Eating for Heart Health: the Mediterranean Way

If you want to make a sustainable lifestyle change that can support your long-term heart health, the Mediterranean diet might be right for you. Don’t let the term ‘diet’ confuse you. It’s not about counting calories. It’s a healthy way of eating and living based on the traditional eating habits in the countries bordering the Mediterranean Sea. It combines the basics of healthy eating with the traditional cuisine of the Mediterranean region.

“Incorporating this diet doesn’t mean giving up flavor or satisfaction,” says Ted Hodges, MD, FACC, WakeMed Heart & Vascular - Cardiology. “It’s about embracing a way of eating that is rich in taste, variety and tradition.”

The Mediterranean diet is widely regarded as one of the healthiest ways to eat among cardiologists, nutrition experts and the American Heart Association.

Where It Began

The Mediterranean diet gained interest from health professionals in the 1960s after they observed that some Mediterranean countries reported fewer deaths linked to cardiovascular disease than those experienced in the U.S. and northern Europe.

Since then, research studies have demonstrated the diet’s many health benefits – particularly as it relates to reducing cardiovascular risk. One study, published in 2018 in the JAMA Open Network, followed women adhering to a Mediterranean diet for 12 years and found that they had a 25 percent reduced risk of experiencing cardiovascular events, such as heart attacks and strokes, compared to women whose diets did not resemble a Mediterranean diet. Another large study, known as the PREDIMED Study, involved nearly 7,500 people at high risk for heart disease. This study found the Mediterranean diet reduced the combined risk of stroke, heart attack and death from heart disease. The same study also suggested that people who followed the Mediterranean diet experienced reductions in LDL cholesterol, along with improvements in several other risk factors for heart disease. Finally, the study suggested that following a Mediterranean diet – even without calorie restriction – appeared to prevent the development of type 2 diabetes.

What Is the Mediterranean Diet?

Primary food sources found in the Mediterranean diet are plant-based, including vegetables, fruits, nuts, seeds, legumes, potatoes, whole grains, breads, herbs, spices and extra virgin olive oil. While there is no set meal plan or definition for the Mediterranean diet, here are common patterns to follow:

• Eat plenty of fruits, vegetables, whole grains and nuts.
• Extra virgin olive oil is preferred as a healthy fat source.
• Consume fish and poultry just 2-3 times a week.
• Limit red meat to once a month.
• Incorporate a moderate amount of dairy — 2 servings per day.
• Replace salt with herbs and spices whenever possible.
• If drinking alcohol, opt for red wine, in moderation.
• Avoid added sugars, processed meat, refined grains, refined oils and other highly processed foods.

Fruits and vegetables, whole grains, legumes and nuts are high in fiber, which can slow digestion and help you to feel full while eating less. They are also rich in vitamins, minerals and antioxidants, which help lower cholesterol and aid in digestive health, blood sugar control and weight management. Many fish (including salmon, sardines, mackerel, herring and tuna) and plant-based foods (such as flaxseeds, chia seeds, walnuts and soybeans) are rich in omega-3 fats, which reduce inflammation and help reduce the risk of heart disease and stroke. Fish is also a rich source of protein and contains less saturated fat than red meat.

Healthy Fats

The Mediterranean diet’s focus on unsaturated fat sources offers major benefits for cardiovascular health. Numerous studies have found that replacing saturated fat with healthier fats commonly found in the Mediterranean diet can protect against inflammation, cardiovascular disease and death related to cardiovascular disease. Olive oil and nuts are the main sources of fat in the Mediterranean diet. Healthy fats can also increase satiety, which helps reduce overeating.

More Benefits of the Mediterranean Diet

1. Reduce the risk of cancer
2. Improve cognitive function; may prevent dementia
3. Supports digestive health
4. Blood sugar control
5. Supports a healthy weight; reduces risk of obesity
6. Reduce the risk of type 2 diabetes

The Mediterranean Lifestyle

Lifestyle plays a big role in health and aging, too. While it’s a great place to travel, you don’t have to travel to an island in Greece to reap the benefits of the Mediterranean way of life. To get the most out of the Mediterranean diet, incorporate these practices:

• Prepare and eat as many meals as possible with family and friends.
• Slow down. Try to sit at a table for 2-3 meals (or more) a week, taking at least 20 minutes to enjoy these meals.
• Cook at home more than you eat out.
• Eat locally sourced products when you can.
• Exercise regularly, ideally with others and by doing an activity you enjoy such as gardening, dancing or yoga.
• Avoid smoking or using any tobacco products.

“If you’re looking to make changes to support your heart, the Mediterranean diet is a safe, sustainable and delicious place to start," Dr. Hodges offers.

This blog is adapted from Heart to Heart Magazine. Subscribe today.