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The Mediterranean diet is a way of eating that draws from the tradition of more than a dozen countries in the region of the Mediterranean Sea. In one respect, it looks similar to the traditional American diet, in that the Mediterranean approach consists of (on average) 55 percent carbohydrates, 15 percent protein, and 30 percent fat. However, the benefits of the Mediterranean diet are significantly better.
The major difference between the two diets is in the food choices in each of these categories. For example, while most of the carbohydrates enjoyed by non-Mediterranean diet consumers are in the form of white sugar, breads, pasta, cereals, and other grains, Mediterranean diet lovers get the majority of their carbs from fresh fruits and vegetables, along with legumes.
The fresh fruits and vegetables are key because they are a rich source of polyphenols, micronutrients that are potent antioxidants and anti-inflammatory agents. For those who enjoy red wine, this beverage also is part of the Mediterranean diet in moderation and is another source of polyphenols.
When it comes to fats, the Mediterranean diet focuses on healthy options, such as monounsaturated fats (olive oil, nuts) and omega-3 fatty acids, while the traditional American diet is heavy with saturated fat and omega-6 fatty acids. Protein in the Mediterranean diet comes primarily from fish, legumes, and small amounts of red meat, fowl, and eggs.
Here are the 11 foundations of the Mediterranean diet to help you get started:
- Get lots of exercise
- Don’t eat alone: share your meals with family and friends. Savor and enjoy your food and your company. Eat slowly
- Enjoy generous amounts of fruits, vegetables, and legumes
- Consume healthy fats such as monounsaturated fats (olive and canola oils) and omega-3 fatty acids
- Use herbs and spices instead of salt to flavor foods
- Eat small portions of nuts
- Drink red wine, in moderation
- Consume very little red meat (the traditional Mediterranean diet is practically vegetarian)
- Eat shellfish or fish at least twice a week
- Eat locally grown, seasonal foods and avoid processed foods
- Practice portion control—small portions of high-quality food
Mediterranean Diet, the Prostate and Sexual Health
Can diet have an impact on the prostate and sexual health? How about diet and erectile dysfunction? In the International Journal of Impotence Research, a team evaluated the role of the Mediterranean diet in 100 men with erectile dysfunction and compared them with 100 men without the problem. The authors also considered other factors such as high blood pressure, exercise level, total caloric intake, high cholesterol, and body mass index.
Overall they discovered that two elements of the Mediterranean diet—intake of fruits and nuts and the ratio of monounsaturated fats to saturated fats—were associated with erectile dysfunction. They concluded that men who adopt a healthful diet such as the Mediterranean way of eating could help prevent development of erectile dysfunction.
Other research emphasized that a combination of the Mediterranean diet and exercise were beneficial in tackling erectile dysfunction. A review, appearing in the Journal of Sexual Medicine, pointed out that “combining the two interventions [physical exercise and Mediterranean-style diets/reduced calories] provides additional benefit to erectile function.”
Among men with both erectile dysfunction and type 2 diabetes, the Mediterranean diet has been found to be beneficial. In one study, the authors rated how well 555 men followed the Mediterranean diet. Overall, those who were the best at adhering to the diet were less likely to experience erectile dysfunction than were those who had not followed the diet well.
The risk of prostate cancer also may be reduced by following a Mediterranean style diet. One review examined the components of the Mediterranean diet and compared prostate cancer mortality among Greek men (who have a low risk for prostate cancer) who stayed in Greece with those who had migrated to Australia and maintained their traditional Mediterranean diet. Because the men who had migrated to Australia maintained their low risk for prostate cancer, the authors suggested that following this dietary plan “may confer protection to Greek migrant men, and this dietary pattern offers a palatable alternative for prevention of this disease.”
Mediterranean Diet and Cardiovascular Health
In a recent review in the American Journal of Medicine, the authors pointed out that the Mediterranean diet is “one of the best studied diets for cardiovascular health” and that it’s been “known to improve surrogates of cardiovascular disease, such as waist-to-hip ratio, lipids, and markers of inflammation, as well as primary cardiovascular disease outcomes such as death.” The diet has been shown to lower blood pressure and cholesterol levels as well.
One of the most recent reports looked at a decade-long incidence of cardiovascular disease (The ATTICA study). A total of 2,583 adults without cardiovascular disease at the beginning of the study were followed-up after 10 years to look at the association between adherence to a Mediterranean-type diet, lifestyle behaviors, clinical status, and a 10-year incidence of cardiovascular disease.
Here’s what they found:
- Following a Mediterranean diet reduced risk of cardiovascular disease independently of lifestyle, sociodemographic, and clinical factors
- Individuals with an unhealthy lifestyle (e.g., smoking, sedentary, obesity) gained some protection from cardiovascular disease via a greater adherence to the diet
- Following a Mediterranean diet reduced levels of interleukin-6 and C-reactive protein (markers of inflammation and heart disease) and also provided an independent protective role against the risk of cardiovascular disease
Mediterranean Diet and Alzheimer’s Disease
Currently, Alzheimer’s disease has no cure, and it continues to grow in leaps and bounds. In 2014, 5.2 million people in the United States alone had been diagnosed with Alzheimer’s disease, and that figure is projected to reach 16 million by 2050, according to the Alzheimer’s Association. Following a Mediterranean diet may help in the prevention of this debilitating disease.
In a recent article in the Journal of Prevention of Alzheimer’s Disease, the authors pointed out that prior research had indicated that closely adhering to a Mediterranean diet “is associated with a reduced risk of AD.” In their more current research, they considered adherence to the diet and also used magnetic resonance imaging to examine brain atrophy in cognitively normal adults with and without risk factors for Alzheimer’s.
Overall the investigators found that participants who did not follow the Mediterranean diet closely had thinning in the same brain areas as did people with Alzheimer’s disease compared with participants who had better adherence to the diet. This finding led the authors to conclude that the Mediterranean diet “may have a protective effect against tissue loss, and suggest that dietary interventions may play a role in the prevention of AD.”
In a previous review published in Expert Review of Neurotherapeutics, the authors evaluated the current evidence regarding diet and Alzheimer’s disease risk factors and prevention. They wrote that following the Mediterranean diet “may affect not only the risk of AD, but also of predementia syndromes and their progression to overt dementia.” Although they fell short of making definitive dietary recommendations, they encouraged people to adopt the elements of the Mediterranean diet, including high intake of low glycemic fruits and nonstarchy vegetables, fats from fish, low sugar, and moderate wine intake.
Mediterranean Diet and Cancer
The quest for evidence that the Mediterranean diet can help reduce the risk of cancer has resulted in numerous research efforts. In a study appearing in Public Health Nutrition, the authors evaluated data from more than 10,000 cases and concluded that specific elements of the diet were associated with a reduced risk of cancer, including intake of whole grains, monounsaturated fats, and the omega-3 fatty acids in fish.
A recent effort analyzed the habits of more than 461,000 individuals who were in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The investigators were evaluating the impact of lifestyle factors such as the Mediterranean diet, smoking, alcohol, and weight on gastrointestinal cancer risk. Overall they concluded that adoption of positive behaviors—adherence to the Mediterranean diet, not smoking, limiting alcohol, and maintaining a normal weight—was associated with “a large decreased risk of GC.”
Several other studies have indicated that the Mediterranean diet has a role in reducing the risk of cancer, including:
- Oral and pharyngeal cancer
- Pancreatic cancer
- Breast cancer
Mediterranean Diet and Diabetes
The Mediterranean diet may also have a role in diabetes. Two variations of the Mediterranean diet (one supplemented with extra virgin olive oil; one supplemented with mixed nuts) plus a control diet (advice to eat low-fat) were assigned to 3,541 older adults without diabetes but at high cardiovascular risk. Median follow-up was 4.1 years. The researchers found that the Mediterranean diet supplemented with olive oil reduced diabetes risk among the participants.
How to Follow the Mediterranean Diet
The 11 foundations of the Mediterranean diet are your best guidelines for making a transition to this healthful way of eating. Most people find that making a slow but steady switch to a new way of eating works best for them, while some prefer to go “cold turkey.”
In either case, begin by looking at the food you have in your home right now and note which ones are not in line with the Mediterranean diet. Now make a list of the new foods you will shop for next time at the supermarket or fresh produce stand. You can choose to make a complete changeover or make several food changes every few days until you have gone Mediterranean! Here are a few more tips:
- Switching to a Mediterranean diet is easier if you do it with others, so make it a family affair or share it with your friends. Overall it is healthful choice for everyone.
- Talk to or make contact with others who are following the Mediterranean diet for recipe ideas and other helpful hints. Sharing experiences can make it so much easier.
- Don’t be afraid to try new foods or things you may have hated as a child. If you couldn’t stand broccoli when you were nine and haven’t eaten it since, you may find some wonderful ways to enjoy it now that you’re 39 or 49.
- The Mediterranean diet is a lifestyle, not a temporary “diet,” so view it as such. Embrace it as a way of living a healthier life.
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Bosetti C et al. Diet and cancer in Mediterranean countries: carbohydrates and fats. Public Health Nutrition 2009 Sep; 12(9A): 1595-600
Buckland G et al. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study. International Journal of Cancer 2014 Dec 31
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