While a Mediterranean-type diet has long been touted as heart-healthy, it was only recently that substantial research has been done to validate this claim, said experts with the Texas A&M AgriLife Extension Service.
"The research recently completed in Spain was not based on anecdotal evidence or observation," said Dr. Sharon Robinson, AgriLife Extension nutrition specialist, College Station. "For this study, a significant number of people were given different diets to follow for a substantial length of time and were carefully monitored. It also involved extensive collaboration among academic, medical and health-care entities."
Results of this five-year study involved almost 7,500 people and were published by the New England Journal of Medicine. Participants were ages 55 to 80, just over half of whom were women. Almost all participants were overweight or obese, and while heart-disease-free at the beginning of the study, all were at high risk for heart disease. In addition to their weight, participants' health-related problems included type 2 diabetes, smoking, high cholesterol and hypertension.
"Participants were divided into three groups," Robinson said. "One followed a Mediterranean diet supplemented with extra-virgin olive oil. A second followed a Mediterranean diet supplemented with nuts. A third control group followed a standard low-fat diet. Groups were provided dietary sessions and detailed information on their diets, along with menus and recipes."
After five years, the study showed participants following the two Mediterranean-type diets had a 30 percent lower combined rate of heart attack, stroke and deaths from related causes than those on a low-fat diet.
However, Robinson said, a notable difference between a Mediterranean and low-fat diet coming from the study was that participants could derive a greater percentage—up to 40 percent—of daily calories from fat. This contrasts with the less than 35 percent recommended in most heart-healthy diets.
"It's very important to note that the fats in a Mediterranean diet are typically what we refer to as healthy fats—unsaturated oils like fish oil, olive oil, and seed oils like canola, soybean or flaxseed – which studies have shown may have a protective effect on the heart," she said. "And while the study indicated a high-vegetable fat diet is better for cardiovascular health than a low-fat diet, there is certainly substantial scientific evidence to indicate that reducing the amount of fat in a person's diet is important for improving overall health and wellness. Of course, it's not so much the amount of fat in your diet as the type of fat."
Mediterranean diet staples include fish, fruits, vegetables, beans, high-fiber grains and olive oil, plus other foods rich in monounsaturated fats, fiber, proteins and omega-3 fatty acids.
For someone wanting to go from a more American diet to a more Mediterranean one, Robinson said the transition need not be particularly difficult.
"Many foods typically found in or similar to those in a Mediterranean diet are already grown in or are readily available in the U.S.," she said. "It's just a matter of being mindful of them when you're planning meals and shopping.
"You can start by simply adding fish – broiled or grilled, not fried—to your diet a few times a week. And place more attention on vegetables, fruits and whole-grains."
Robinson said other ways people can transition to a more Mediterranean diet include:
- Cooking foods in olive or canola oil vs. butter or saturated fat.
- Having a salad a few times each week, using oil and vinegar or a vinaigrette dressing.
- Shopping the "outer aisles" of the supermarket, choosing fresh over processed foods.
- Serving whole-grain breads, pasta and rice.
- Switching to low-fat or fat-free milk and other lower-fat dairy products.
- Choosing an apple, orange or dried fruit for a snack or dessert.
- Reducing the amount of salt in recipes, substituting herbs and spices for flavor.
- Drinking water with your meal instead of sodas or other sugar-sweetened drinks. A glass of wine, especially red wine, with evening meals may be another option.
"A number of our Dinner Tonight! recipes from this eat-at-home AgriLife Extension program promoting family nutrition are based on the Mediterranean diet," said Dr. Susan Ballabina, AgriLife Extension's North Texas regional program director for family and consumer sciences.
Ballabina said free video webcasts of easy-to-prepare, nutritious recipes are available at healthyliving.tamu.edu under the Dinner Tonight! tab. Videos average 3-5 minutes long and are produced like mainstream television cooking shows. The site is updated every Monday with a new recipe and webcast, and families can sign up on the website to receive weekly emails announcing new recipes.
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