Exploring the Mediterranean Diet and Heart Health

July 28, 2019

"The Mediterranean diet is a wonderful diet that helps reduce your risk of heart disease."

In today’s Inside Health, Dr. Keller Wortham, MD, will continue his series on popular diets by taking a look at the Mediterranean Diet. Dr. Keller will share a few of the healthy, great-tasting foods from this diet, and he’ll examine both the various health benefits and potential drawbacks associated with the Mediterranean Diet.

Video Highlights

  • 2:06: What exactly is the Mediterranean Diet?
  • 2:49: Four pillars of the Mediterranean Diet
  • 4:15: Less Known Benefits of the Mediterranean Diet
  • 5:10: Coronary Heart Disease
  • 06:34: How the Mediterranean diet reduces the risk factors of coronary heart disease
  • 12:05: Potential Drawbacks of the Mediterranean Diet
  • 14:20: Top 7 Mediterranean Diet Tips
  • 16:16: Wrap-Up

What exactly is the Mediterranean Diet?

There’s not really one hard and fast definition of what the Mediterranean diet entails. Basically, it’s a way of eating that incorporates the eating styles in the countries along the Mediterranean, like Greece, Italy, Coastal Spain, and even further east like Turkey and Lebanon. Some of the foods eaten in these regions include:

  • A lot of fresh seafood
  • A lot of fruits and vegetables
  • A lot of whole grains
  • Limited amounts of dairy
  • Limited amounts of red meat

Four pillars of the Mediterranean Diet

The Mediterranean diet includes four basic pillars:

  • Daily Fruits and vegetables — The communities that live in the Mediterranean region consume plenty of vegetables that include broccoli, peppers, and cucumbers, as well as fruits such as mangoes, oranges, and bananas.
  • Weekly Eggs and fresh seafood — These are not consumed as much as the fruits and vegetables; they include salmon and farm raised eggs.
  • Moderate Dairy — The dairy consumed here tends to be lighter dairies like Feta Cheese.
  • Limited amounts of red meat.

Lesser Known Benefits of the Mediterranean Diet

During the 1960s, doctors and researchers in the medical community started to notice that people who live in these countries, around the Mediterranean, tended to die a lot less frequently from cardiovascular disease, coronary artery disease, or heart disease. 

So they started asking why these people were dying in so much lower numbers than their counterparts in the United States and in Northern Europe. They started to study and they found that the diet of the Mediterranean is very good at reducing some of the things that lead to coronary artery disease. 

Coronary Heart Disease

The heart is a very vital organ and it has tiny little blood vessels that bring oxygen and blood to it. These are called the coronaries. There are things in our diet that cause an increase in cholesterol and an increase in inflammation. As these two things go up, our arteries in general start to get inflamed, they become less flexible, they become thicker, and they start to build up deposits of cholesterol. This causes a narrowing of that little artery. If gunk builds up in the arteries to your heart, it’s not a good thing. This is because the heart cannot get the oxygen it needs, which can lead to a heart attack. 

This is important because coronary artery disease is the number one killer of people in the US. One out of four people will eventually die of coronary artery disease. It is the number one killer in both men and women. 

How the Mediterranean diet reduces the risk factors of coronary artery disease

Well, the secret to the Mediterranean diet’s success at helping to lower risk is in a couple of arenas:

  • Number one, you’re getting a lot of fruits and vegetables in this diet. You’re basically having a plant-based diet, which has a lot of antioxidants and they are very high in fiber which can help reduce cholesterol. These two things are very good at keeping arteries clean.
  • Healthy Fats — These do not include things like butter, or Crisco, or fried foods. We are talking about the healthy fats that exist naturally in things like salmon which is very rich in omega-3s, olive oil which is rich in omega-6, fresh olives themselves, and nuts like almonds. These do something very particular to the cholesterol levels. They start to lower them and they start to cause a shift from bad cholesterol, also known as IDL, to the good cholesterol, known as HDL. They also can lower triglycerides, which are other fatty components of the blood that can be very bad and inflammatory for your vessels. 
  • Limited portions of things that are pro-inflammatory. In the Mediterranean diet they do not eat a lot of red meat, which is very high in saturated fat, very high in cholesterol and is very inflammatory to the vascular system. If you want to basically eat a Mediterranean diet, you’re going to start reducing your amounts of red meat you eat, and begin looking to improve and increase the whole greens, fresh fruits, fresh vegetables and some cholesterol-lowering powerhouses that include the antioxidants that we talked about, and the omega-3s found in olive oil and in seafood. 
  • Wine — There is a mixed bag with any kind of alcohol. However, there are studies that do show that limited amounts of red wine have certain properties that can help protect your arteries against inflammation, help manage cholesterol. However, there are other studies that show that alcohol in any form is certainly a toxin and there have been recent studies that show that alcohol in any form does actually limit life. When it comes to a Mediterranean diet, the big question about whether you can have alcohol or not, if you’re drinking already, is to try to keep it in moderation. If you are choosing alcohol, red wine is probably one of the best ones you can choose from a health standpoint and you want to keep it in moderation. For women this means one glass of red wine, for men it means two. As a counterpoint to this, if you don’t drink already, don’t start drinking anything, red wine or otherwise, just for health benefits. 
  • The meals in the Mediterranean tend to be very communal affairs. When we come together and we share a meal together, that conversation and that connection tends to improve our endorphins, reduce stress, lower cortisol (the stress hormone). This way of eating has been shown to be very anti-inflammatory for the body. Also the conversation typically can lead us to maybe eat a little bit less and make healthier choices. So that’s another component you might want to think about when planning your meals.

Potential Drawbacks of the Mediterranean Diet

There are some things that you might want to consider when choosing this type of diet. Some potential drawbacks include:

  • The Mediterranean diet is high in grains. It includes whole grains like Farro and whole wheats. However, grains that are more processed, pastas, and pizzas have a lot of gluten in them and this can be inflammatory, especially for certain people. So you might want to think about limiting the amount of processed grains that you have with your diet.
  • The Mediterranean diet is very rich in nightshade vegetables. Nightshade vegetables include tomatoes, eggplants, and mushrooms. This particular category of vegetable or fruit could also be very inflammatory. If you’re someone who suffers from inflammation, either because of an autoimmune disorder like rheumatoid arthritis, or because of a gut issue, maybe crohn's disease or maybe another inflammatory bowel disease, you really might want to consider limiting the amount of nightshade vegetables that you include in your Mediterranean diet.
  • When following this type of diet, you may also want to look at how much dairy you consume. Some people are more sensitive to dairy than others. At least in the Mediterranean diet, they tend to opt for some of the healthier, leaner dairies, such as Feta cheese and fresh Greek yogurts. These dairy products have less of an effect than some of the heavier cheeses or some of the processed dairies that you might get in other diets.

Top 7 Mediterranean Diet Tips

  1. Try to get lots of fruits and vegetables. This is a plant-based diet, with some of the primary elements including broccoli, peppers, and cucumbers.
  2. Go for more whole grains and seeds and other things like lentils and beans.
  3. Stick to healthy fats such as olive oil and avocado oil that help cut inflammation and help to lower cholesterol.
  4. Choose seafood like wild-caught salmon, which is rich in omega-3, as compared to other meats.
  5. Drastically reduce your red meat intake, especially processed red meats like ground beef or other processed meat like salami, and things like that.
  6. Consume dairy and eggs in more limited quantities, compared to what you might be eating right now. 
  7. The Mediterranean is great at adding a lot of wonderful spices: oregano, peppers and salt, different kinds of paprika and saffron, and lots of spices that you can put in your diet. This will give your meals a lot of flavor without having to add a lot of sugar.

Wrap-Up

The Mediterranean diet is a wonderful diet that helps reduce your risk of heart disease. It’s been shown to actually do that and these communities around the Mediterranean are already benefiting. People in Greece have a heart attack 50% less often than those in the United States or in northern Europe. This statistic alone shows that they’re doing something right. So consider this one of the good diet options out there!

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