Mediterranean diet

As the name suggests, the Mediterranean diet is borrowed from the inhabitants of this region. And while the food traditions of different countries bordering the Mediterranean, including France, Greece, Italy and Spain, differ depending on culture, historical and religious characteristics, there are also unifying factors. This is the prevalence of plant products, vegetables, fruits, legumes, nuts, beans, cereals, grains, oily fish and seafood, essential ingredients are unsaturated fats such as olive oil, cheese and even red wine. This usually includes low consumption of meat and dairy products. According to research by nutritionists, all this works only 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 seven-country study, this diet was associated with a reduced risk of coronary artery disease (CHD) compared with the Nordic countries and the United States after 25 years of follow-up. [3]The  [4] study of the Mediterranean diet has moved forward over the past few decades, and the definition originally coined by Keyes has evolved and changed. There are several ways to define a diet, including general descriptions, dietary pyramids, a priori scoring systems, a posteriori nutritional structure, or food and nutrient content. [5],  [6],  [7], [8]

Indications

The importance of the Mediterranean diet is so important that it has been listed as an Intangible World Heritage Site by UNESCO. This method of nutrition is highly appreciated due to the fact that it provides effective prevention of excess weight and cardiovascular pathologies. [9] Thanks to this, the lives of millions of people are prolonged and become of better quality. 

On this basis, the clinical indications for the prescription of 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;
• arrhythmias;
• 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 cancer pathologies, including colorectal cancer. [24] The Mediterranean menu is rightfully called the diet of centenarians, because it makes it possible to live well and fully until old age. [25]

Mediterranean diet for weight loss

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

Let's dwell on the seven-day version, created specifically for the purpose of weight loss. The dishes are arranged in such a way that it is tasty and pleasant to lose weight - however, the mass of portions is cut.

• Spaniards, Italians, 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 one cannot do without restrictions, at least temporary.

The Mediterranean menu is so varied that it is somehow inconvenient to call it a diet. Breakfast offers traditional dishes of oatmeal, eggs, sandwiches, fruits, juice, green tea. For lunch, if you wish, you can serve a glass of dry red wine. Food is prepared from pasta, seafood, vegetables, cheese, olive oil. Those who are losing weight on a Mediterranean diet have supper with rice with herbs, hard cheese, fish - baked or steam. [27] Green tea is preferred as a drink. The mass of dishes is from 60 to 200 g.

In addition to the main meals, the diet allows one or two snacks per day, consisting of one food. It 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 was created on the basis of the nutritional method inherent in the Spaniards, Greeks, 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 the prevention of pathologies of the circulatory system and aging of the body. [31] It is especially beneficial to consume unrefined oil enriched with polyphenols. It has a bitter taste and a green tint, and is labeled as "virgen". [32]

Butter is a must-have breakfast product, which has a particularly important place. Even a slice of bread dipped in olive oil is suitable.

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

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

An optional but desirable diet 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 of the mediterranean diet

When they talk about the Mediterranean diet, they mean not only food, but also the unique climate, cultural priorities, and lifestyle - a kind of philosophy of the inhabitants of the southern latitudes. There are many options for the diet, as well as the countries included in 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: the inhabitants of the coast give preference to plant and dairy foods, generous seafood, and eggs. [37]

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

• Healthy fats predominate in the diet of these peoples, but heavy red meat is practically absent.

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

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

Products for the Mediterranean diet

A typical Mediterranean diet 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 varieties of nuts;
• home-grown poultry;
• white bread, rice, pasta, potatoes.

Sweet peppers, eggplants, tomatoes, zucchini, spinach, broccoli are suitable vegetables for the Mediterranean diet. [39] Their fruits are avocados, 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. The 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 do great too.

Foods consumed daily in the Mediterranean regions are rich in fiber, antioxidants, healthy fats. The ingredients are minimally processed, so they retain their natural taste and benefits. Pork and other types of heavy meat, as well as eggs are not abused here.

Mediterranean diet in Russia

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

The methodology has thousands of years of tradition, as well as practical examples in our time. So, overweight Europeans who moved to work or a place of residence in Spain, Greece, Italy, thanks to the local food system, will soon become slim, younger and healthier before our eyes.

• Fortunately, it is not necessary to travel to lose weight, because the Mediterranean diet is also available in Russia today. It is balanced, as useful as possible, and not too expensive.

To compose the menu, you need olive oil, nuts, sea fish, assorted vegetables and fruits, including garlic, milk, cheese and a variety of dairy products, eggs in limited quantities, bakery and pasta.

Alcohol is a separate line in the Mediterranean diet. More precisely - dry wine for lunch or dinner, in moderate dosage: up to 200 ml. Such a portion is believed to perform the function of preventing pathologies of the cardiovascular system. Spanish law even allows this amount of wine to be driven by drivers.

• However, the same Spanish nutritionists warn against the danger of abuse of a weak, seemingly, alcoholic beverage.

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

Detailed menu for every day

When drawing up a detailed menu for every day, you should use the recommendations of specialists. They primarily relate to the ratio of key nutrient components, and not calorie content, as is customary in many other systems.

• Experts advise to present the diet of the Mediterranean diet in the form of a kind of pyramid.

It is based on carbohydrates, preferably with a low glycemic index. They contain fruit and vegetables  [42],  [43] pasta from durum wheat, beans, bread, cereals. The total amount of carbohydrates is 60%.

• Vegetable fats account for 30% of the total calories. The main ingredient is olive oil, which replaces butter, spreads, and other not so healthy fats that are present on the tables of most Europeans.

Extremely beneficial is the 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.

10% of the diet is protein. They are found in cheeses, low-fat dairy products. Fish and poultry are cooked once a week. Red meat - beef, lamb, pork appear on the table quite rarely. This is a heavy food that the followers of the diet consume in very moderation. Eggs are limited to 4 per week, including baked goods. [44]

Comparison of dietary recommendations for the three pyramids of the Mediterranean diet.

Food	Oldway's Recommendations (2009)	Mediterranean Diet Foundation (2011)	Diet Guidelines for Greece, (1999)
Olive oil	Every meal	Every meal	Every meal
Vegetables	Every meal	≥2 servings of each meal	6 servings daily
Fruits	Every meal	1-2 servings of each meal	3 servings daily
Bread and cereals	Every meal	1-2 servings of each 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
Domestic bird	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

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

Breakfast

The advantage of the Mediterranean diet is the ability to compose the menu yourself. During the day, losing weight is offered three traditional meals and two snacks. A feature that distinguishes this food system from the rest is the ability to drink a little wine. According to one version - before lunchtime, according to others - at lunchtime and in the evening. It is allowed to replace wine with grape juice, which also contains many antioxidants.

• Energy-rich carbohydrate meals are prepared for breakfast. It is necessary for every person in the morning in order to spend it on mental work and physical activity during the day.

Thanks to this, carbohydrates are not deposited in the fatty layers. Protein omelet, ricotta cheese, assorted pasta, toast with fruit or smoothies are a great set of dishes for a diet breakfast. Having received the maximum energy material, the body is actively awake during the day. In this case, calories are successfully spent, without having time to be deposited in the form of excess weight.

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

Before dinner, you can drink the notorious wine, without which the Mediterranean diet will be inadequate. For dinner, they drink yogurt or savor a curd-fruit dessert.

Two snacks are recommended throughout the day: before and after lunch. Suitable for a snack are nuts, fruits, salads with tuna, feta cheese, olive oil.

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

Dish recipes

If some diets are repelled by the fact that they make you spend a lot of time in the kitchen and prepare complex dishes, then the Mediterranean diet is devoid of these frills. Sandwiches, sandwiches, rice, nuts, fruits, pasta are simple food for people who eat high-quality natural products, often of their own production. The recipes for the dishes are quite simple: baked fish, vegetable stew, cottage cheese casserole or cheesecakes can be prepared by anyone, even an unprepared person.

• For breakfast, they eat oatmeal with milk or fruit, fruit salad, scrambled eggs, cheese cakes, whole grain bread.
• Dine with rice and stew, cheese, tuna, tomatoes.
• For dinner, fish baked with cheese, noodles with seafood, feta salad, with the addition of avocado, cherry tomatoes, green salad are suitable.
• The best second breakfast is yogurt or kefir, fruit or tea with cookies; afternoon tea - a sandwich, nuts, dry or fresh fruit.

It is recommended to cook vegetables and meat on a grill or in a double boiler; pre-soak cereals in water.

The unit of measurement of a portion is conventionally taken as a "cup" of 237 ml, which is the equivalent of 16 tablespoons. It is recommended to keep the same time intervals between meals and snacks, because the more evenly the calories come in, the more evenly they are spent.

Benefits

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

It turns out that the diet of the inhabitants of the Mediterranean effectively resists 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 a huge benefit of the diet for a particular person. [46], [47]

In addition, research has unexpectedly revealed another benefit. If earlier it was believed that in the prevention of cardiac pathologies an important role should be assigned to the minimization of fats, now it turned out that it is not the quantity, but the quality of the fat components that is important. That there are bad fats, and they need to be limited, and there are good ones that should be present in the diet in even greater quantities. [48]

• Convincing figures are suggested: the Mediterranean menu can reduce the risk of heart pathologies by a third and malignant tumors by 24%. And also provides the prevention of such severe ailments as Parkinson's and Alzheimer's. [49], [50]

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

What can and what can not?

Answering the question: what can you eat? - one should start from the so-called pyramid principle. At its base are foods for the daily diet, consumed in large quantities, and at the top is food that is eaten occasionally and little by little. The pyramid is divided into blocks.

• You should eat carbohydrate foods for breakfast, and protein foods in the evening. Instead of sugar, it is better to put honey or sweeteners in tea.

Water occupies a special place in the Mediterranean diet. It is consumed at 2 liters per day. We are talking about clean water - without gas, dyes and flavors. Other drinks are not prohibited, but limited (coffee, tea). An exception is green tea, which can be drunk both in the morning and in the evening. Soups, compotes, and teas are also sources of liquid. The effectiveness of the diet directly depends on a 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. A dry grape drink is not only an excellent aperitif: red wine contains flavonoids, antioxidants, minerals, and vitamins that are beneficial to the body.

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

• those that 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 food is made up of traditional southern products: vegetables, fruits,  [52] olive oil, legumes, pasta, cereals, cheeses, yogurt, water. Potatoes are allowed to be eaten only in the morning.

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

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

The main idea of the diet is the normalization of weight through the normalization of metabolism. It is ideal for those willing to eat this consistently, follow healthy eating habits, and achieve slow but steady results.

Contraindications

According to nutritionists, the Mediterranean diet is an example of a balanced diet. It is practically devoid of shortcomings, therefore it is shown to all categories of people who do not have indications for special nutrition. Even pregnant women are not contraindicated if a woman eats such food for a long time. True, it is not entirely justified to switch to a new diet precisely while waiting for a child, if the woman ate differently before.

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

The diet is effective if it becomes permanent, practically a way of life for losing weight. Fats in the body are burned slowly but surely. Therefore, experts advocate that more overweight people make such a diet permanent.

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

Possible risks

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

There is information on observation of pregnant women about the risks associated with diet. The women ate in the usual way, recording all the foods they ate. It turned out that the diet, as close as possible to the Mediterranean, has the best effect on the health of the unborn child. In particular, the risk of asthma and allergies in children is reduced. This was confirmed by follow-up observations of children during the first six years of life. [54]

Complications

For a healthy person, the Mediterranean diet is not harmful. Possible complications when eating dishes with vegetables, fried meat, garlic, spices threaten people with gastrointestinal problems, severe liver and gall bladder disorders. In severe heart pathologies, the dietary ration should be agreed with the attending physician.

Reviews

Nutritionists have left positive feedback on the Mediterranean diet. In their opinion, the Mediterranean diet, with some refinements, is suitable for everyday family meals. The result is slow, but steady and reliable.

Some who have lost weight do not see any drawbacks in the technique. They note the benefits, the absence of discomfort and additional costs, without which many other techniques cannot do. They write about improving the condition of the skin and health in general. Weight loss is observed by 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 next summer. This makes the diet more expensive for them.

Results

The first results become noticeable after one to two weeks. They manifest themselves in body shaping and improving well-being. What has been achieved should be supported by more intense exercise, a healthy diet 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.

Smooth weight loss is not stressful for the body, so the kilograms are in no hurry to come back. In addition to a slimmer figure, a person who has lost weight gains the experience of 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 decide to eat right. The main task of the technique is to teach you a healthy diet and improve the condition of the body as a whole. Unlike rigid diets, you can live on such a diet permanently, normalizing weight and improving health without stress and hunger.