Back in the 1960s, residents of southern Italy, Crete and Greece started a trend that would-four decades later-become a model for healthy eating throughout the world. It wasn't conscious. In fact, these folks ate what they could afford, piling their plates high with widely available produce and building main dishes around whole grains and beans instead of expensive meats.

What we now recognize as the Mediterranean diet-a mix of fresh fruits and vegetables, whole grains, nuts and legumes, fish, olive oil and red wine-was a simple way of eating that produced surprisingly profound health benefits. The focus of much research over the years, the Mediterranean diet has been shown to lower cholesterol levels, protect against heart disease, stroke, and even extend life expectancy.

One of the biggest studies on the Mediterranean diet involved more than 74,000 healthy seniors, age 60 and over, from nine European countries¹. Researchers gathered information on diet, lifestyle and medical history and scored individuals according to their adherence to a Mediterranean-style diet. It was found that higher dietary scores, indicating a strict following of the diet, were associated with lower overall death rates. An increase in score by just two points corresponded to an 8 percent reduction in mortality. A three or four point increase was associated with a reduction of total mortality by 11 percent or 14 percent, respectively.

How It Works
There are several reasons the Mediterranean diet is believed to positively impact health.

First, high consumption of fruits and vegetables-often lacking in the typical American diet-provides nutrients and antioxidants that nourish and protect the body's cells and systems. Antioxidants are crucial to good health, as they work to neutralize harmful compounds called free radicals that attack and damage healthy cells, which may ultimately lead to disease and aging. While most people struggle to reach the five-a-day requirement here, nine or more servings daily is the norm in Greece and southern Italy.

Second, olive oil-used as a dressing, dip or marinade as well as in cooking and baking-is a staple of the Mediterranean diet. Olive oil contains monounsaturated fat-a healthier type of fat known to reduce total and low-density lipoprotein (LDL or "bad") cholesterol in the blood². The less-processed, "extra virgin" type of olive oil is also rich in antioxidant polyphenols that support heart and overall health.

Fish provide omega-3 essential fatty acids, compounds needed by the body for normal growth and development as well as many basic functions such as the maintenance of healthy blood composition and a healthy inflammatory response.

Red wine is considered an important part of the Mediterranean diet. Studies have shown that drinking red wine benefits heart and brain health. I recommend drinking red wine with one meal daily, and having no more than 5 ounces a day for women and 10 ounces a day for men. Red wine contains powerful antioxidants called proanthocyanidins (from grape seeds) and resveratrol (from grape skin). Alternately, one could obtain the healthy antioxidants in red wine by supplementing with grape seed extract and resveratrol.

Making the Switch
Switching to the Mediterranean diet isn't as hard as you might think. Start by replacing unhealthy food items with healthier options: use olive oil instead of butter or margarine; replace plain pasta with a whole wheat version; grill salmon fillets instead of steak. Use the shopping list below as a guide.

And remember, how you eat is almost as important as what you eat. Reduce portion sizes, increase (healthful) snacks throughout the day, eat fruit for dessert, drink a glass of wine with dinner and enjoy your meals with friends and family as often as possible to truly adopt a Mediterranean-style diet.

As always, to your good health,
David N. Ilfeld, M.D.


MEDITERRANEAN DIET SHOPPING LIST

• Fresh organic fruits: grapes, plums, pomegranates, kiwis, bananas, strawberries, apples, avocados, etc.
• Fresh organic vegetables: tomatoes, broccoli, spinach, red/green peppers, mushrooms, eggplant, carrots, squash, olives, etc.
• Grains: whole wheat pasta, bread, pita, rice, polenta, couscous, barley, bulgur, oatmeal, cereals
• Beans: chickpeas (garbanzo), white (cannellini), black, pinto, lentil
• Nuts/seeds: walnuts, almonds, pine nuts, cashews, sunflower seeds, flax
• Healthy oils: olive (extra virgin), canola, grape seed, avocado
• Seafood: salmon, shrimp, cod, scallops, clams, tilapia, tuna, crab
• Herbs/spices: garlic, basil, cilantro, parsley, mint, cumin, coriander, oregano
• Dairy/eggs: low-fat milk, yogurt, cheese, eggs

1. Trichopoulou A, Orfanos P, et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005 Apr 30;330(7498):991

2. Haban P, Klvanova J, Zidekova E, Nagyova A. Dietary supplementation with olive oil leads to improved lipoprotein spectrum and lower n-6 PUFAs in elderly subjects. Med Sci Monit. 2004 Apr;10(4):PI49-54