
Dip into this traditional cuisine and reap lifelong rewards. Stephanie Osfield reports on the many benefits of including simple, tasty and nutritious food from the Med in your diet.
Let’s be clear from the start: This diet is not about restricting kilojoules. The Mediterranean way of eating serves up hearty meals that thrill the taste buds and fill the stomach. The traditional food of villagers in Greece, Spain, Italy and other countries bordering the Mediterranean Sea is not only delicious, it also packs a powerful health punch.
A sea of health benefits
Research into the Mediterranean diet has produced some exciting results. The PREDIMED (Primary Prevention of Cardiovascular Disease with a Mediterranean Diet) study, which has been tracking the eating habits of nearly 7500 people in Spain since 2003, is proving especially significant.
After spending four years on the Med diet, study subjects not only cut their risk of developing type 2 diabetes by 52 per cent, but they also reduced their susceptibility to stroke and heart disease by 30 per cent, when compared to the control group on a low-fat diet. Also, subjects who’d been teetering on the brink of diabetes showed fewer signs of metabolic syndrome, experiencing shrinking waistlines in particular, without having to count kilojoules or do any more exercise.
Enjoying a Mediterranean diet may also lengthen your lifespan. When 4676 healthy middle-aged women ate this way for a major 2014 US study, those who stuck the most closely to the diet had longer telomeres, tiny structures that cap our chromosome ends to protect their genetic codes.
As markers of ageing, telomeres shorten gradually over time, so the women’s healthy telomere length suggested that their lives would be long, too.
The key foods
So what does this healthy way of eating actually involve? There are about as many kinds of Med diets as there are countries, but the traditional diet emphasises plant foods, such as veges, fruits, nuts and legumes (beans, lentils and chickpeas). This means making olive oil the main source of fat in your diet, which would also include wholegrain breads and cereals, along with natural yoghurt and cheese (in moderation), some fish and only small portions of meat.
The Med diet is heart healthy because it’s high in unsaturated fats from olive oil and oily fish, and low in fatty meats. As a result, this cuisine offers life- long health rewards. Research links long-term adherence to this way of eating with a reduced mortality risk at any age, mostly because of the reduction in the risk of developing heart disease or cancer.
Research shows that eating this way also means you’ll be less likely to develop the cardiovascular disease risk factors of type 2 diabetes, high blood pressure, elevated blood cholesterol and obesity.
The Mediterranean diet has another drawcard – its ability to satisfy hunger. “In the PREDIMED study, people didn’t count kilojoules — they ate until they were full, yet they didn’t gain weight,” says Catherine Itsiopoulos, PhD, head of dietetics and human nutrition at La Trobe University in Melbourne. Itsiopoulos is also the author of The Mediterranean Diet. “If people feel satisfied by their meals, they snack less and are far more likely to keep following a healthy eating plan, because they don’t feel deprived.”
Eight ways to be led by the Med
A diet that delivers good health and long life while satisfying hunger sounds like a win-win approach to well-being, but you don’t need to take it to extremes. Embracing the diet’s principles in a sensible way is important for a couple of key reasons. “Yes, people who eat a traditional Mediterranean diet have a longer-than-average lifespan,” says dietitian Alan Barclay, PhD, who’s chief scientific officer at the Glycemic Index Foundation, an Australian not-for-profit health promotion charity. “But we mustn’t forget that other eating patterns are also associated with longevity. This includes Japan’s Okinawa diet, even though this way of eating is high in carbohydrates and low in fat.”
In other words, there’s more than one way to eat well. As Barclay explains, following the Med diet isn’t the only way to live a long and healthy life. “Personal food preferences are important, because they affect our quality of life.”
Still, research shows that we’d all benefit from embracing the Med diet’s principles.
We also need to heed this major sticking point: Some of the meals we think of as Mediterranean, such as pizza, pasta and lasagne, can be packed with red meat and drowning in cheesy or creamy sauces — foods that can send our health heading in the wrong direction. Traditional Mediterranean families did not eat these sorts of rich foods every day, rather they saved such meals for special occasions.
To find your sea legs and take this way of eating on board, embrace the following Med-diet moves.
1. Eat less red meat
“In countries such as Spain and Greece, red meat was both expensive and not always readily available. People ate meat only once or twice a week, or once a fortnight,” says Karen Murphy, PhD, a senior research fellow at the University of South Australia. Murphy is currently exploring the effects of an ‘Australianised’ Mediterranean diet on heart health and cognitive function.
“Plants provide the protein,” says Murphy. Legumes provide fibre and minerals, and having a high-fibre intake helps lower cholesterol and blood pressure. Eating less red meat also cuts kilojoules and assists weight maintenance.”
- Tip: Swap red meat and chicken for more meals with seafood and legumes.
- Recipe idea: Seafood tagliatelle
2. Build meals around vegetables
“The traditional Mediterranean diet was largely vegetarian,” says Catherine Itsiopoulos. “In fact, most people ate half a kilo of vegetables a day, often in casseroles, as one serve gave them many different veges, such as carrots, artichokes and courgettes.”
Mediterraneans also picked and ate lots of wild leafy greens, she says. “Spinach and silver beet, among other greens, such as endive and chicory, are high in the antioxidants lutein and beta-carotene.”
Traditional Med menus, such as those of Greece, also featured plenty of vegetables cooked in olive oil, and sometimes with tomato. “This style of cooking is very healthy,” says dietitian Antigone Kouris, PhD, from La Trobe University. As Kouris explains, cooking with olive oil doesn’t create the unhealthy chemical compounds that result from dry cooking methods, such as barbecuing.
“The vegetables in the Mediterranean diet were often quite soft, but this doesn’t mean they were less nutritious,” says Kouris. “Slow cooking helps break down vegetable cell walls, making their antioxidant vitamins and minerals easier for the body to absorb. Tomatoes, for example, release more of the antioxidant lycopene the longer they’re slow cooked.”
Meanwhile, the Med diet’s onion and garlic not only boost flavour, but also health benefits.
“These sorts of foods have antibacterial properties and improve digestive health,” says Kouris. “Studies also show that they promote heart health and may help stabilise blood sugars and cholesterol levels.”
- Tip: Slow-cook your veges and eat five serves of them every day to reduce your risk of early death from any cause.
3. Splash more olive oil into meals
Perhaps surprisingly, Mediterraneans eat more fat, not less. But as Karen Murphy explains, “this comes from healthy monounsaturated foods, such as olive oil. These contain phytosterols that benefit ‘good’ HDL cholesterol.” Adding at least four tablespoons of olive oil to meals every day provides health benefits, according to the PREDIMED study guidelines.
“Olive oil has phytochemicals and other plant compounds that have potent anti-inflammatory properties, and these help fight disease,” says Catherine Itsiopoulos. “This oil also makes our blood vessels more flexible, lowering blood pressure and improving heart health. And like other healthy fats, olive oil helps you feel full for longer.”
“Olive oil makes veges such as [sometimes bitter] greens more palatable, just as garlic and tomato do,” says Antigone Kouris. “And, more important for your health, olive oil improves absorption of the fat-soluble nutrients in these plant foods.”
- Tip: Use extra-virgin olive oil to sauté onion and garlic, to coat veges and baking dishes and as a garnish.
4. Curb your cheese consumption
Mediterraneans tossed just a few cubes of feta into salads and scattered only a little parmesan into soups. “They didn’t grate half a block of cheese over their meal,” says Karen Murphy. Butter, cream and milk didn’t feature much either, partly because cows and goats only produced milk for part of the year.
Despite these modest serves of dairy foods, studies show that Mediterraneans enjoyed strong bones, says Murphy. In fact, they managed to consume a healthy 800mg of calcium a day. “This calcium came from various foods, including broccoli, almonds, oily fish (such as sardines and salmon with intact bones) as well as lamb and chicken bones, which broke down during slow cooking, thus leaving their calcium in the stew.”
Meanwhile, these dairy-food choices were also boosting the health of everyone’s gut bacteria.
“People in Mediterranean countries often made their own yoghurt and feta,” says Catherine Itsiopoulos.
“These foods are full of live cultures that have probiotic properties, and probiotics increase levels of beneficial bugs, the ‘good’ bacteria in the gut. Other Med foods that provide probiotics include olives, whose skins develop a bacterial bloom. Research now links this bacteria to everything from weight loss to allergy protection.”
- Tip: Enhance meals with only 30 to 40g of hard cheese, such as cheddar, or with 120g of soft cheese, like cottage cheese or ricotta.
5. Serve rice and pasta as sides
Although some Mediterraneans frequently ate pasta (especially Italians!) others, such as Greeks, ate pasta and rice only once or twice a week. “The serves were small, too — they didn’t fill the bowl or plate,” points out Catherine Itsiopoulos.
- Tip: Make veges and salads the stars of every meal and treat pasta and rice as though they’re the support acts.
6. Break the best bread
Bread was a staple food across the Mediterranean, “but it wasn’t white, fluffy and low in fibre”, says Antigone Kouris. Med bread was a blend of grains such as wheat, barley and corn. “It was sourdough, too, so it contained healthy bacteria and didn’t cause a rapid surge in blood-sugar levels.”
When buying sourdough, “check the label to ensure that the sour taste is due to a starter culture”, advises Barclay. “If the flavour comes from vinegar, the bread probably has a higher glycaemic index (GI)”, which means you’ll miss out on some of the bread’s health benefits.
In regions such as Crete, people ate 300-400g of bread a day (which is the equivalent of 7-10 slices), often with a drizzle of olive oil, onion or feta. “This is a big serve of bread, but people were very physically active, ploughing fields and walking a lot,” says Kouris. “We’re far less active, so those who eat that much bread every day are likely to gain weight.”
- Tip: Choose dense, heavy breads with visible grains or authentic sourdough.
7. Nail your nut serves
Hearty and tasty, Mediterranean meals are very filling, so snacking is somewhat uncommon in countries such as Greece, Spain and Italy.
Nibbling on small handfuls of raw nuts — roughly 30g about three times a week — is optimal, according to PREDIMED study guidelines, along with other healthy unprocessed snacks. These include fresh fruit, lightly roasted pumpkin seeds, dry-roasted chickpeas and wholegrain bread with a little olive oil or tahini.
- Tip: Swap processed foods — and their bulky loads of salt, sugar, fat and kilojoules — for healthy seasonal foods.
8. Scrutinise your sips
On traditional menus, health-boosting herbal teas took the place of black varieties. “Sage tea, in particular, is still popular in Mediterranean countries,” says Antigone Kouris, “and studies now confirm it’s good for brain health and memory.”
Greek coffee also has health benefits. “It’s a great source of magnesium, because the beans are boiled whole, leaving all their goodness in the water.”
Mediterraneans also enjoyed a tipple or two, but not alone. “People drank with family or neighbours at mealtimes and stopped after just one or two glasses,” says Kouris.
This is a good strategy, especially if you make sure your wine glass is small. (Otherwise you could inadvertently down the alcohol of four standard drinks, even though you’ve had only two glasses of wine.)
- Tip: Swap a few of your usual teas for some tasty herbal blends.
Food for happy thoughts!
A Med diet may benefit your mind as much as your body. Late last year, a small study from Melbourne’s Swinburne University of Technology revealed that people who ate a Mediterranean-style diet for just 10 days became more alert and content.
In fact, typical Med foods, such as minestrone, lentil fritters and baba ganoush, can even help us battle the blues. “Our research shows that people who stick closely to a Mediterranean diet enjoy better moods and fewer bouts of depression,” says Natalie Parletta, PhD, Senior Research Fellow at The University of South Australia’s School of Population Studies. “Studies also show that this diet may protect us against dementia.”
Strolls, siestas and socialising
Experts believe the Mediterranean way of life offers other important health benefits.
Regular exercise
Mediterranean villagers tended to walk or cycle everywhere. Even daily chores, such as washing clothes by hand and kneading dough, helped them burn more kilojoules.
Daily siestas
“Shops and businesses would often close in the afternoons to accommodate this refreshing catnap, which could last anywhere from 15 minutes to an hour,” says Catherine Itsiopoulos. US studies suggest that taking regular midday naps (about three times a week for at least 30 minutes) can reduce the risk of death from heart disease, possibly because this helps lower stress levels. Other US research shows that an hour’s nap significantly boosts brainpower, particularly memory.
Strong community ties
“Families lived near each other, and extended family and neighbours often socialised together,” explains Itsiopoulos. “So if you felt lonely or needed help, you always had someone to rely on.” Studies suggest that having strong social networks helps protect brain function as we age.
Want to jump into the Med right now? Start with these easy and delicious meals
Spiced pork with red cabbage, bulgar and parsley salad
Oregano and lemon chicken with kale and chickpeas
Za’atar-roasted vegetable, lentil and couscous pilaf
Mussels in ginger, coriander and garlic
Article sources and references
- Babio et al. 2014. Mediterranean diets and metabolic syndrome status in the PREDIMED randomised trial. CMAJ. 186: e649-57https://www.ncbi.nlm.nih.gov/pubmed/25316904
- Brehm et al. 2009. One-year comparison of a high-monounsaturated fat diet with a high-carbohydrate diet in type 2 diabetes. Diabetes Care 32:215-6https://www.ncbi.nlm.nih.gov/pubmed/18957534
- Charles et al. 2014. Protection from hypertension in mice by the Mediterranean diet is mediated by nitro fatty acid inhibition of soluble epoxide hydrolase. PNAS 111: 8167-72https://www.ncbi.nlm.nih.gov/pubmed/24843165
- Crous-Bou et al. 2014. Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. BMJ 349: g6674https://www.bmj.com/content/349/bmj.g6674
- Esposito et al. 2011. Mediterranean diet and weight loss: meta-analysis of randomised controlled trials. Metabolic Syndrome and Related Disorders. 9:1-12https://www.ncbi.nlm.nih.gov/pubmed/20973675
- Estruch R et al. 2013. Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine 368:1279-90https://www.nejm.org/doi/full/10.1056/NEJMoa1200303
- Lahl et al. 2008. An ultra short episode of sleep is sufficient to promote declarative memory performance. Journal of Sleep Research 17:3-10https://www.ncbi.nlm.nih.gov/pubmed/18275549
- Naska et al. 2007. Siesta in healthy adults and coronary mortality in the general population. Archives Internal Medicine 167: 296-301https://www.ncbi.nlm.nih.gov/pubmed/17296887
- Noah A & Truswell AS. 2001. There are many Mediterranean diets. Asia Pacific Journal of Clinical Nutrition 10: 2-9https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1440-6047.2001.00198.x
- Okinawa Centenarian Study www.okicent.org/study.html Accessed December 2014https://en.wikipedia.org/wiki/Okinawa_Centenarian_Study
- Correspondence with Mary Barry, CEO, the National Heart Foundation of Australia. December 2014https://www.heartfoundation.org.au/images/uploads/main/About_us/HF_AnnualReview_2014.pdf
- Salas-Salvado et al. 2011. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomised trial. Diabetes Care. 34:14-9https://www.ncbi.nlm.nih.gov/pubmed/20929998
- Su Q et al. 2002. Identification and quantitation of major carotenoids in selected components of the Mediterranean diet: green leafy vegetables, figs and olive oil. European Journal of Clinical Nutrition 56:1149-54https://www.ncbi.nlm.nih.gov/pubmed/12428183
- Wang X et al. 2014. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 349:g4490https://www.ncbi.nlm.nih.gov/pubmed/25073782
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