Mediterranean diet

As the name suggests, the Mediterranean diet is borrowed from the people of this region. And although the food traditions of the various countries bordering the Mediterranean Sea, including France, Greece, Italy and Spain, differ depending on culture, history and religion, there are also unifying factors. This is the prevalence of plant products, vegetables, fruits, legumes, nuts, beans, grains, cereals, fatty fish and seafood, essential ingredients - unsaturated fats, such as olive oil, cheese and even red wine. Usually, this includes low consumption of meat and dairy products. According to research by nutritionists, all this only works in combination. [ 1 ]

The Mediterranean diet was first defined by Ancel Keys as a diet low in saturated fat and high in vegetable oils observed in Greece and southern Italy in the 1960s. [ 2 ] In a study of seven countries, this dietary pattern was associated with a reduced risk of coronary heart disease (CHD) compared with northern European countries and the United States after 25 years of follow-up. [ 3 ], [ 4 ] Over the past few decades, research on the Mediterranean diet has advanced, and the definition originally introduced by Keys has evolved and changed. There are several ways to define the dietary pattern, including general descriptions, dietary pyramids, a priori scoring systems, post hoc dietary patterns, or food and nutrient content. [ 5 ], [ 6 ], [ 7 ], [ 8 ]

Indications

The importance of the Mediterranean diet is so important that it has been included in the list of intangible objects of UNESCO World Heritage. The high assessment of this way of eating is due to the fact that it provides effective prevention of excess weight and cardiovascular pathologies. [ 9 ] Thanks to which the lives of millions of people are extended and become more qualitative.

Based on this, clinical indications for the diet are clearly defined. The Mediterranean diet is recommended for the prevention and treatment of the following pathologies:

• obesity; [ 10 ]
• type 2 diabetes; [ 11 ], [ 12 ]
• atherosclerosis; [ 13 ]
• angina pectoris;
• arrhythmia;
• myocardial infarction; [ 14 ]
• hypertension, stroke; [ 15 ]
• ischemic disease;
• depression; [ 16 ]
• Alzheimer's disease; [ 17 ], [ 18 ]
• dementia;
• breast cancer; [ 19 ], [ 20 ], [ 21 ]
• inflammatory bowel disease. [ 22 ], [ 23 ]

The list of indications also includes some intestinal oncopathologies, including colorectal cancer. [ 24 ] The Mediterranean menu is rightly called the diet of long-livers, because it gives the opportunity to live a quality and full life until old age. [ 25 ]

Mediterranean Diet for Weight Loss

The term "Mediterranean diet" is used for convenience to denote the daily diet of the inhabitants of the warm coast, which helps them to be healthy and vigorous, to maintain youth and beauty for as long as possible. Based on this diet, nutritionists offer their own versions of the Mediterranean diet for weight loss - taking into account the beneficial properties of the ingredients and calculating the amount of food. [ 26 ]

Let's focus on the seven-day version, created specifically for the purpose of losing weight. The dishes are composed in such a way that losing weight is tasty and enjoyable - although the portion sizes are reduced.

• Spaniards, Italians, and residents of other coastal areas eat with pleasure and without restrictions, because they do not need to lose weight. If the goal is to lose weight, then you can’t do without restrictions, at least temporary ones.

The Mediterranean menu is so varied that it is somehow inconvenient to call it a diet. Traditional dishes of oatmeal, eggs, sandwiches, fruits, juice, and green tea are offered for breakfast. A glass of dry red wine can be served for lunch, if desired. The food is prepared from pasta, seafood, vegetables, cheese, and olive oil. For dinner, those losing weight on the Mediterranean diet eat rice with greens, hard cheese, and fish – baked or steamed. [ 27 ] Green tea is the preferred drink. The weight of the dishes ranges from 60 to 200 g.

In addition to the main meals, the diet allows one or two snacks per day, consisting of one product. This can be kefir or milk, [ 28 ] nuts, one of the fruits.

Mediterranean Diet for Lowering Cholesterol

The name "Mediterranean diet" is attributed to the American doctor Ansel Keys. The nutritionist studied the connection between the way of eating and some diseases that depend on it: obesity, diabetes, [ 29 ] atherosclerosis, hypertension. According to his observations, these diseases are more common in people living far from the Mediterranean coast.

• The Mediterranean diet for lowering cholesterol is based on the diet of the Spanish, Greeks, and Italians. Experts believe that olive oil, rich in beta-carotene, vitamin E, and healthy fats, is a key element of the diet. [ 30 ]

Modern research confirms the exceptional properties of the product in preventing circulatory system pathologies and aging of the body. [ 31 ] It is especially useful to consume unrefined oil, enriched with polyphenols. It has a bitter taste and a green tint, and is designated on labels as "virgen". [ 32 ]

Butter is a must-have breakfast item, and it has a special place. Even a piece of bread dipped in olive oil is suitable.

• The second essential ingredient of the anti-cholesterol diet is a variety of nuts, which are a source of minerals, proteins, and vitamins. Walnuts are especially beneficial for the heart. [ 33 ]

When using the product for several weeks, cholesterol levels are reduced to normal. According to the conclusions of doctors conducting such studies, a diet based on olive products, with the inclusion of nuts, significantly reduces the risk of developing cardiovascular pathologies. [ 34 ], [ 35 ]

An optional but desirable dietary drink is quality wine. Some write about red, others about white, but everyone agrees that the wine should be dry and in a volume of no more than 200 ml. [ 36 ]

General information Mediterranean diet

When people talk about the Mediterranean diet, they mean not only the food, but also the unique climate, cultural priorities, and lifestyle – a unique philosophy of the inhabitants of the southern latitudes. There are many variations of the diet, as well as countries that are part of the Mediterranean zone. There are 16 of them – from the Spanish coast to the Middle East, and different fruits grow in different places. But the essence of the diet is the same: coastal residents prefer plant and dairy foods, generous gifts of the sea, and also eggs. [ 37 ]

They pay tribute to wines, since their fertile lands generously bear fruitful grape plantations. Such a diet contains a maximum of minerals, antioxidants, vitamins, fiber.

• The diet of these peoples is dominated by healthy fats, but heavy red meat is practically absent.

In addition to food, which should bring pleasure, the inhabitants of the region traditionally perceive life as a holiday, not a heavy duty. This has a positive effect on the emotional state, mood and attitude to the world around them.

In particular, Italians and Greeks are distinguished by strong family ties. They regularly meet in large families for common dinners, are in no hurry and are not fanatical about work. In any case, not all of them can be called workaholics. [ 38 ]

Mediterranean Diet Foods

A typical Mediterranean diet food list consists of the following ingredients:

• olives and olive oil;
• colored vegetables;
• legumes;
• fish, seafood;
• spicy vegetables (onions, garlic);
• greens (basil, rosemary, thyme, oregano);
• grape wine (red varieties);
• eggs;
• walnuts and other types of nuts;
• domestic poultry;
• white bread, rice, pasta, potatoes.

Vegetables suitable for the Mediterranean diet include sweet peppers, eggplants, tomatoes, zucchini, spinach, and broccoli. [ 39 ] Fruits include avocados and grapes. [ 40 ]

Red wine occupies a special place in the diet. Its presence or absence in the diet depends on the local food and religious culture. Traditions of European countries are more loyal to alcoholic beverages, especially to wines of their own production, and red wine is a natural component of feasts. [ 41 ]

• Those countries where non-Christian faiths prevail traditionally do without wine and seem to feel just fine too.

The products consumed daily in the Mediterranean regions are rich in fiber, antioxidants, and healthy fats. The ingredients undergo minimal cooking, so they retain their natural flavor and health benefits. Pork and other types of heavy meat, as well as eggs, are not overused here.

Mediterranean Diet in Russia

The modern world is so small and communicates so closely that the postulates of the Mediterranean diet are applicable in any corner of the planet, far from warm seas and coasts. After all, all the main ingredients can be purchased in most countries that are territorially far from the Mediterranean coast.

The methodology's assets include thousand-year-old traditions, as well as practical examples in our time. Thus, plump Europeans who moved to work or live in Spain, Greece, Italy, thanks to the local nutrition system, soon become slim, younger and healthier before our eyes.

• Fortunately, you don't have to go abroad to lose weight, because the Mediterranean diet is also available in Russia today. It is balanced, extremely healthy and not too expensive.

To create a menu, you need olive oil, nuts, sea fish, a variety of vegetables and fruits, including garlic, milk, cheeses and a variety of fermented milk products, eggs in limited quantities, bakery products and pasta.

Alcohol is a separate item in the Mediterranean diet. More precisely, dry wine for lunch or dinner, in moderate dosage: up to 200 ml. Such a portion is considered to perform the function of preventing cardiovascular pathologies. Spanish legislation even allows such a quantity of wine for drivers who get behind the wheel of cars.

• However, the same Spanish nutritionists warn against the danger of abusing this seemingly weak alcoholic drink.

They mean not only the effect on the brain and psyche of a person, but also the high caloric content of wine. Excess alcohol supplies the body with extra calories that do not represent energy value, but perfectly replenish fat depots.

Detailed menu for every day

When creating a detailed menu for each day, you should use the recommendations of specialists. They primarily concern the ratio of key nutritional components, and not caloric content, as is customary in many other systems.

• Experts advise to imagine the Mediterranean diet as a kind of pyramid.

It is based on carbohydrates, preferably with a low glycemic index. They are found in vegetables and fruits, [ 42 ], [ 43 ] durum wheat pasta, legumes, bread, cereals. The total amount of carbohydrates is 60%.

• 30% of the total caloric content is made up of vegetable fats. The main component is olive oil, which replaces butter, spreads, and other not so healthy fats present on the tables of most Europeans.

Exceptionally useful is extra cold-pressed oil, consisting of monounsaturated and photochemical fats. Less popular, but still used in the diet, oils are soybean, sesame, corn, sunflower, and various types of nuts.

Proteins make up 10% of the diet. They are found in cheeses and low-fat dairy products. Fish and poultry are cooked once a week. Red meat – beef, lamb, pork – appears on the table very rarely. This is heavy food, which diet followers consume in very moderate quantities. Eggs are limited to 4 pieces per week, including baked goods. [ 44 ]

Comparison of dietary recommendations for the three Mediterranean diet pyramids.

Food	Oldway's Recommendations (2009)	Mediterranean Diet Foundation (2011)	Dietary Guidelines for Greece (1999)
Olive oil	Every meal	Every meal	Every meal
Vegetables	Every meal	≥2 servings per meal	6 servings daily
Fruits	Every meal	1-2 servings per meal	3 servings daily
Bread and cereals	Every meal	1-2 servings per meal	8 servings daily
Legumes	Every meal	≥2 servings weekly	3-4 servings weekly
Nuts	Every meal	1-2 servings daily	3-4 servings weekly
Fish / Seafood	Often at least twice a week	≥2 servings weekly	5-6 servings weekly
Eggs	Moderate portions, daily or weekly	2-4 servings weekly	3 servings weekly
Poultry	Moderate portions, daily or weekly	2 servings weekly	4 servings weekly
Dairy products	Moderate portions, daily or weekly	2 servings daily	2 servings daily
Red meat	Less often	<2 servings per week	4 servings per month
Sweets	Less often	<2 servings per week	3 servings weekly
Red wine	Moderately	In moderation and respect for social beliefs	Daily

The indicated serving sizes are: 25 g bread, 100 g potatoes, 50-60 g cooked pasta, 100 g vegetables, 80 g apple, 60 g banana, 100 g orange, 200 g melon, 30 g grapes, 1 cup milk or yogurt, 1 egg, 60 g meat, 100 g cooked dry beans.

Breakfasts

The advantage of the Mediterranean diet is the ability to create your own menu. During the day, the dieter is offered three traditional meals and two snacks. The feature that distinguishes this diet from others is the ability to drink a little wine. According to one version - before lunch, according to others - at lunch and in the evening. It is allowed to replace wine with grape juice, which also contains many antioxidants.

• Carbohydrate dishes rich in energy are prepared for breakfast. Every person needs it in the morning so that during the day it can be spent on mental work and physical activity.

Thanks to this, carbohydrates are not deposited in fat layers. Protein omelet, ricotta cheese, assorted pasta, toast with fruit or smoothie - an excellent set of dishes for a dietary breakfast. Having received the maximum energy material, the body is actively awake during the day. At the same time, calories are successfully spent, not having time to be deposited as excess weight.

• A good lunch consists of pasta, Greek salad, cornbread, chicken breast with olives and rice.

Before lunch, you can drink the notorious wine, without which the Mediterranean diet would be incomplete. For dinner, drink yogurt or savor a cottage cheese and fruit dessert.

During the day, two snacks are recommended: before and after lunch. Nuts, fruits, salads with tuna, feta cheese, olive oil are suitable for snacking.

In general, you need to eat a kilogram of vegetables per day, fresh or processed. [ 45 ] And also drink 7-8 glasses of water - preferably before meals.

Recipes

While some diets are off-putting because they require spending a lot of time in the kitchen and preparing complex dishes, the Mediterranean diet is devoid of these excesses. Sandwiches, rice, nuts, fruits, pasta – simple food for people who eat high-quality natural products, often home-made. The recipes are not at all complicated: baked fish, vegetable stew, cottage cheese casserole or syrniki can be prepared by anyone, even an unprepared person.

• For breakfast they eat oatmeal with milk or fruit, fruit salad, omelette, cheesecakes, whole grain bread.
• They dine on rice and stew, cheese, tuna, and tomatoes.
• For dinner, you can have fish baked with cheese, noodles with seafood, feta salad with avocado, cherry tomatoes, and green salad.
• The best second breakfast is yogurt or kefir, fruit or tea with cookies; afternoon snack is a sandwich, nuts, dried or fresh fruit.

It is recommended to cook vegetables and meat on the grill or in a steamer; cereals should be soaked in water beforehand.

The unit of measurement for a portion is conventionally taken to be a "cup" of 237 ml, which is equivalent to 16 tablespoons. It is recommended to maintain equal intervals of time between meals and snacks, because the more evenly calories are received, the more evenly they are spent.

Benefits

Why does following a Mediterranean diet protect blood vessels and the heart? How and why does such a diet affect human health?

It turns out that the diet of Mediterranean residents effectively counteracts all risk factors for the development of cardiovascular pathologies. This is not only total cholesterol, but also triglycerides and other substances, as well as AT and sugar levels. This is the huge benefit of the diet for a particular person. [ 46 ], [ 47 ]

In addition, studies have unexpectedly discovered another benefit. If it was previously believed that minimizing fats should play an important role in preventing heart disease, now it turns out that it is not the quantity but the quality of fat components that is important. That there are bad fats, and they need to be limited, and there are good fats, which should be present in the diet in even greater quantities. [ 48 ]

• Compelling figures are cited: the Mediterranean menu can reduce the risk of heart disease by a third and malignant tumors by 24%. It also provides prevention of such serious illnesses as Parkinson's and Alzheimer's diseases. [ 49 ], [ 50 ]

Followers of this diet, combining it with physical activity, successfully get rid of excess weight. Perhaps not as quickly as with fashionable express methods, but safely. And, as the experience of the Mediterranean confirms, forever. At the same time, the diet helps eliminate cellulite, and also improves the condition of nails, skin, and hair. [ 51 ]

What can and what can not?

When answering the question: what can you eat? – you should start from the so-called pyramid principle. At its base are products for the daily diet, consumed in large quantities, and at the top are foods that are eaten occasionally and in small amounts. The pyramid is divided into blocks.

• For breakfast, you should eat carbohydrate foods, and in the evening - protein foods. Instead of sugar, it is better to put honey or sugar substitutes in tea.

Water occupies a special place in the Mediterranean diet. It is consumed 2 liters per day. We are talking about pure water - without gas, dyes and flavors. Other drinks are not prohibited, but limited (coffee, tea). The exception is green tea, which can be drunk both in the morning and in the evening. Soups, compotes, teas are also sources of liquid. The effectiveness of the diet directly depends on the sufficient amount of liquid.

A distinctive feature of the diet is the presence of alcohol. Most methods strictly prohibit any alcohol. In our case, there is alcohol traditional for southern peoples - natural grape wine. Dry grape drink is not only an excellent aperitif: red wine contains flavonoids, antioxidants, minerals, and vitamins that are beneficial for the body.

The peculiarity of the Mediterranean diet is that it divides foods into several groups:

• those who eat every day;
• those that are allowed once a week;
• those that are present on the menu occasionally: only a few times during the month.

The daily diet consists of traditional southern foods: vegetables, fruits, [ 52 ] olive oil, legumes, pasta, cereals, cheeses, yogurt, water. Potatoes are allowed only in the first half of the day.

What you can't eat every day is fish, meat, eggs. They are eaten no more than 2-4 times a week. You can't drink industrial juices, sweet soft drinks and sweet wines, strong alcohol, coffee, semi-finished products, fast food, butter. Sugar - infrequently and in small portions, and it is better to sweeten drinks with natural honey.

The permitted food is divided into 5 meals: three main meals and two snacks. The range of Mediterranean products is quite varied to prepare enough tasty and healthy dishes every day. You can drink wine twice a day, up to 150 ml in total.

The main idea of the diet is to normalize weight through normalizing metabolism. It is ideal for those who are ready to eat this way constantly, follow healthy eating habits and achieve slow but sure results.

Contraindications

According to nutritionists, the Mediterranean diet is an example of a balanced diet. It has virtually no shortcomings, so it is recommended for all categories of people who do not have indications for special nutrition. It is not even contraindicated for pregnant women if the woman eats such food for a long time. However, it is not entirely justified to switch to a new diet precisely during pregnancy if the woman previously ate differently.

• We can talk not so much about contraindications as about some shortcomings of the diet. It is not suitable for those who want instant results, regardless of the price of the issue.

The diet is effective if it becomes permanent, almost a way of life for the person losing weight. Fats in the body are burned slowly but surely. That is why experts advocate that more people with excess weight make such a diet permanent.

Compared to other methods, the Mediterranean diet is very loyal. True, the diet contains almost no sweets, and this can be a real challenge for those with a sweet tooth. And, of course, individual intolerance to certain products or food components is not excluded. [ 53 ]

Possible risks

People with severe obesity wait in vain for the effect, hoping only for the Mediterranean diet menu. In their case, more rigorous correction methods are necessary. For other categories of losing weight, you should be patient: body weight decreases, but gradually.

There is information about observations of pregnant women regarding the risks associated with diet. Women ate in their usual way, recording all the products they consumed. It turned out that a diet as close as possible to the Mediterranean diet has the best effect on the health of the future child. In particular, the risk of asthma and allergies in children is reduced. This was confirmed by subsequent observations of children during the first six years of life. [ 54 ]

Complications

The Mediterranean diet does not cause harm to a healthy person. Possible complications when eating dishes with vegetables, fried meat, garlic, spices threaten people with gastrointestinal problems, severe liver and gallbladder disorders. In case of severe heart pathologies, the dietary ration should be agreed with the attending physician.

Reviews

Nutritionists leave positive reviews about the Mediterranean diet. In their opinion, the Mediterranean diet, with some clarifications, is suitable for everyday family nutrition. The result is slow, but stable and reliable.

Some who have lost weight do not see any disadvantages in the method. They note the benefits, the absence of discomfort and additional costs, which many other methods cannot do without. They write about the improvement of the skin condition and health in general. Weight loss is observed at 3-5 kg per month.

In more northern latitudes, people are faced with the fact that quality fresh vegetables at affordable prices run out in the fall and reappear on the shelves the following summer. This makes the diet more expensive for them.

Results

The first results become noticeable after one or two weeks. They manifest themselves in body shaping and improved well-being. The results should be supported by more intensive exercise, healthy eating and lifestyle. It is not for nothing that the Mediterranean diet is often practiced by world celebrities: stars of show business and the film industry. For many, the system has become a way of life and a way to always be in the best shape.

A smooth weight loss is not stressful for the body, so the kilograms are in no hurry to return. In addition to a slimmer figure, a person who has lost weight gains experience in healthy eating, as well as the opportunity to make it permanent.

The main disadvantage of the Mediterranean diet is slow weight loss. But this is not a priority for those who have decided to eat right. The main goal of the method is to accustom to a healthy diet and improve the condition of the body as a whole. Unlike strict diets, you can live on such a diet permanently, normalizing your weight and strengthening your health without stress and hunger.