Make Way for Mediterranean!

With summer fast approaching, it’s a good time to think about our health overall, but especially our heart health.  Since most of us are more active during the warmer months, our heart is working the hardest it does all year.  So how can you optimize your heart through diet?

The Mediterranean Diet is all about heart health (and May is Mediterranean Diet month)!  Don’t get too concerned about the word “diet” in the title – the Mediterranean Diet is more so a lifestyle change and a shift in the types and amounts of foods typically consumed, as well as other lifestyle modifications.


First, the research – as in why are we even considering this “diet” when you can just watch portion size or count calories to lose weight?  The Seven Countries Study, which was initiated shortly after World War II, examined the idea that Mediterranean-style eating patterns contributed directly to improved health outcomes.  This study ran from 1947-1981 (wow!) and examined the health of nearly 13,000  middle-aged men in the United States, Japan, Italy, Greece, the Netherlands, Finland and then-Yugoslavia.  What they found was that adherence to a Mediterranean diet is associated with a significant improvement in health status; specifically, a  reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson’s disease and Alzheimer’s disease (13%).

So what are the cornerstones of this “diet”?  As you can see in the Pyramid, being active and enjoying meals with others is a main component of the Mediterranean lifestyle.  This will help keep our bodies and minds active.  The next largest chunk contains fruits, vegetables, whole grains, and healthy fats and proteins from olive oil (replacing margarine or butter), beans, nuts, legumes, seeds.  It emphasizes the use of herbs and spices (not salt) for flavor.

Fish and seafood compose the next tier.  It is recommended that these foods are consumed twice weekly.  Not only are fish and seafood typically lower in saturated fat than meats and poultry, but they contain omega-3 fatty acids, which can reduce inflammation throughout the body and delay or prevent atherosclerosis and heart disease.  Omega-3s can also aid with fetal, infant, and child brain and neurological development.  Keep in mind that if you are pregnant or nursing to check the mercury content of seafood prior to consumption.

The fourth tier contains poultry, eggs, cheese, and yogurt, which with moderate portions can be consumed daily to weekly.  At first, I thought that maybe decreased bone density (which can lead to osteoporosis) would be a side effect of the Mediterranean diet.  Their suggestion of “moderate” portions daily to weekly is in strong contrast to the US suggestions of 3 servings of low-fat dairy each day.  However, research shows that the Mediterranean diet pattern, particularly when combined with additional olive oil, can improve bone markers.

The top tier of the pyramid contains red meat and sweets, which are recommended to be consumed less than any other foods.  Red meats, if not from a lean cut, can contain excess fat and cholesterol.  Added sugar gives calories with virtually no nutritional value, which can lead to excess weight gain if consumed in excess.

Beverages are found on the side of the pyramid.  Water is highly emphasized and red wine is suggested in moderation.  *Please note that if you are pregnant, have dependency issues, or are taking certain medications, alcohol may not be appropriate to incorporate and it is best to abstain.

Interested, but having trouble getting started?  Try incorporating some of these tips from

1. Eat lots of vegetables. From a simple plate of sliced fresh tomatoes drizzled with olive oil and crumbled feta cheese to stunning salads, garlicky greens, fragrant soups and stews, healthy pizzas, or oven-roasted medleys, vegetables are vitally important to the fresh tastes and delicious flavors of the Med Diet.

2. Change the way you think about meat. If you eat meat, have smaller amounts – small strips of sirloin in a vegetable sauté, or a dish of pasta garnished with diced prosciutto.

3. Always eat breakfast. Start your day with fiber-rich foods such as fruit and whole grains to keep you pleasantly full for hours. Layer granola, yogurt, and fruit, or mash half an avocado with a fork and spread it on a slice of whole grain toast.

4. Eat seafood twice a week. Fish such as tuna, herring, salmon, and sardines are rich in omega-3 fatty acids, and shellfish including mussels, oysters, and clams have similar benefits for brain and heart health.

5. Cook a vegetarian meal one night a week. Build meals around beans, whole grains, and vegetables, and heighten the flavor with fragrant herbs and spices. Down the road, try two nights per week.

6. Use good fats. Include sources of healthy fats in daily meals, especially extra-virgin olive oil, nuts, peanuts, sunflower seeds, olives, and avocados.

7. Enjoy some dairy products. Eat Greek or plain yogurt, and try small amounts of a variety of cheeses.

8. For dessert, eat fresh fruit. Choose from a wide range of delicious fresh fruits — from fresh figs and oranges to pomegranates, grapes and apples. Instead of daily ice cream or cookies, save sweets for a special treat or celebration.

Also, you can look for this symbol on packages.Med_Mark_Stamp
To use the Med Mark, products must meet these health thresholds per serving:

  1. Artificial trans fats: limit of zero grams (no added trans fats in any amount)
  2. Saturated fat: limit of 8 percent of total calories from saturated fat **
  3. Sodium: limit of 480 milligrams (for individual food) or 600 milligrams of sodium (for meal-type products) ***
  4. Added sugars: limit of 4 grams (or about 1 teaspoon)

Make the most of Mediterranean Diet Month and get your heart in shape for summer by incorporating some of these Med-inspired tips!

Written by: Kelly Houston, St. Louis University Dietetic Intern



Sofi F, Cesari F, Abbate R, et al. Adherence to Mediterranean diet and health status: meta-analysis.
British Medical Journal. 2008;337:a1344-50.

Fernández-Real, J., Bulló, M., Moreno-Navarrete, J., Ricart, W., Ros, E., Estruch, R., & Salas-Salvadó, J. (2012). A mediterranean diet enriched with olive oil is associated with higher serum total osteocalcin levels in elderly men at high cardiovascular risk. Journal Of Clinical Endocrinology & Metabolism, 97(10), 3792-3798. doi:10.1210/jc.2012-2221


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