Mediterranean diet: A heart-healthy eating plan Source: mayoclinic.org/mediterranean-diet

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1 Mediterranean diet: A heart-healthy eating plan Source: mayoclinic.org/mediterranean-diet The heart-healthy Mediterranean is a healthy eating plan based on typical foods and recipes of Mediterranean-style cooking. Here's how to adopt the Mediterranean diet. By Mayo Clinic Staff If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet incorporates the basics of healthy eating plus a splash of flavorful olive oil and perhaps even a glass of red wine among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea. Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet remain tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease. Benefits of the Mediterranean diet Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. In fact, an analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of death from heart disease and cancer, as well as a reduced incidence of Parkinson's and Alzheimer's diseases. The Dietary Guidelines for Americans recommends the Mediterranean diet as an eating plan that can help promote health and prevent disease. And the Mediterranean diet is one your whole family can follow for good health.

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3 Key components of the Mediterranean diet The Mediterranean diet emphasizes: Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts Replacing butter with healthy fats, such as olive oil Using herbs and spices instead of salt to flavor foods Limiting red meat to no more than a few times a month Eating fish and poultry at least twice a week Drinking red wine in moderation (optional) The diet also recognizes the importance of being physically active, and enjoying meals with family and friends. Focus on fruits, vegetables, nuts and grains The Mediterranean diet traditionally includes fruits, vegetables and grains. For example, residents of Greece average six or more servings a day of antioxidant-rich fruits and vegetables. Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet. However, throughout the Mediterranean region, bread is eaten plain or dipped in olive oil not eaten with butter or margarine, which contains saturated or trans fats. Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat, but most of the fat is healthy. Because nuts are high in calories, they should not be eaten in large amounts generally no more than a handful a day. For the best nutrition, avoid candied or honey-roasted and heavily salted nuts. References 1. Traditional Mediterranean diet. Oldways Preservation Trust. Accessed March 23, Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine. In press. Accessed March 23, Sofi F, et al. Adherence to Mediterranean diet and health status: Meta-analysis. BMJ. 2008;337:a Mitrou PN, et al. Mediterranean dietary pattern and prediction of all-cause mortality in a U.S. population. Archives of Internal Medicine. 2007;167: AHA Scientific Statement: Diet and lifestyle recommendations revision Circulation 2006;114: Dietary Guidelines for Americans, U.S. Department of Health and Human Services. Accessed March 23, Van de Laar RJ, et al. Adherence to a Mediterranean dietary pattern in early life is associated with lower arterial stiffness in adulthood: The Amsterdam Growth and Health Longitudinal Study. Journal of Internal Medicine. 2013;273: Mediterranean diet pyramid. Oldways Preservation Trust. Accessed March 22, 2013.

4 9. Meet the fats. American Heart Association. Accessed March 23, AHA Scientific Advisory: Wine and your heart. Circulation 2001;103: Cicerale S, et al. Chemistry and health of olive oil phenolics. Critical Reviews in Food Science and Nutrition. 2009;49: Nelson JK (expert opinion). Mayo Clinic, Rochester, Minn. March 22, Rethinking drinking: Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. Accessed April 4, WHAT DO WE KNOW? (Dr. Snyder Focused Literature Review 2014) A Mediterranean diet (MeDi) can lead to significant weight loss and maintenance 1. Significant adherence to the MeDi can help high-risk cardiovascular patients to significantly lower their risk of major cardiovascular events 2, 5-7. All-cause death rates from cardiovascular and cancer can be lowered with the MeDi 3.. Even hepatocellular liver cancer risk can be reduced by adherence to the MeDi 8. Adopting a MeDi may help prevent type 2 diabetes 9. High adherence to the MeDi increases the likelihood of asthma to be under control in adults 10. If the MeDi is coupled with a healthy lifestyle characterized by abdominal leanness, regular physical activity and long-tern nonsmoking, premature deaths rates might drop by about 33% 4. Higher adherence to the MeDi is associated with a reduced risk of developing Mild Cognitive Impairment (MDI) and Alzheimer s Disease (AD), and a reduced risk of progressing from MCI to AD 11. References 1) Paoli A, et al. Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol. Nutrients 2013;5(12):5205 2) Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013;368(14):1279 3) Mitrou PN, et al. Mediterranean dietary pattern and prediction of allcause mortality in a US population: results from the NIH-AARP Diet and Health Study. Ann Intern Med 2007;167(22):2461 4) Behrens G, et al. Healthy lifestyle behaviors and decreased risk of mortality in a large prospective study of U.S. women and men. Eur J epidemiol 2013;28(5):361

5 5) Rees K, et al. Mediterranean dietary pattern for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2013 Aug 12;8:CD doi; / CD pub2. 6) Hoevenaar-Blom MP, et al. Mediterranean style diet and 12-year incidence of cardiovascular diseases: the EPIC-NL cohort study. PLoS One 2012;7(9):e ) Gardener H, et al. Mediterranean-style diet and risk of ischemic stroke, myocardial infarction, and vascular death: the Northern Manhattan Study. Am J Clin Nutr 2011;94(6):1458 8) Turati F, et al. Mediterranean diet and hepatocellular carcinoma. J Hepatol Pii: S (13) Doi: /j.jhep (Epub) 9) Esposito K, Giugliano D. Mediterranean diet and type 2 diabetes. Diabetes Metab Res Rev 2013 Dec 19. doi: /dmrr.2516 (Epub) 10) Barros R, et al. Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma control. Allergy 2008;63(7):917 11) Singh B, et al. Association of Mediterranean diet with Mild Cognitive Impairment and Alzheimer s Disease: A Systematic review and Meta- Analysis. J Alzheimers Dis 2013Oct 28 (Epub)