I've never been to Greece or to Tuscany in
Italy, but I do know that their Mediterranean cuisine is fabulous,
full of richly colored, heart-healthy fruits and vegetables, whole
grains, fish and poultry and, of course, plenty of olive oil.
Fascinating: In spite of the liberal use of oil and grains,
researchers have found that people who eat a "Mediterranean diet"
have vastly lower rates of heart disease than people in many other
parts of the world. Harvard published a study almost 50 years ago
about this effect among Greeks. Recently The New England Journal
of Medicine published a study that reiterated the power of this
diet for advancing good health.
LATEST STUDY RESULTS
Dimitrios Trichopoulos, MD, PhD, from the Harvard
School of Public Health, worked with a group of Greek scientists
from the University of Athens Medical School to investigate the
impact of the diet. For the study, 22,000 Greek men and women,
ages 20 to 86, recorded what they ate each day over a four-year
period. The investigators then rated the responses on a scale of
zero through 10 based on how closely the participants stayed with
the tenets of the diet, with 10 being the best. They discovered
that following the diet not only lowered the risk of death by heart
disease or stroke, but that for every two-point increase achieved
in the rating scale, there was a 25% drop in mortality risk. A
separate but similar American study showed that the diet also
helps reduce the risk of gallstones by nearly 20%.
DIET DETAILS
Unlike the detailed approach of many weight-loss
plans, this diet has no particular structure.
Instead, it includes...
Lots of fruits and vegetables
Plenty of whole-grain products
Some beans, legumes and nuts
A moderate amount of fish and poultry
Limited amounts of meats, dairy and alcohol.
That looseness makes it easy to fool yourself
into thinking you are following it, but the key to success is not
tucking it in between helpings of ice cream and chips. To discuss
how careful people need to be and where their weak points are, I
called Eric B. Rimm, ScD, associate professor of epidemiology and
nutrition at the Harvard School of Public Health in Boston. Dr. Rimm
has studied the diet extensively and is coauthor of an editorial in
Journal of the American Medical Association concerning it.
THE REAL DEAL
Dr. Rimm offers the following strategies for sticking
with a true Mediterranean diet...
Whole grains are whole grains. In addition to their
nutritive value, whole grains slow the digestion of other foods and
leave you feeling full for a longer period of time. This lowers the
"net carb" effect. He urges people to select the least processed whole-grain
foods -- even if a food is technically a whole grain, commercial preparation
pulverizes the grain, reducing its healthfulness. Don't be fooled by packaging
ploys. Bread must have the word "whole" as the first or second one listed
on the ingredients list to qualify as truly whole wheat.
Variety of grains. Sure, images of those fabulous
fresh breads make you think that it is a mainstay of the Mediterraneans,
but in fact they eat a variety of delicious and nutritious grains.
Brown rice also counts, as do a number of other grain products,
including oats (especially steel-cut oats) and barley. For more
about healthful grains, see Daily Health News,
September 16, 2004.
Lotsa produce. The Greeks typically eat
nearly a pound of vegetables a day! Twice what Americans eat.
Don't be shy with your produce.
Plenty of protein. Dr. Rimm advises
having a good protein source on a daily basis, be it fish,
poultry or eggs. Plant protein, in the form of beans and
nuts, also is good.
Counting calories. Portion control
always is important -- even when it comes to olive oil.
Although the Mediterranean diet features up to 40% of
calories from fat, this includes from all sources,
including fish, poultry and dairy, as well as from
monounsaturated oils -- canola, soy and especially olive oil.
"Super-sizing" your portions definitely is not the way to go.
Eat moderate amounts at all times.
Active lifestyle. Another critical aspect of
Mediterranean eating actually is the way of life. Exercise is
as much a part of the diet, he says, as is olive oil. These
people work hard physically each day, unlike Americans who
live a more sedentary life. According to Dr. Rimm, it is
mandatory to get at least 30 minutes of brisk exercise
a day most days.
As for the gelato and other goodies from
the region -- Dr. Rimm says to limit these "extra" foods to
occasional treats. These foods -- including red meat -- are
tolerable only about once a week. Even then, he says, think
small, not binging on three scoops of ice cream. He also
advises moderation in dairy products. The diet includes
dairy but doesn't emphasize it. Stick with low-fat products
when possible and limit portions.
CULTURAL SATURATION
Dr. Rimm is one of the first professionals
to acknowledge that changing the way you eat, fully and forever,
is a major challenge. He suggests approaching it in two ways.
First, make the decision and set it as a goal. Then transition
slowly. Over whatever period of time you are comfortable with,
slide the right foods into your eating regimen and the wrong
ones out. Review where you are at six months and perhaps at a
year, and see what changes you may need to make. Eventually,
he says, you'll look forward to eating the Mediterranean diet
foods because they taste wonderful and make you feel
even better. Mangia.
Sources...
Eric B. Rimm, ScD, associate professor
of epidemiology and nutrition, Harvard School
of Public Health, Boston.
