On a daily basis, we are inundated with information, and from my perspective as a cardiologist, it seems like a good percentage of that information has to do with the latest diet fads.
We hear how eating more of this or less of that will affect our health. If this information evolved from a base of common sense, that would be a good thing, but it doesn’t. Instead, what we get is a lot of statistics and research analyses that conflict.
We hear passionate arguments from all sides about which foods are bad and which are good, but even the experts don’t seem to agree. However, there is one diet that has bypassed all of that noise. It has been around for centuries, and it continues to result in normal weight, good heart health, and even a good mood. I’m talking about the Mediterranean diet.
I’m sure you’ve heard of it, and perhaps you have dismissed it as one of the fads, but the Mediterranean diet is no fad. While other diets that come and go have research that supports them and research that condemns them, the Mediterranean diet has consistently been shown to reduce the risk of heart disease, cancer, Alzheimer disease, and diabetes.
The people who decide to switch to this way of eating consistently have improved overall health. In the Lyon Heart Trial — one of the most well-known trials to look at the effects of the Mediterranean Diet, published in the New England Journal of Medicine in June 2003 — 605 people who had suffered from a heart attack were randomly assigned to a typical Western diet (high in saturated fat and low in fiber), or to a Mediterranean diet (high in mono- and polyunsaturated fats and high in fiber).
During a four-year period, there was approximately a 70% reduction in cardiac deaths, heart attacks and strokes in those people eating the Mediterranean diet, compared to those eating a high fat, low fiber diet.
This is just one example of many studies that support the Mediterranean diet as the ultimate human diet for a healthy heart. While the fad diets attack each other and wage their petty wars, the Mediterranean diet stands alone as superior, not only in what it does for health, but in how easy and pleasurable it is to follow.
So what, exactly, is it like to eat a Mediterranean diet? First, close your eyes, and picture yourself on the shore of the Mediterranean Sea. You might be in any of the countries that circle it — Greece, Italy, France, Spain, Morocco, Tunisia, Egypt, Israel, Lebanon, or Turkey (and that’s not naming them all).
Maybe you are on one of the Mediterranean islands, Cyprus or Malta, Sicily or Crete. Imagine the warm sun, the smell of the salty ocean, and behind you, olive trees and fields of grain, soil filled with vegetables and fruit trees and vineyards.
Now open your eyes. Let’s eat! The basics are simple. The Mediterranean diet is primarily a plant-based diet, with an emphasis on fruits and vegetables, whole grains, legumes, nuts, and with a liberal use of olive oil (canola oil works, too). It limits red meat to a few times a month, but allows for lots of delicious seafood — incorporating fish at least twice a week.
Another important part of the Mediterranean diet is its reliance on whole grains. Grains were plentiful and inexpensive in the Mediterranean so they formed a central part of the diet.
As much controversy as there is surrounding carbohydrates these days, research bears out the fact that the whole grains in the Mediterranean diet are an important component. But we’re not talking about doughnuts here. We’re talking about bulgur wheat, barley, quinoa, and the whole array of multi-grains and complex carbohydrates available.
Even pasta and rice are appropriate, as long as they are whole grain and in small portions, the way they ate it traditionally in the Mediterranean. Nobody would pile a whole platter full. Pasta and rice servings should be about half cup, and no more than one cup cooked in a single meal.
When focusing on fats, the emphasis is always on mono and polyunsaturated fats. The fats found in plants can reduce LDL cholesterol, and, along with nuts, have become another essential part of the Mediterranean diet.
In fact, in the PREDIMED trial, which evaluated 7,447 men and women over an eight-year period who were at high risk for cardiovascular disease, incorporating nuts and olive oil decreased the risk of cardiovascular disease by 30%, including decreasing the incidence of heart attacks and strokes.
Fatty fish, which are filled with omega 3 fatty acids, also decrease cholesterol, lower triglycerides, and can decrease clotting. These fish are recommended at least twice a week. Some of the best sources are mackerel, sardines, tuna, salmon, and herring.
Saturated fats, in the form of meat, are only recommended several times a month, but in small portions of lean cuts. Processed foods and meats are not part of the heart-healthy program and should not be eaten at all. In the traditional Mediterranean, there was no such thing as fast food or dinners from a box.
Moderate alcohol is another part of the diet. For those who can indulge (it’s not necessary, but fine for those who enjoy it), one glass of a four to five ounce serving for women and two glasses for men is an appropriate amount; don’t go over this, or you begin to negate the benefits.
In moderation, however, washing down the fish and grains with a glass filled with antioxidants, resveratrol, and bioflavonoids, all which dilate the arteries and prevent clotting and plaque formation, are an integral part of the Mediterranean experience.
More than anything, the Mediterranean diet proves that the components of healthy food can truly promote health. The individual components of the Mediterranean diet all have known cardiovascular benefits; when studied independently, high fiber diets, nut-rich diets, and olive-oil-rich diets all reduced heart attacks significantly. Add the vegetable and legumes and benefits of fish and you’ve got a cardiologist’s dream diet.
In my own practice, I have seen many patients transform their lives by switching to a Mediterranean diet. I watch their bodies change shape before my eyes as they shift their food choices from butter to olive oil, muffins to whole grains, junk snacks to hummus and vegetables, red meat to fish and legumes.
I see weight go down, belly fat decrease, cholesterol drop, with LDL and triglycerides decrease significantly. I see sugar levels plummet and energy levels rise. I see health manifesting in front of me every day, with these simple changes in food choices.
So why aren’t you taking advantage? Try it. It’s easy! Just close your eyes and picture yourself on the beaches of Greece…
Suzanne Steinbaum, DO, is an attending cardiologist and the director of Women and Heart Disease of Lenox Hill Hospital in New York City.