most protective effect and flavor, but this can be lost in higher heat cooking. So use extra virgin olive oil on salads and cold prepared foods and virgin olive oil in cooking. The more processed varieties have less health protection benefits. Other main sources of fat found in the Mediterranean diet come from fish (omega-3 polyunsaturated fat) and nuts (monounsaturated and omega-3 polyunsaturated fats) - all good, health-promoting types of fat.
2. Beans and legumes are a staple in the Mediterranean diet, such as chickpeas (garbanzo beans), lentils, cannelloni (white beans), fava beans, black or pinto beans and soybeans. Beans are a great source of protein and fiber. Try replacing a meat serving with beans at least once a week.
3. Grains in the Mediterranean are largely unrefined, often whole grains and very few "processed" grains and cereals. Common grains are bread, pasta, rice, couscous, polenta and barley. They do not put butter or margarine on their bread, which also means less saturated fat and "trans" fat, both known to increase the risk of heart disease.
4. Vegetables and fruits are abundant in the Mediterranean diet. Examples are spinach, eggplant, tomatoes, broccoli, peppers, mushrooms, garlic, onions, olives, avocados, grapes, and figs. The Mediterranean diet is plant based and loaded with nutrients, antioxidants and phytochemicals that produce health benefits and protect against many diseases, such as heart disease and cancer.
5. Nuts are another plant based food loaded with nutrients that you will find in the Mediterranean, especially almonds, hazelnuts, pistachios, walnuts, pine nuts and peanuts. Nuts are rich in protein, fiber, Vitamin E, and monounsaturated and polyunsaturated fats. Remember, they are also loaded with calories, so only one handful a day(about 1 ounce or 1/4 cup).
6. Less meat and meat products are found in Mediterranean diets. Meat, such as beef or lamb, is consumed only about once a month. Even poultry, fish and eggs are only consumed weekly. This results in a reduction in saturated fat, further reducing the risk of disease. Plant-based proteins are emphasized instead, such as legumes, nuts, and grains, along with yogurt and cheese.
7. Limited amounts of milk and dairy products are consumed on the Mediterranean. Yogurt and cheese are the primary sources and are consumed daily, but not in large quantities. Try to find low fat or nonfat dairy choices. Butter, margarine and cream are not typically found in the Mediterranean diet.
8. Wine, in particular red wine, is typically a daily drink with meals, but in moderation. Red wine contains antioxidants, from the skin of the grapes, and can help increase HDL-cholesterol (the good cholesterol). Moderation is key here, which is 1 glass per day for women and 2 glasses per day for men. Above this amount can actually promote disease rather than protect against disease. If you do not drink, do not start to follow this diet, grape juice has also shown some protective effects.
9. Exercise and an active lifestyle are a basic along the Mediterranean. You knew it was coming... it always does... you must move your body!!

The Traditional Mediterranean Diet Pyramid below illustrates the dietary pattern of this region. The sad news is now that many along the Mediterranean are adopting Western lifestyle habits, some of these benefits are disappearing from their population. An effort is being made now to update the "traditional Mediterranean diet" to a more modern model that is based on the health benefits of the Mediterranean but also incorporates healthful practices from other regions of the world.

Here's to a long, healthy life!