Not only is the month marching right by (pun intended), but Spring is here! It’s been more than a month now since my last blog and I had hoped to follow up with my previous post in February as some extra support for Heart Health awareness.
Despite my intentions, a constant stream of samples has kept me on my toes in the lab and away from my desk. As evidence to support my excuses, I’ve included a snapshot of myself and our lab director (Dr. Kurt Doege) doing some trouble shooting with our HPLC. For those of you unfamiliar with lab equipment this stands for high performance liquid chromatograph, the instrument we use to identify and quantify many of the compounds in our product.
In any case, heart health and eating well is a topic for all months of the year! Individuals that have searched Google in pursuit of a healthier lifestyle know that there’s an overwhelming plethora of health trends and fad diets that claim to be the only way to reach your goals. While expensive regimens and structured programs may work for some, I prefer to focus on well supported, tried and true dietary patterns (supplemented with some of my favorite Bio-Tech products of course!). Amongst the various diets I have become familiar with (Western, vegetarian, paleo, DASH), the Mediterranean Diet (MD) stands out to me as one of the most achievable and effective for an average individual (no special dietary needs or cultural/religious limitations) seeking to support their heart and overall health. A large body of evidence from observational studies have established the beneficial effects of the MD in health. Mediterranean patterns have been inversely associated with chronic diseases including but not limited to metabolic syndrome, type 2 diabetes, and cardiovascular disease (see references for more information). In 2016, an article was published detailing a 12-year study that followed 1658 individuals, observing their dietary patterns and different measure related to cardiovascular health. They observed that adherence to the MD was associated with a decreased in fatal and non-fatal cardiovascular events (Bo et al., 2016).
Entire books could be written about the implications of the MD (and I’m sure they have!), but due to time restraints I’m going to keep it simple. I’ll go over some brief background on its development, the basic guidelines for following the diet, and my beginners’ approach to eating MD-style.
The Mediterranean Diet Pyramid is not a result of intricate experiments or laboratory research, but rather of decades spent observing patterns of eating in countries around the Mediterranean basin. The development of this pyramid was first initiated in 1993 at the International Conference on the Diets of the Mediterranean. The original pyramid targeted Crete, Greece, and Southern Italy, which in the 1960s ranked amongst the lowest across the globe for major diet-related chronic diseases and amongst the highest for life expectancy. The MD is first depicted using a black and white diagram (see below) with general food groups listed in compartments proportional to their prescribed prevalence in the diet.
In 2010 the MD Foundation released a second pyramid developed by health professionals to reflect changes in Mediterranean societies and hopefully increase adherence to the healthy MD pattern of eating in other countries as well. This new, more colorful version provided enhanced visuals and went into greater detail to aid in food selection and cooking. For example, instead of just “Fruits” and “Vegetables” the 2010 pyramid suggests a variety of colors and textures and allows them to be consumed cooked or raw.
Another feature of this pyramid that I think is particularly handy is the change of its categories from “Daily”, “A Few Times Per Week”, and “A Few Times Per Month” to “Every Main Meal”, “Every day”, and “Weekly”. Within each category it further defines approximate number of servings for each food group. These clarifications allow a little more wiggle room with certain foods while leaving less room for interpretation.
The MD is characterized by high intake of plant foods such as fruits, vegetables, grains, legumes and nuts, lower intake of animal foods with the dominant sources being dairy, seafood, and white meat, and relatively high levels of olive oil as the predominant added fat. Also, a daily intake of 1.5-2 liters of water or herbal infusions (aka tea) is encouraged. The MD allows moderate intake of wine, preferable red which contains high levels of health-promoting polyphenols.
Below I have summarized the MD recommendations for each food group.
1-2 servings Fruit, 2+ servings Vegetables
· Go for different colors and textures to gain a variety of antioxidants and other polyphenols
· Keep at least one of your vegetables raw
1-2 servings Grains
· Bread, pasta, rice, couscous, etc.
· Choose whole grains for optimal fiber and polyphenol content
· High nutritional value
· Replacement of butter and other fats
· Use for cooking and dressings
2 servings Dairy
· Choose low fat items (1% or fat free)
· Yogurt is especially nutritious as it harbors probiotics (healthy bacteria for gut health optimization)
1-2 servings Olives/Nuts/Seed
· About a handful of these make a great snack!
· Caution: check nutrition label for high levels of added sodium or sugar
· These foods are very high in antioxidants and other polyphenols
· Use as rich flavoring agents to reduce added salt
2+ servings Fish/Seafood
· High levels of omega-3 fatty acids convey anti- inflammatory benefits
· Great choices include salmon, trout, sardines, shrimp, crab, and lobster
2 servings White Meat
· High quality protein
· Lower levels of saturated fat than red meat
<2 servings Red Meat
· High levels of saturated fat
· Associated with some chronic diseases
· High levels of sodium, often high levels of fat
· Associated with some chronic diseases
2+ servings Legumes
· Beans, lentils, etc.
· Healthy meat alternative
· Good source of fiber and healthy fat
2-4 servings* Eggs
· High quality protein
*It is recommended to limit egg consumption due to cholesterol levels; I feel that this is a none-issue it you eat enough fiber. I probably eat 5-10 eggs a week.
<2 servings potatoes
· Included in many traditional fish recipes.
· Eat with skin to increase fiber content
· Consume in small amounts and limit to special occasions.
*Sweets are my kryptonite. If I didn’t like sugar, I’m sure I’d be 20 pounds thinner!
Freedom of Portions
The component of the MD pyramid that I find most intriguing (and liberating!) is the approach they take with portions. If you go to the 2010 pyramid pictured above and look for the text in the uppermost right corner, you will read “serving size based on frugality and local habits.” This emphasizes to me the importance of the proper patterns of eating rather than exact amounts. Don’t get me wrong, if you find yourself struggling with your weight and needing to lose weight you still want to be aware of your portions. The beauty of healthy eating, however, is that if you are eating a diet high in fiber-rich plant foods and healthy fats and low in processed foods, sugar, and other addictive substances you will be less likely to overindulge. If you have low tendency to over-eat, portion control is a moot point.
My Beginner’s Approach
In complete transparency, my advocacy for the Mediterranean Diet is based on research and not my own personal experience. The truth is, I haven’t tried it yet. My current diet, while not being a complete Westernized mess, is far from the MD. While I wish to give it a go, I am a full-time wife and professional with a fairly busy schedule of church and family activities, and a diet transformation is not going to happen overnight. Instead of adding the stress and pressure of immediate and perfect adherence, I am going to start with some strategies that will help me (and my husband, for he eats what I prepare) gradually migrate towards the MD pattern:
- Focus on Fish. I am typically good about bringing white meat into the house as opposed to red, but I am going to take that a step further and try to plan fewer meals around chicken and more around seafood. Lucky I am an Aldi frequent and they carry salmon, shrimp, and other marine items at great prices. Up until now I have considered seafood at home an occasional fun deviation; now I am going to redirect and make it a norm!
- Open my mind to plant-only dinners. While I have been pretty comfortable with no animal protein lunches, my first thought when planning the evening meal is always “what will the meat be?”. For me, dinner is the one meal a day that I focus on as a source of comfort and pleasure, so a satisfying plateful of food is a must. According to the MD guidelines it is not necessary to eat meat (or fish) every day, as long as you are getting high quality protein from other sources. Excluding meat from more of my “main meals” will most likely prompt me to get more creative and diverse with my selections of fruits, vegetables, and grains, and will hopefully increase my appreciation for and total consumption of these food groups.
- Phase out the butter. Luckily for me, I already do the bulk of my cooking with olive oil. The hard part for me here will be doing away with the butter. I love to spread butter on bread and toast. In place of buttered bread with dinner I’ll have to step outside my comfort zone and mix up some oil, vinegar and spices for dipping. The toast will be a bit easier, as I can replace butter with sugar-free natural peanut butter.
- Off. The. Sweets. This is tough for me. The toughest. I am a sweet tooth through and through. Unfortunately, the delightful, delectable desserts I love so much bring with them mounds of sugar and saturated fat…. Aka, empty calories that sabotage my constant weight-loss efforts. Fortunately, the MD calls for lots of fruits, and though they are not quite the same as a chocolate chip cookie or a Reese’s concrete they can serve as healthy dessert replacements. There are also a surprising number of recipes on the web that combine various grain, Greek yogurt, and even dark chocolate to make a healthy, MD friendly sweet last course.
There you have it: my crash course on the Mediterranean Diet. To get you started, here is a yummy treat you can make to help with the last bullet I covered:
Popped Quinoa Crunch Bites
85-100% Dark Chocolate
No Sugar Added Peanut Butter
(You’ll notice that I didn’t include amounts, and it’s because you can proportion the ingredients to your liking! This is a no-bake recipe, and there’s basically no way of messing it up.)
- Start by popping your quinoa. You’ll do this by heating a pan to medium-high heat on the stove, no oil needed! Once the pan is hot, add a thin layer of red quinoa and wait for the poppy to begin! Once it does, lightly shake the pan until 1/2-3/4 of the kernels have popped (1-2 minutes). It is unlikely that every kernel will pop, and waiting for this may result in burning. Even the kernels that did not pop will be toasty and delicious! Repeat the process until you have your desired amount of popped quinoa. I prefer red quinoa, as it pops better and has higher nutritional value.
- Using a double boiler or microwave, melt chocolate and peanut butter to a smooth consistency. Add Truvia to reach desired sweetness.
- Stir in quinoa and chia seeds. I add quinoa until it seems like the chocolate/peanut butter mixture is just there to hold the other ingredients together.
- Line a cookie sheet (or any flat container) with parchment/wax paper, spread mixture in even layer, and refrigerate to harden.
- Break into manageable pieces and enjoy!
Bach-Faig A, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2001, 14(12A), 2274-2284.
Bo S, et al. Predictive role of the Mediterranean diet on mortality in individuals at low cardiovascular risk: a 12-year follow-up population-based cohort study. J Transl Med. 2016, 14, 91.
Esposito K, et al. Mediterranean diet and the metabolic syndrome. Mol Nutr Food Res. 2007, 51(10), 1268-74.
Sofi F, et al. Adherence to the Mediterranean diet and health status: meta-analysis. BMJ. 2008, 337, a1344.
Willet WC, et al. Mediterranean Diet Pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995, 61(suppl.), 1402S-1406S.