Columbia University Medical Center

Mediterranean Diet Tips: What to Eat and What Not to Eat

Olive oil is a staple of the Mediterranean diet, which has been linked to a lower risk of heart attack and stroke in a recent NEJM study.

A Mediterranean diet, including four tablespoons of olive oil a day, was recently found to lower the risk of heart attack and stroke in a group of high-risk Spanish men and women.

After a recent study published in the New England Journal of Medicine showed that people consuming a Mediterranean diet substantially reduced their risk of heart attack and stroke, many Americans became curious about adopting the diet.

“I think it’s wonderful that people want to try the Mediterranean diet, as long as they’re interpreting it properly,” says Wahida Karmally, DrPH, director of the Bionutrition Research Core in Columbia’s Irving Institute of Clinical and Translational Research.

“People often think that if something is shown to be good for them, more is better, and they can eat unlimited quantities. But the portions are very important.”

Olive oil is a staple of the Mediterranean diet described in the NEJM study, “but that doesn’t mean people should pour it on their food all the time,” Karmally says. Though the study was not designed to help people lose weight and did not restrict calories, “the recommended intake of olive oil was still rather modest, four tablespoons a day, including oil used in cooking and in salad dressings.”

Half the participants in the study were also given packets of unsalted nuts to eat every day. “Each contained 30 grams, about one ounce. That’s not too many, about 20 to 25 nuts,” Karmally says. “When I tell my patients to eat nuts, I say eat a handful, not a canful.”

Care also must be taken not to confuse foods now common in the Mediterranean region with foods of the Mediterranean diet. “In Spain, where this study was conducted, there can be a lot of red meat or sausage in the food,” Karmally says. “In the true Mediterranean diet, red meat intake is minimal.”

Other tips Karmally suggests for people looking to adopt the Mediterranean diet:

Make sure half your plate is covered with different colored vegetables. “When you tell people to eat vegetables, they often think they have to make a special trip to a farmer’s market and then clean the vegetables, which can become a burden. But good vegetables can be found in the freezer section of the supermarket. Nutrients are really packed in when the freezing plant is close to the farm, and that’s better than ‘fresh’ vegetables that have been sitting in a warehouse for a month.”

Use unsaturated oils such as olive oil or canola. “Extra virgin olive oil is rich in polyphenols, which come from the skin of the olive. Polyphenols have been shown to be beneficial to heart health.”

Don’t fall for the “100% wheat” gimmick on bread labels. “Whole grains are important because when you eat whole grain, you get anti-oxidants as well as fiber. But some bread labels are misleading. If the first ingredient doesn’t have the word ‘whole’ in it, such as ‘whole wheat flour,’ it’s not whole grain.”

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