Mediterranean Diet: Recommended by Healthcare Professionals

Most of the diets handed down from healthcare professionals to their patients can be regarded (sometimes by both parties) as punishment for past excesses. The diets themselves are often spartan regimes unrelieved by tasty or satisfying foods.

The Mediterranean diet is different. The variety of taste and texture, the bright colorful fruits, vegetables and pulses, the discovery of fish as an exciting and tasty alternative to meat makes the diet easy and satisfying to follow and easy to recommend.

The following should be recommended.

Bread, Potatoes, Pasta, Rice and Other Cereals

1) These are filling but not fattening and should contribute half the calories of the diet.
2) They should form the largest part of the main course dish.
3) Add a wide variety of vegetables or salad and smaller quantities of meat, poultry or fish.
4) Eat all types and choose wholegrain varieties where possible for their extra fiber.

Fruit and Vegetables

1) Choose a wide variety and eat at least five portions a day (not counting potatoes).
2) Include seeds, pulses and nuts, which are all good sources of essential fatty acids and soluble fiber.
3) Fruit and green leafy vegetables are a good source of soluble fiber, vitamin C and folic acid.
4) Yellow, orange and red fruits and vegetables contain vitamins A, C, E, beta-carotene and other antioxidants which protect against heart disease.

Meat, Poultry and Fish

1) Meat is a good source of protein and some vitamins and minerals, but fatty meat is high in saturated fats.
2) Choose lower fat alternatives such as poultry, fish or lean red meat.
3) Oily fish is a good source of essential fatty acids which may protect against heart disease.
4) Eat fish, including oily fish, such as mackerel, herring, tuna and salmon, at least three times a week.

Milk and Dairy Products

1) Dairy products, including low-fat varieties, are a very good source of protein, vitamins and minerals, especially calcium, which is needed for healthy bones.
2) Cheese, butter, whole milk and cream are high in saturated fat and total fat.
3) Choose lower fat varieties, such as low-fat yoghurts, fromage frais, skimmed and semi-skimmed milk.

Olive oil

1) Olive oil is the main source of fat in the Mediterranean diet and is a good source of MUFA.
2) Ideal for dressings, frying, baking, stir fries and marinades for fish and meat.

Fatty and Sugary Foods:

Eat only small amounts of fried foods, cakes, pastries and chocolates, and not too often.


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Mediterranean Diet Recipe: Daube De Cuisse De Canard

Daubes, or long-cooked stews, are popular throughout Province and the region of Nice. Beef and lamb are commonly used, but so are game and domestic fowl. This recipe comes from Franck Cerutti, owner-chef of Don Camillo in Nice, where authentic local cooking is presented in a refined but not sissified form. To accompany it, serve polenta or gnocchi tossed with butter and Parmigiano-Reggiano.

Ingredients required:
10 duck legs
Extra-virgin olive oil
Butter
2 carrots, diced
2 onions, chopped
4 shallots, chopped
2 stalks celery, diced
1 tablespoon flour
1 (750-milliliter) bottle dry red wine
2 to 3 sprigs fresh thyme
2 to 3 sprigs fresh rosemary
2 bay leaves
2 sprigs fresh thyme
6 juniper berries
Salt
Freshly ground pepper
1 tablespoon glace de viande, optional

Procedure:
• Cut duck legs in half lengthwise. Put plenty of oil and butter in large heavy-bottomed pot and cook slowly in batches, turning frequently until lightly browned on all sides.

• Return all cooked duck pieces to pot. Add carrots, onions, shallots and celery. Increase heat and cook 5 minutes, stirring frequently.

• Turn all ingredients out of pan into colander. Let drain 5 to 10 minutes. Place ingredients in large terracotta or glass baking dish that can be covered. Sprinkle flour over ingredients and stir until it disappears. Add wine, thyme, rosemary, bay leaves and juniper berries. Season to taste with salt and pepper. Cover tightly and bake at 325 degrees, without lifting lid, 2 hours.

• When daube is done, stir in glace de viande. Serve 3 pieces per person. There will be 2 pieces left over for those who want seconds.

• Makes 6 servings.

Each serving contains about:
658 calories;
206 mg sodium;
93 mg cholesterol;
52 grams fat;
13 grams carbohydrates;
13 grams protein;
0.82 gram fiber.

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Mediterranean Diet and Cancer

It is generally accepted that diet is an important factor in the aetiology of cancer. The scientific evidence for detailed recommendations with respect to cancer prevention is limited by the difficulty in designing and implementing strictly controlled intervention studies to support the role of single foods or nutrients.

However, there is some evidence supporting the beneficial effects of components of the Mediterranean diet. For example, the link between animal fat intake and colorectal cancer is particularly strong. In contrast, Greece, Spain and southern Italy, where animal fat intakes are low and olive oil intake is high, have relatively low colon cancer mortality rates. High fiber foods, such as those found in the Mediterranean diet, are also protective against colorectal cancer.

A high intake of fruit and vegetables (particularly raw vegetables) protects against cancers at various sites, especially those of the digestive and respiratory tracts and the hormone-related cancers. Fruit and vegetables contain a variety of anti-carcinogenic agents: carotenoids, vitamins C and E, dietary fiber, selenium, glucosinolate, indoles, flavenoids, protease inhibitors and plant sterols. Only the actions of antioxidant vitamins and pro-vitamins are supported by epidemiological studies at present, but it is likely that all have a protective role in certain circumstances.

Olive oil has been shown to have an effect in preventing breast cancer, and there is evidence for its role in colon, endometrium and ovary cancer prevention. There is no evidence implicating either olive oil or fruit and vegetables in causing or promoting cancer at any site.

The Europe against Cancer program made the following recommendations on nutrition and diet:
1) Increase the daily intake of fresh fruits and vegetables, as well as high-fiber grain products.
2) Avoid obesity, increase regular physical activity and limit the intake of high-fat foods
3) Reduce alcohol consumption.

These recommendations are largely fulfilled by following the traditional Mediterranean-style diet.


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Key Ingredients of Mediterranean Diet

There are five key ingredients to the Mediterranean Diet:

Olive Oil
Its delicate taste has made it a foodie favorite and it is indispensable to most Italian and Spanish dishes. Olive oil is far better than butter for the heart because it is rich in mono-unsaturates, a type of fatty acid thought to help protect against heart disease by reducing high density lipoprotein concentrations in the blood. Olive oil contains the same amount of calories as other oils, so excess could lead to weight gain.

Garlic
Its distinctive flavor adds that special something to the most basic sauce, and a Latin flavor to the breath. But the hidden benefits are great. Regular consumption protects against heart disease by decreasing the level of cholesterol in the blood and lowering blood pressure. Cooking garlic removes most of the smell.

Oily Fish
Tuna, swordfish and salmon are generally holiday treats, but if they replaced red meat in our everyday diet we would be slimmer and healthier. The health benefits are well-documented. Fish oil contains essential fatty acids which reduce the risk of heart disease by lowering levels of 'bad' cholesterol.

Fruit and Vegetables
Mediterranean vegetables may be common to us, but are prepared and served imaginatively to bring out the flavors and textures. The World Health Organization recommends we eat 400g of fruit and vegetables a day - about five pieces. Eating this amount is both filling and a source of vital nutrients, especially antioxidant vitamins which may protect against some cancers.

Red Wine
Few diets allow the luxury of a drink; our diet encourages it. The benefits speak for themselves. The French drink ten times more than their American counterparts, and there are no prizes for guessing which nation is fatter and more prone to heart disease. Red wine contains flavonoids which attack heart disease from two fronts, as antioxidants and platelet inhibitors. Wine contains high levels of natural aspirin, and in France is still sometimes prescribed as a diuretic and a source of minerals. It is also thought to play a role in killing bacteria. But most importantly, a glass of red wine is delicious, relaxing and highly Continental.




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Effect of Mediterranean Diet on Various Diseases

Mediterranean diets have an effect on various diseases. Their effects are as follows:

Hypertension:
A direct relationship between dietary fat intake and hypertension has not been proved but evidence indicates that the balance offered by the Mediterranean diet (low SFAs, high MUFAs, carbohydrate, fiber, vitamin and mineral content) has a favorable effect on blood pressure.

Diabetes:
The Mediterranean diet contains a lot of vegetables and cereals, and meets the demands of an adequate diabetic diet. Carbohydrates are usually taken as fiber-rich foods and fats as MUFAs not SFAs; the total fat content being variable depending on individual needs for weight loss.

Obesity:
The fiber-rich carbohydrates of the Mediterranean diet help protect against and reduce obesity. The reduction in animal fats also offers the opportunity for achieving a more sensible balance of energy intake.

Thrombosis:
A low-fat diet or a vegetable fat diet is preferable to a high SFA diet for protection against thrombosis, therefore the Mediterranean diet is recommended for the prevention of thrombosis.

Lipid levels:
There is a direct correlation between plasma cholesterol levels and CHD. Lowering cholesterol levels reduces the risk of heart attacks. A 1 per cent reduction in cholesterol produces a 2-3 per cent reduction in CHD risk.

There are two types of cholesterol - LDL and HDL. High levels of the latter reduce the CHD risk, while high levels of LDL cholesterol increase the risk. High levels of triglyceride fats, especially with high levels of LDL and low levels of HDL also increase the risk of CHD.

Three saturated fatty acids (SFA) - lauric, myristic and palmitic acids - comprise 60-70 per cent of all SFA. Replacing SFA in the diet with monounsaturated fatty acids (MUFA) or polyunsaturated fatty acids (PUFA) helps to maintain a good energy balance.

The primary dietary PUFA is linoleic acid contained in vegetable oils, such as sunflower oil. This markedly lowers cholesterol when substituted for SFA. Alpha-linoleic acid (in soybean and rapeseed oils), and eicosapentaenoic acid and docosahexaenoic acid (in oily fish such as herring and mackerel) lower triglyceride levels with little effect on cholesterol levels.

The major dietary MUFA is oleic acid, the predominant fat in olive oil. MUFAs and PUFAs both significantly reduce LDL when substituted for SFA. A high MUFA intake does not significantly alter HDL levels. LDL cholesterol in people on high MUFA diets is more resistant to oxidation, a process which causes free radical production detrimental to cells.


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Delights of Mediterranean Diet

Nothing conjures up the delights of a Mediterranean holiday better than a snapshot of a simple wooden table laden with food. There's a rack of grilled sardines, a plate of tomatoes drizzled with olive oil and a bottle of robust warm red wine. Lazing on a sun dappled porch, every British tourist has harbored dreams of living like this back home. But as winter sets in, and the memories of the sun recede, so too does the lifestyle of Italy, Greece, southern France and Spain and the lithe, toned body we had begun to attain on holiday.

For it is one of life's ironies that we can eat and drink uninhibitedly while relaxing in the Mediterranean, yet gain weight instantly we return to England and a cupboard stocked with crisp breads.

This apparent contradiction has a simple explanation. The foods we eat on holiday are both delicious and naturally slimming - olive oil instead of animal fat, fish instead of meat, and lots of pasta, red wine and fresh fruit and vegetables.

Switching to a southern European diet could help us stay slim throughout the year. What's more, the sumptuous ingredients and tasty recipes will remind you of hotter, happier times.

So why do we not do as the Romans do, and eat like this all year round? The reason used to be that essential ingredients simply weren't available. That is no longer the case. Almost all the staples of the southern European diet are now available on our supermarket shelves.

It's now quite usual to find feta cheese, and fresh olives alongside the English cheddar and meat pies. Olive oil, once a specialist item, now takes up as much room on the shelves as lard. Even modest shops have several varieties.

Our new lifestyle plans very easily makes clear how to combine the flavors of the Mediterranean, and a more active lifestyle, to stay fit, strong and gastronomically satisfied throughout the winter months.

Pessimists will insist that such a luxurious existence cannot possibly be healthy. Thankfully they are wrong. Medical studies have shown that a gourmet diet with wine is better for both health and happiness than a strict low-fat regime.

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