When I hear “Mediterranean Diet” numerous words come to mind, including heart, health, healthy, warmth, Italian, fruits, vegetables, fiber – and so on. This diet is a melting pot of various culinary traditions, and is one of my favorite diets to counsel patients on - I adhere to it myself!
Our world contains “blue zones” or regions where people live longer on average than the rest of the world. Two of these zones are Icaria, Greece and Sardina, Italy both of which reside along the Mediterranean Sea. With inquisitive minds, scientists took on the task of identifying lifestyle factors such as the diet that contributed to this heightened longevity. Their findings are what lead to the development of the Mediterranean diet, which emphasizes a whole food diet that is mostly plant based with quality protein and fat sources.
Consistent research from the past decade has shown that those who adhere to a Mediterranean diet have lower risk factors for future heart disease, such as improved arterial function, balanced blood pressure, less arterial thickening (ie. atherosclerosis), and improved cholesterol measures. (1)
According to the CDC, heart disease is the number one cause of death across the United States. (2) This prevalence in conjunction with our growing senior community makes prevention key, now more than ever. Fortunately, Naturopathic medicine is geared toward prevention and the necessary first step is evaluating and adjusting the way we eat.
What I appreciate about this diet is that it is holistically minded. It follows a set of main principles that not only nourish us but also encourage us to rethink how to eat:
Think of vegetables and fiber sources first vs. meats
Eat fish and lean forms of meat vs. red meats
Moderation is key - integrate small plates of various types and flavors vs. large plates
Eat what’s in season
Share meals with loved ones! Engaging others over a meal allows you time in between bites to let yourself digest and it nourishes the heart and soul.
The following table outlines food-specific recommendations of the Mediterranean diet that may make it easier to integrate into your routine. The emphasis is on specific foods that are power packed with nutrients to support cardiovascular health (3-11):
5+ Servings -- OR -- Approx. ½ your plate at each meal
- Serving: 1 cup or handful leafy greens, ½ a cup of cooked veggies - Benefits: fibers and sterols in veggies bind cholesterol to help remove it digestive tract, antioxidants to keep blood vessels flexible - Emphasize: Try to incorporate at least three different colors of veggies into your diet daily! (i.e. leafy greens, artichoke, beets, peppers, etc.)
2 - 4 Servings daily
- Serving: ½ a cup of whole berries or fresh cut fruit, 1 medium sized fruit, ½ banana, 1 cup of 100% pure pomegranate juice - Benefits: many contain high levels of heart & artery protective antioxidants (i.e. vitamin C, flavonols, resveratrol, anthocyanins, etc.) - Emphasize: berries, cherries, pomegranate, apples, grapes - Minimize: tropical & pitted fruits
2 - 4 Servings daily
- Serving: ½ cup cooked grain - Benefits: fiber, B-vitamins, protein - Emphasize: quinoa, wild long grain brown rice, teff, oatmeal - Minimize: refined white flour baked goods, breads, pastas, white rice, bagels
2-3 Servings of fish / lean meat weekly 3-4 servings of protein daily
- Serving: 3oz of fish or lean poultry, ½ cup cooked legumes, ½ cup plain yogurt, ¼ cup of nuts or seeds, ¼ cup of cheese - Benefits: eating fish anywhere from once a week to once a day has been shown to support HDL-C (“good cholesterol”) and balance triglycerides - Emphasize: salmon, mackerel, anchovies, sardines, herring, 85%+ lean poultry, eggs, nuts, seeds, legumes (i.e. beans & lentils), plain Greek yogurt - Minimize: Red meat, cured meats, dairy (2 servings maximum daily)
2 - 4 Servings daily
- Serving: 1 tbsp of oil, ground seeds or ¼ cup of nuts, ¼ cup of cheese - Benefits: fish, nuts and seeds are rich in anti-inflammatory omega-3 fatty acids which raise HDL and lower LDL - Emphasize: fish, ground flax seeds, chia seeds, pepitas, sunflower seeds, hemp hearts, walnuts, almonds, pecans, avocado, olive oil, olives - Minimize: Canola, Palm, Coconut, dairy (2 servings maximum daily)
No limit! (*Except salt)
- Benefits of Garlic: Prevents LDL or “bad cholesterol” from oxidizing and sticking to the blood vessels, improves artery function and oxygenation capacity, gently thins the blood and reduces blood pressure by relaxing and dilating constricted blood vessels - Emphasize: garlic (2-3 cloves daily), ginger, thyme, oregano, rosemary, sage, - Minimize: salt & high sodium powders/dressings as they can cause the blood vessels to constrict which raises blood pressure
1 Glass Wine Max.
2+ Cups Green Tea
- Water: ½ Body Weight in oz of Water - Red wine: contains polyphenol compounds that can lower cardiovascular risk factors such as stroke, diabetes and elevated triglycerides - Green tea: contains polyphenols that prevent bad cholesterol from sticking to your blood vessels producing plaques and shows lowered risk of ischemic heart disease due to its anti-inflammatory, lipid lowering, and anti-oxidant properties.
I highly recommend adding the America’s Test Kitchen Complete Mediterranean Cookbook to your shelf as it includes 500 tried and tasty recipes for any meal of your day.
There are multiple tables throughout the text that help guide your meal preparation, inform on different varieties of foods and their flavor profiles (i.e. lentils, vinegars, etc.), provide conversion charts for cooking grains, and instruct on chopping techniques.
My husband and I have tried nearly 20 of these recipes and it is a goal of mine to find 2-3 new recipes weekly to introduce to my kitchen and palate.
To learn more about how the Mediterranean diet can serve you, please feel free to connect with me or ask your Naturopathic doctor at your next visit!
Disclaimer: this information is meant for educational purposes only, and should not be used as a replacement for professional medical advice.
In honor of February as Heart Awareness Month and all those living with Cardiovascular Disease.
1. Jennings A, Berendsen AM, De groot LCPGM, et al. Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults. Hypertension. 2019;73(3):578-586.
3. Sahebkar A, Pirro M, Banach M, Mikhailidis DP, Atkin SL, Cicero AFG. Lipid-lowering activity of artichoke extracts: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018.
4. Sohrab G, Roshan H, Ebrahimof S, Nikpayam O, Sotoudeh G, Siasi F. Effects of pomegranate juice consumption on blood pressure and lipid profile in patients with type 2 diabetes: A single-blind randomized clinical trial. Clin Nutr ESPEN. 2019;29:30-35.
5. Alhassan A, Young J, Lean MEJ, Lara J. Consumption of fish and vascular risk factors: A systematic review and meta-analysis of intervention studies. Atherosclerosis. 2017;266:87-94.
6. Rodriguez-leyva D, Dupasquier CM, Mccullough R, Pierce GN. The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol. 2010;26(9):489-96.
7. Lawson LD, Hunsaker SM. Allicin Bioavailability and Bioequivalence from Garlic Supplements and Garlic Foods. Nutrients. 2018;10(7)
8. Genetics Home Reference: NIH U.S. National Library of Medicine. January 7, 2020. Accessed from: https://ghr.nlm.nih.gov/condition/lactose-intolerance#statistics. Accessed: 1.15.20.
9. Focus On: Chronic Diseases and Conditions Related to Alcohol Use. NIH National Institute on Alcohol Abuse and Alcoholism. Alcohol Research Current Reviews. 2013;35(2):155-173
10. Li X, Yu C, Guo Y, et al. Tea consumption and risk of ischaemic heart disease. Heart 2017;103:783-789
11. America’s Test Kitchen (Firm), ed. The Complete Mediterranean Cookbook: 500 Vibrant, Kitchen-Tested Recipes for Living and Eating Well Every Day. America’s Test Kitchen; 2016.