The Mediterranean Diet: A Research-backed Heart Healthy Diet

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Diet is a Large Factor in Heart Health

We know that to keep our heart healthy, our diet needs to include a variety of nutrient-dense, plant-based foods, healthy fats, and limited amounts of salt, added sugars, and unhealthy fats.

We also know that rather than focusing on eating individual nutrients, dietary patterns which look at whole foods and how they are eaten in combination with other foods are more crucial when assessing the impact on our health status.

 

What dietary patterns support heart health?

The Mediterranean style diet is an evidenced based dietary pattern based on the traditional cuisines of Greece, Italy and other countries that border the Mediterranean Sea. It has an abundance of research indicating it is one of the most effective dietary patterns for a healthy heart.

Research suggests there is an association between lower cardiovascular risk and protection against coronary heart disease for those individuals following a Mediterranean style diet.

Further research within a meta-analysis involving over 4 million people demonstrated adherence to a Mediterranean diet was associated with a 10% reduction in cardiovascular deaths and overall mortality.

What are the social and cultural aspects of the Mediterranean diet?

The Mediterranean dietary pattern is not only a way of eating but also has social and cultural aspects. These emphasize the importance of mindful eating and social connections which we know are strong indicators for healthy food behaviours.

Social and cultural practices include:

  • Enjoying meals with family and friends
  • Taking time to savour and appreciate food
  • Eating meals and snacks without distractions
  • Using fresh, locally-sourced ingredients
Mediterranean social and cultural practices

What do I eat when following the Mediterranean style diet?

The Mediterranean dietary pattern focuses on intake of food mostly from plant-based foods. These are known to be nutrient dense foods that are high in polyphenols (a type of antioxidant), high in fibre and high in good types of fat (monounsaturated and polyunsaturated fats).

Foods that make up the majority of daily meals and snacks should include fruits, vegetables, whole grains, legumes, beans, extra virgin olive oil, nuts, seeds, herbs and spices.

Fish and other seafood should be consumed at least 3 times per week. These animal-based foods are high in protein and a type of polyunsaturated fat called omega-3 fatty acid which has been shown to increase our good type of cholesterol and reduce inflammation within the body.

Moderate consumption of poultry, eggs, milk, yoghurt and cheese is recommended which may include daily to weekly servings.

Red meats and sweets are only eaten in very small amounts and other ultra processed foods (such as processed meats) should be limited to rare occasions.

Foods to increase on the Mediterranean style diet:

  1. Using extra virgin olive oil as the main fat (raw and in cooking)
    • Serve size ~60ml/day
  2. Vegetables or salads with every main meal
    • serve size >400g cooked/day or 200g raw/day
  3. Fresh fruits
    • 2-3 serves/day (serve size 2x small fruit or 1x medium fruit)
  4. Legumes
    • 3-serves per week (serve size ~150g)
  5. Fish or seafood
    • 3-serves of fish (serve size ~100-150g) or shellfish (200g/week)
  6. Nuts and Seeds
    • 3-serves/week (serve size ~30 grams)
  7. Meals cooked in tomato, onion, garlic, olive oil (sofrito or salsa)
    • 2x dishes per week
  8. Chicken, turkey, wild meats as main meats

Foods to decrease on the Mediterranean style diet:

  1. Red meat/meat products
    • 1-serve per day (serve size 100-150g
  2. Sweet/carbonated beverage
    • 1-serve per day (serve size ~375ml)
  3. Butter, margarine or cream
    • < 1-serve per day (serve size ~20g)
  4. Commercial sweets, cakes, biscuits
    • < 3-serves per week (serve size ~600kJ)

Other top tips for adhering to a Mediterranean style diet

  • Vegetables or salads should be the base of your main meals.
  • Use extra virgin olive oil instead of butters or other fat-based spreads.
  • Use herbs and spices or citrus/vinegars to flavour foods.
  • Cakes, chocolate, pastries and other ultra processed high fat or sugar foods consumed only on special occasions.

References:

  1. Sofi F, Abbate R, Gensini GF, Casini A. 2010. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. The American Journal of Clinical Nutrition. 92(5):1189-96. doi: 10.3945/ajcn.2010.29673.
  2. Martínez-González MÁ, Hershey MS, Zazpe I, Trichopoulou A. 2017. Transferability of the Mediterranean Diet to Non-Mediterranean Countries. What Is and What Is Not the Mediterranean Diet. Nutrients. 9(11):1226. doi: 10.3390/nu9111226.
  3. De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. 1999. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 99(6):779-85. doi: 10.1161/01.cir.99.6.779.
  4. Mente A, de Koning L, Shannon HS, Anand SS.2009. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Archives of Internal Medicine.169(7):659-69. doi: 10.1001/archinternmed.2009.38.
  5. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, Trichopoulos D. 1995. Mediterranean diet pyramid: a cultural model for healthy eating. American Journal of Clinical Nutrition. 61(6 Suppl):1402S-1406S. doi: 10.1093/ajcn/61.6.1402S.
  6. Sofi, F., Macchi, C., Abbate, R., Gensini, G., & Casini, A. (2014). Mediterranean diet and health status: An updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutrition, 17(12), 2769-2782. doi:10.1017/S1368980013003169
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