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Is the Mediterranean Diet Truly the Best Choice?

Dr. James Stein UW Health Preventive Cardiologist explains why a Mediterranean Diet isn't the answer to healthy eating.

We hear frequently how the Mediterranean diet is one of the healthiest ways we can eat. But does it really live up to its reputation?


Clinical nutritionist Kavita Poddar explains that while the building blocks of the Mediterranean diet are certainly healthy – such as lots of fruits, vegetables and fish – there’s a bit more to a healthy diet than just that.


“The Mediterranean dietary patterns emulate the eating habits of people who live in the area around the Mediterranean Sea and are known to have a low risk of heart disease,” Kavita explains.


She notes that the typical diet contains an abundance of fruit, vegetables, vegetarian proteins and a moderate amount of whole grains. There is also a small amount of red meat, simple sugars and moderate alcohol consumption – mostly in the form of wine, which equals about one drink per day for women and two for men.


The components of the diet work together to help reduce inflammation in the body and decrease risk factors for heart and vascular disease. And research has backed up the many positive benefits. Poddar points to studies that suggest a Mediterranean diet eating style reduced bad cholesterol and blood fats when compared to individuals who consumed other more traditional low-fat diets. In other studies, the dietary pattern was shown to lower the odds of developing metabolic syndrome by reducing waist circumference, improving good cholesterol and triglycerides.


But even with such a positive reputation, recent American College of Cardiology-American Heart Association guidelines reflected a shift away from the Mediterranean diet. Dr. James Stein, director of UW Health’s Preventive Cardiology program, explains part of the issue comes from the research.


“There is no single ‘Mediterranean Diet’,” he says. “All of the research studies showing its benefits used supplemental foods such as olive oil, canola oil and certain nuts. While the pattern of eating is healthy, the findings in the research studies are difficult to reproduce in real life.”


He explains that individuals also tend to overdo aspects of the diet they enjoy the most, such as nuts or alcohol, which can lead to weight gain and the exact metabolic problems they were trying to avoid in the first place. The other issue is that there are differences in lifestyle between Mediterranean countries and the U.S.


“Other genetic and lifestyle factors such as physical activity, tobacco use and differences in farming and food processing also may play a role,” he adds.


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The Essential Elements of a Healthy Diet


So what should a person eat to protect or improve their heart health? Poddar points to a dietary pattern called DASH – or Dietary Approaches to Stop Hypertension – that is similar to the Mediterranean diet. DASH evolved from studies at the National Institutes of Health, and is commonly recommended to cardiac patients. But rather than focus on the diet name, Poddar points to the essential elements that comprise a healthy diet and lifestyle.


A healthy diet includes:

  • A variety of fruits, vegetables and whole grains each day
  • 3 servings of low-fat dairy products each day
  • Lean meats like fish and skinless chicken
  • Nuts and legumes
  • Non-tropical vegetable oils and olive oil
  • Controlled portion sizes to avoid excess calories

And it limits the intake of:

  • Saturated fats
  • Trans fat (often found as hydrogenated or partially hydrogenated oils on food labels)
  • Sodium
  • Red meat
  • Sweets and sugar sweetened beverages

And of course, no diet is complete without other lifestyle factors including no smoking, alcohol in moderation and exercise 45-60 minutes a day at least five days a week.


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Date Published: 05/19/2016

News tag(s):  healthy eatingwellnessjames h steinheart

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