The Mediterranean Diet is fresh on my mind, having recently
returned from a trip to Turkey. During
my trip I became a particular fan of Turkish vegetables—white beans with
tomatoes and onions in olive oil, oven baked green beans or okra, eggplant
stuffed with walnuts with a tomato ragout, to name a few. My husband commented
that I must be a true fan of olives, as he surveyed my breakfast plate, which
was chalk full of several varieties of olives, raw cucumbers, tomatoes, a few
arugula leaves, fresh cheese and bread.
During my travels I also enjoyed a variety of grilled fresh fish served with
lemon, seaweed salad, pomegranate juice, freshly pressed at the side of road,
and roasted chestnuts, also sold by street vendors.
I was elated to hear that a new study published in the New England Journal of Medicine in April of this year
validated the health benefits of the Mediterranean diet. The study randomized
7447 women and men with risk factors for cardiovascular disease to receive either a Mediterranean diet enriched with olive
oil, a Mediterranean diet enriched with nuts, or a standard low fat diet
for the control group. Participants assigned to the two Mediterranean diet arms were
found to have a significantly reduced risk of adverse cardiovascular outcomes
(heart attack, stroke, death from cardiovascular causes) compared with the
control group. The study was terminated after a mean follow up time of 4.8 years.
Are you wondering how
your diet matches up with the “Mediterranean Diet” as defined by the recent
study? I was after I read these results.
Here are the criteria with answers qualifying for the
Mediterranean Diet shown in bold.
1. Do you use olive oil as main culinary fat? Yes
2. How much olive oil do you consume in a given day
(including oil used for frying, salads, out of house meals, etc.)? 4 or more tablespoons
3. How many vegetable servings do you consume per day? (1
serving = 200g - consider side dishes as 1/2 serving) 2 or more (at least 1 portion raw or as
salad)
4. How many fruit units (including natural fruit juices) do
you consume per day? 3 or
more
5. How many servings of red meat, hamburger, or meat
products (ham, sausage, etc.) do you consume per day? (1 serving = 100-150
g) Less than 1
6. How many servings of butter, margarine, or cream do you
consume per day? (1 serving = 12 g) Less
than 1
7. How many sweet/carbonated beverages do you drink per
day? Less than 1
8. How much wine do you drink per week? 7 or more glasses
9. How many servings of legumes do you consume per week? (1
serving = 150 g) 3 or more
10. How many servings of fish or shellfish do you consume
per week? (1 serving: 100-150 g fish, or
4-5 units or 200 g shellfish) 3 or
more
11. How many times per week do you consume commercial sweets
or pastries (not homemade), such as cakes, cookies, biscuits, or custard? Less than 3
12. How many servings of nuts (including peanuts) do you
consume per week? (1 serving = 30 g) 3 or
more
13. Do you preferentially consume chicken, turkey or rabbit
meat instead of veal, pork, hamburger or sausage? Yes
14. How many times per week do you consume vegetables,
pasta, rice, or other dishes seasoned with sofrito (sauce made with tomato and
onion, leek, or garlic, simmered with olive oil)? 2 or more
*From Table in S1 in Supplement to:
Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovasculardisease with a Mediterranean diet. N Engl J Med 2013.
Taking a closer look at the details of the study as
described in the NEJM supplement, it seems to me that the particular factors of
those listed above that really differentiated the Mediterranean groups from the
control group were: the quantity of olive oil ingested, the increase in nuts
consumed, and, somewhat less significantly, the amount of seafood consumed,
legumes consumed, and sofrito sauce consumed.
In this study the particular kinds of nuts prescribed were
walnuts, hazelnuts and almonds. However, there may be health benefits with
other nuts as well. Here is some useful nutritional information from University
of Michigan Health System (my alma mater) about nuts.
Personally, this study has changed my health practices. While
I was already doing well with some of its components, since reading the
specifics of the Mediterranean Diet prescribed and found to be associated with reduced cardiovascular risk I’ve made greater attempts to incorporate
legumes, nuts, and fish into my diet.
