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Heart Health: Mediterranean Diet Food Guide HF#410

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People who live in the area around the Mediterranean Sea have been found to have a lower risk of heart disease. Research studies show that when people in other parts of the world eat a diet similar to that eaten in Mediterranean countries, they reduce their risk of heart disease.

The Mediterranean diet contains large amounts of fruits, vegetables, and vegetarian proteins, moderate amounts of whole grains, and small amounts of red meat. Regular use of fish, olive oil, and nuts makes this diet higher in fat than the classic “heart healthy diet”, but the fat is mostly unsaturated, which can be good for the heart. The pyramid to the left and the chart below describe types and amounts of foods found in a heart healthy Mediterranean diet.

Getting enough physical activity is very important. Aim for a total of at least 150 minutes per week, spread out over 3-5 times per week. Moderate exercise like walking, biking, or swimming is recommended.

Weight Control - Even though the higher fat content in the Mediterranean diet can be healthy for your heart, large portions of food may lead to increased calorie intake and weight gain. If you are trying to lose weight, choose the smaller number of servings from each food group, and make sure your serving sizes match those listed.

Food Groups	Serving sizes, examples, and notes
Non-starchy Vegetables 4-8 servings per day	One serving is 1/2 cup of cooked vegetables or 1 cup raw vegetables. Non-starchy vegetables include artichoke, asparagus, beets, broccoli, Brussels sprouts, cauliflower, cabbage, celery, carrots, tomatoes, eggplant, cucumber, onion, green and wax beans, zucchini, turnips, peppers, salad greens and mushrooms. (Potatoes, peas, and corn are starchy vegetables.)
Fruit 2-4 servings per day	One serving is a small fresh fruit, 1/2 cup juice or 1/4 cup dried fruit. Fresh fruits are preferred because of the fiber and other nutrients they contain, but fruits canned in light syrup or their own juice, and frozen fruit with little or no added sugar are also good choices. Use only small amounts of fruit juice (8 oz per day or less), since even unsweetened juices can contain as much sugar as regular soda.
Legumes and Nuts 1-3 servings per day	Legumes: One serving is ½ cup cooked kidney, black, garbanzo, pinto, soy, navy beans, split peas, or lentils, or ¼ cup fat free refried beans or baked beans Nuts and Seeds: One serving is 2 Tbsp. sunflower or sesame seeds, 1 Tbsp. peanut butter, 7-8 walnuts or pecans, 20 peanuts, or 12-15 almonds Aim for 1-2 servings of nuts or seeds and 1-2 servings of legumes per day. Legumes are high in fiber, protein, and minerals. Nuts are high in unsaturated fat, and may increase HDL without increasing LDL cholesterol levels. If servings of dairy or fortified soy are less than 2 per day, a calcium and vitamin D supplement is advised.
Low-fat Dairy Products 1-3 servings per day	One serving is 1 cup of skim milk or light yogurt, or 1 oz of low-fat (part-skim) cheese Calcium-fortified soy milk, soy yogurt, and soy cheese can take the place of dairy products. If servings of dairy or fortified soy are less than 2 per day, a calcium and vitamin D supplement is advised.
Fish or Shellfish 2-3 times per week	One serving is 3 ounces (about the size of a deck of cards) Cook fish by baking, sautéing, broiling, roasting, grilling, or poaching. Choose fatty fishes like salmon, herring, sardines, or mackerel often. The fat in fish is high in omega-3 fats, so it has healthy effects on triglycerides and blood cells.
Poultry, if desired 1-3 times a week	One serving is 3 ounces (about the size of a deck of cards) Bake, sauté, stir fry, roast or grill the poultry you eat. Eat it without the skin.
Whole Grains and Starchy Vegetables 4-6 servings per day	One serving is one of the following: 1 slice whole wheat bread ½ cup potatoes, sweet potatoes, corn, or peas ½ large whole grain bun 1 small whole grain roll 6-inch whole wheat pita 6 whole grain crackers ½ cup cooked whole grain cereal (oatmeal, cracked wheat, quinoa) ½ cup cooked whole wheat pasta, brown rice, or barley Whole grains are high in fiber and have less effect on blood sugar and triglyceride levels than refined, processed grains like white bread and pasta. Whole grains also keep the stomach full longer, making it easier to control hunger.
Healthy fats 4-6 servings per day	One serving is one of the following: 1 tsp. olive or canola oil 2 tsp light margarine 1 Tbsp of regular salad dressing 2 Tbsp of light salad dressing, made with oil 1 tsp regular mayonnaise 1/8 of an avocado 5 olives (high salt – limit if you have high blood pressure) These fats are mostly unsaturated and contain little or no trans fat, so they will not increase LDL cholesterol levels. Remember that all fats are a concentrated source of calories, so keep the servings small, as recommended.
Alcohol- per day, no more than one drink for women or two drinks for men.	One drink equals one 12 ounce beer, 4 ounces of wine, or 1½ ounces liquor (whiskey, vodka, brandy, etc). People with high blood pressure or high triglycerides, or those taking certain medicines may be advised to avoid all alcohol. Ask your doctor to be sure.

Food Groups

Serving sizes, examples, and notes

Non-starchy Vegetables

4-8 servings per day

One serving is 1/2 cup of cooked vegetables or 1 cup raw vegetables.

Non-starchy vegetables include artichoke, asparagus, beets, broccoli, Brussels sprouts, cauliflower, cabbage, celery, carrots, tomatoes, eggplant, cucumber, onion, green and wax beans, zucchini, turnips, peppers, salad greens and mushrooms. (Potatoes, peas, and corn are starchy vegetables.)

Fruit

2-4 servings per day

One serving is a small fresh fruit, 1/2 cup juice or 1/4 cup dried fruit.

Fresh fruits are preferred because of the fiber and other nutrients they contain, but fruits canned in light syrup or their own juice, and frozen fruit with little or no added sugar are also good choices. Use only small amounts of fruit juice (8 oz per day or less), since even unsweetened juices can contain as much sugar as regular soda.

Legumes and Nuts

1-3 servings per day

Legumes: One serving is ½ cup cooked kidney, black, garbanzo, pinto, soy, navy beans, split peas, or lentils, or ¼ cup fat free refried beans or baked beans
Nuts and Seeds: One serving is 2 Tbsp. sunflower or sesame seeds, 1 Tbsp. peanut butter,
7-8 walnuts or pecans, 20 peanuts, or 12-15 almonds

Aim for 1-2 servings of nuts or seeds and 1-2 servings of legumes per day. Legumes are high in fiber, protein, and minerals. Nuts are high in unsaturated fat, and may increase HDL without increasing LDL cholesterol levels. If servings of dairy or fortified soy are less than 2 per day, a calcium and vitamin D supplement is advised.

Low-fat Dairy Products

1-3 servings per day

One serving is 1 cup of skim milk or light yogurt, or 1 oz of low-fat (part-skim) cheese

Calcium-fortified soy milk, soy yogurt, and soy cheese can take the place of dairy products. If servings of dairy or fortified soy are less than 2 per day, a calcium and vitamin D supplement is advised.

Fish or Shellfish

2-3 times per week

One serving is 3 ounces (about the size of a deck of cards)

Cook fish by baking, sautéing, broiling, roasting, grilling, or poaching. Choose fatty fishes like salmon, herring, sardines, or mackerel often. The fat in fish is high in omega-3 fats, so it has healthy effects on triglycerides and blood cells.

Poultry, if desired

1-3 times a week

One serving is 3 ounces (about the size of a deck of cards)

Bake, sauté, stir fry, roast or grill the poultry you eat. Eat it without the skin.

Whole Grains and Starchy Vegetables

4-6 servings per day

One serving is one of the following:

1 slice whole wheat bread
½ cup potatoes, sweet potatoes, corn, or peas
½ large whole grain bun 1 small whole grain roll
6-inch whole wheat pita 6 whole grain crackers
½ cup cooked whole grain cereal (oatmeal, cracked wheat, quinoa)
½ cup cooked whole wheat pasta, brown rice, or barley

Whole grains are high in fiber and have less effect on blood sugar and triglyceride levels than refined, processed grains like white bread and pasta. Whole grains also keep the stomach full longer, making it easier to control hunger.

Healthy fats

4-6 servings per day

One serving is one of the following:

1 tsp. olive or canola oil       2 tsp light margarine
1 Tbsp of regular salad dressing       2 Tbsp of light salad dressing, made with oil
1 tsp regular mayonnaise                  1/8 of an avocado
5 olives (high salt – limit if you have high blood pressure)

These fats are mostly unsaturated and contain little or no trans fat, so they will not increase LDL cholesterol levels. Remember that all fats are a concentrated source of calories, so keep the servings small, as recommended.

Alcohol- per day, no more than one drink for women or two drinks for men.

One drink equals one 12 ounce beer, 4 ounces of wine, or 1½ ounces liquor (whiskey, vodka, brandy, etc).

People with high blood pressure or high triglycerides, or those taking certain medicines may be advised to avoid all alcohol. Ask your doctor to be sure.

Limit egg yolks to 4 per week. Egg whites can be eaten in unlimited amounts.

Eat sweets less often- use fruit as your dessert.

Lean red meats (beef, pork, lamb and veal) can be eaten 3-4 times per month.

References: de Lorgeril, M, et al: Lyon Diet Heart Study, Lancet 1994; 343:1454-9.

If you are a UW Health patient and have further questions, please contact UW Health at one of the phone numbers listed below.

Nutrition Clinic Room L33

University Station

2880 University Avenue

Madison, WI 53705

(608) 263-5012

Appts: 608-263-4360

Nutrition Clinic Rm 1296

UW Health West Clinic

451 Junction Road

Madison, WI 53717

(608) 265-7526

Appts: 608-262-9181

Nutrition Clinic

UW Health East Clinic

5249 East Terrace Drive

Madison, WI 53718

(608) 265-0963

Appts: 608-265-7405

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 09/14/2012

Copyright © 09/10/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#410

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