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The Mediterranean Heart Diet - What is it all about?

The Mediterranean diet is not a diet per se, but rather a loose term that describes the eating practices of the people in this region of the world. Foods from that region come from a rich diversity of plant sources and included fruits, vegetables, whole grains, beans, nuts and seeds. The low mortality rate as well as the low incident of chronic diseases in this region is partially attributed to their eating habits as well as their activity level.

This diet is low in saturated fat and is believed to help people with heart conditions. In the traditional Mediterranean diet, fruits and vegetables were locally grown and often consumed raw or minimally processed. This may be crucial given our ever growing understanding of the potential protective factors of dietary fiber, antioxidants and other micronutrients found in plant foods.

The important aspects of the Mediterranean diet are high intakes of cereals, grains, vegetables, dried beans, olive oil, garlic, fresh herbs, seafood, and fruit. Wine is taken with food in moderation. Meat and poultry are also eaten in moderation, with poultry more frequently served than red meat. Animal fats in the form of butter, cream and lard are not included in the diet.

's Registered Dietitian Marian Marcela reviewed a new book, THE MEDITERRANEAN HEART DIET, by Helen V. Fish with Cynthia Thomson, PHD, RD to understand more about their dietary recommendations and its impact on people with diabetes.

The Mediterranean diet recommends:

  • A high consumption of fruits, vegetables, potatoes, beans, nuts, seeds, bread and other cereals
  • Olive oil used for cooking and dressings
  • Moderate amounts of fish but little meat
  • Low to moderate amounts of full fat cheese and yogurt
  • Moderate consumption of wine, usually with meals
  • Reliance on local, seasonal, fresh produce
  • An active lifestyle

This diet emphasizes high fiber complex carbohydrates including 2-3 cups of whole grain pasta or rice per day plus 3 servings of whole grain bread. It recommends use of whole grains, which include bulgur, wheat berry, brown rice, and quinoa.

It also recommends 2-3 servings of fruit per day as a snack or as a dessert. It encourages the use of dried fruit, more fresh fruit, fruit smoothies, and fruit pizza.

Fruits are a healthy food but excess amounts of fruit can increase the elevation of blood sugars, especially for a person with diabetes.

The diet also recommends including 1 cup of cooked legumes per day, using nuts in entrees, and using a total of 2 tablespoons olive oil per day in cooking, in salad dressing, on bread, and on finished dishes.

It does not allow milk, but includes 1 cup of yogurt and cheeses per day, cooked in dishes or with fresh fruit. Eggs are allowed in breads and special desserts. 3 ounces of fish and poultry is allowed 2-4 times per week. As for meat, 3 ounces of lamb or pork is allowed, preferably eaten as a condiment or mixed with vegetables or pasta. 1 glass of wine for women or 3 glasses of wine for men is allowed daily but the glass size is not specified in the book. A multivitamin supplement is recommended if one is not able to increase plant food consumption adequately. Overall, the diet is high fiber, with the recommendation of 25-30 grams of fiber per day.

The Mediterranean Heart Diet is especially designed for those with heart disease. It is low in saturated fats and therefore may help lower blood cholesterol and blood pressure. Because it is high in antioxidants and whole grains, it may also decrease risk of developing certain cancers. Although the book states that the diet is "easily modified to fit the needs of people with diabetes as well as those concerned about preventing heart disease," no guidelines are given to adjust the diet to help control blood glucose levels.

So if you have diabetes and want to follow this type of diet, monitor yourself closely to make sure your sugars are under control.

Although the recipes sound good to the taste, the bread recipes are generally low in fiber and the dessert recipes are high in carbohydrates. The book does list sources of phytochemicals and fat composition of a variety of nuts, which are both sources of valuable information. It also encourages exercise and increased activity, important for general weight loss and blood glucose control. Unfortunately, the book refers to the older lipid guidelines. The new guidelines establish that for people with diabetes, the LDL cholesterol goal should be less than 100 and not less than 130, as stated in the book.

Including adequate fiber and monounsaturated fats (olive oil, nuts, and avocado) is recommended for persons with diabetes. Although this is encouraged in this diet, there are no guidelines regarding grams of carbohydrates per meal, or meal spacing, both very important for optimum blood glucose control.

But this diet will probably help a person improve his or her lipid levels, if the person also controls portion sizes and includes exercise.

According to Mariam, this is not the type of diet you should use for weight loss and more specifics would need to be included to make it appropriate for someone with diabetes.

Adapted by Editorial Staff, November, 2005
Last update, August 2008


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