The Mediterranean Diet

By Joel Fuhrman, M.D.www.drfuhrman.com

Contrary To Common Misconception, Olive Oil And Pasta Are Not Health Foods.

The term Mediterranean diet describes a cuisine with certain characteristics common to countries bordering the Mediterranean Sea. These cuisines have been traditionally plant-based, with fruits, vegetables, cereals, legumes, and nuts eaten regularly. Red meat is rarely consumed, chicken and fish appear in small amounts, yogurt and cheese are used as condiments, and red wine is consumed regularly. One of the most defining characteristics of this dietary approach is the use of pasta and olive oil. Whereas most of the fat in the American diet comes from cheese, butter, and meat (all containing dangerous trans fats), the principal fat source in the Mediterranean diet is olive oil.

Compared with the American population, those eating a more traditional Mediterranean diet in that region exhibit a lower risk of heart disease and common cancers. Heart attack rates are about 25 percent lower than in the U.S., and the rate of obesity is about half that seen in America. The increased amount of broccoli, nuts, and beans, and the heavy use of tomatoes in cooking, makes most of the dishes rich in phytochemicals, which accounts for the protective effects. The climate and fertile soil surrounding the Mediterranean Sea make this area home to a wide spectrum of high-nutrient plants, including broccoli, tomatoes, grapes, figs, walnuts, and olives. The use of fish instead of meat is also an obvious factor that decreases saturated-fat consumption and increases the intake of beneficial omega-3 fats.

Nuts, especially walnuts, are commonly used in dishes. In small amounts, these have beneficial effects, and walnuts are a good source of omega-3 fatty acids. Numerous studies have shown that men who eat walnuts regularly have half the heart disease rates of men who rarely eat these nuts. Additional studies have shown a similar protective effect for women. For these reasons, it is easy to understand why the Mediterranean diet is considered healthful, compared with the standard American diet.

Beneficial health outcomes are also evident in other areas of the world, such as Japan, rural China, Fiji, and Tibet. People in these regions have substantially lower rates of heart disease, cancer, and obesity, and their elderly people are healthier and live longer, than in the United States. We can learn about the positive aspects of all of these culturally diverse diets, and utilize their culinary principles to make a diet deliciously varied and even more disease-protective than the Mediterranean diet. However, we do not want to replicate the drawbacks and unhealthful aspects of these regional cuisines, such as white rice in the Chinese diet and high salt intake in the Japanese diet.

Mediterranean Diet Realities

The fast food and food technology industries have permeated most of the modern world. Mediterranean people now follow a diet much like our own, and the rates of heart disease and obesity are skyrocketing in these countries. In Italy, the diet they follow today does not follow the guidelines of the old-time, healthful Mediterranean style. They eat much like we do, eating more cheese and fewer vegetables than before. They now have the same high prevalence of high cholesterol levels and heart attack risk as Americans. (European Journal of Clinical Nutrition 2005; 59, 584-591)

There is very little difference between white bread and white pasta. The consumption of refined white flour has been linked to diabetes, obesity, heart disease, and various cancers. The pasta aspect of the Mediterranean diet should not be mimicked. Whole grains are immensely superior to refined white flour. Still, these are not ideal human foods and should be eaten sparingly. The benefit of the Mediterranean style of eating comes from the large consumption of fruits and vegetables, not the large consumption of pasta or, as I describe below, oil.

All oil, including olive oil, contains 120 calories per tablespoon, and those tablespoons of fat calories can add up fast. Certainly, it is better to use olive oil rather than butter or margarine, but this feature of the Mediterranean diet easily can sabotage your successful results. Ounce for ounce, olive oil is one of the most fattening, calorically-dense foods on the planet. It packs more calories (4,020) per pound than butter (3,200). The bottom line is any oil will add fat to our already plump waistlines, heightening the risk of disease, including diabetes and heart attacks. Using oil in the preparation of meals will make losing weight more difficult, and many people will not lose weight at all.

A Heavy Dietary Burden

A small amount of olive oil would be fine in an otherwise high-nutrient diet, if the person were thin and very physically active. However, for the overweight individual, oil could add another 300 to 700 calories to the daily menu. Those low-nutrient calories impede the goal of superior health and weight loss. When vegetables are prepared in olive oil, they soak up more oil than you think. Using oil in the preparation of vegetables transforms these filling and satisfying low-calorie foods into high-calorie dishes.

To continue to eat foods prepared in oil and maintain a healthful, slender figure, dieters must carefully count calories and eat tiny portions. All of those calories supplied by olive oil can add up to almost one-third of the total caloric intake, making the diet significantly lower in nutrients and fiber as well. Remember, oil does not contain the nutrients, fiber, or phytochemicals that were in the original seed or fruit. Olive oil contains few nutrients (except a little vitamin E) and a negligible amount of phytochemical compounds compared with the calories supplied.

The Mediterranean people of past years ate lots of olive oil, but they also worked hard in the fields, walking about nine miles a day, often guiding a heavy plow. When reading about the Mediterranean diet, most Americans don’t take home the message to eat loads of vegetables, beans, and fruits and do tons of exercise; they just accept the myth that olive oil is a health food.

Today, Mediterranean people are overweight, just like us. They still eat lots of olive oil, but their consumption of fruits, vegetables, and beans is down. Meat, cheese, and fish consumption has risen; physical activity level has plummeted. Let’s not consider that something to mimic!

My book, Eat To Live, utilizes the valuable aspects of the Mediterranean diet, but leaves behind its weaknesses, so that we do not merely reduce heart disease and obesity a little bit, but eliminate it altogether. Even those with a genetic history of heart disease can be heart disease-free.

I don’t know about you, but for me, a 25-percent reduction in the risk of heart disease by following the Mediterranean diet does not excite me. I want my risk reduced 100 percent; that’s why I Eat To Live.

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