The Mediterranean Diet

The Mediterranean Diet

Syracuse University Florence

Why Change the Way We Eat?

• What has influenced the way we eat today?

• How can we change the way we eat?• What does research say?

What has influenced the way we eat today?

Missing Vitamin DeficiencyVitamin C ScurvyVitamin A Night BlindnessVitamin D Rickets in ChildrenVitamin B1(thiamin) Beri BeriVitamin 3 (niacin) PelagraIron AnemiaCalcium Stunted growth & Osteoporosis

Zinc Growth failure in children

What has influenced the way we eat today? (cont.)

• British Investigators Mann and Orr in the first half of XX th century

• Milk and meat produced growth in malnourished working class

– Farmland was cleared to support milk and dairy industry

What has influenced the way we eat today? (cont.)

• Change in Public Policy since World War II• Farming became a big business, extra

efficient and major money maker• Food Processing – huge development

– Easy distribution, provides all the Kcal, micronutrients, long shelf life.

– Little thought given to additional ingredients such as fats, sugars and other refined items

Consequences

• This preventative approach lead to unforeseen problems:– High caloric content of processed foods vs

lower caloric needs– Lack of important components:

phytochemicals, fiber– Increased incidence of heart disease and

other chronic diseases (cancer, diabetes)

Rockefeller Foundation Study

• First major study to examine the diet of Mediterranean population

• Crete 1948 Allbaugh hired by Greek Gov. to improve Greeks post-war conditions

– However no improvement was needed as Cretan Diet was described as “surprisingly good” and “very conducive to heart health”


Activity One - Food Misconceptions

In groups discuss the following (I assume you read the “The Mediterranean Diet” book)

• Protein, do we get enough or should we be concerned about deficiency?

• Are all fats created equal?• Is a low fat diet helpful to someone at with

compromised heart health?• What is the best way to prevent deficiencies?

The Mediterranean Countries

A Shared Cuisine

A Shared Cuisine

• Bread, Olive oil and wine• Similar attitudes about food• Ancient populations relied on plant foods

and only occasionally on meat & seafood• 1950s and 1960s eating habits similar to

ancient diet

A Shared Cuisine

• Seasonal and fresh produce consumed within miles of harvest

• Meat as flavoring not a staple• Bread as a staple; in rural areas dark and

heavy• Olive Oil• Flavoring: garlic, onions, lemons, basil,

oregano, parsley,


• Whole Grains• Fresh Fruits and Vegetables• Beans and Legumes• Olive Oil (High in Monounsaturated fats)• Some dairy• Very little meat• Very little refined, processed foods

A Shared Eating Philosophy

• Food as expression of life

• Meals as gatherings for family and friends; genuine events not inconvenient chores

• Food as reflection of quality of life:– Reflected in the preparation of food– In the way food is selected, prepared, shared

Importance of Food

• Food not seen as a source of anxiety as it is today – Food for thought: As an American, what is

your personal relationship with food?

• Yet food is important as it means vitality; – a ritual to be shared with love and in integral

part of life

Learn the secretsItalians Secret # 1: Three meals,

period.Rome, Italy

• Eat at meals only. Snacking is low. And when Italians do snack, it's fruit and nuts. Fast food? Not popular.

Prevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4cPrevention; Apr2002, Vol. 54 Issue 4, p60, 2p, 1 chart, 4c

Rome, NY

• Snacking is a way of life. This city is snack-happy like the rest of America, where consumption of corn chips, pretzels, and crackers has gone up 200% since the '70s. Fast food is big too

Learn the secretsItalians Secret # 3: Olive Oil Rules.

Rome, Italy

• Olive oil is served in salads, pasta, and cooked veggies in generous amounts. It continues to be the principle source of fat in the diet. Result? Lots of heart-smart mono-unsaturated fat.


Rome, NY

• Cheese and meat rule. Cheese-laden lasagna fill plates. Italian bread is served with butter. Submarine sandwiches bulge with Italian ham and provolone. Result? Lots of artery-gumming saturated fat.

Learn the secretsItalians Secret # 5: Drink water.

Rome, Italy

• Italians drink water when thirsty.

Rome, NY

• Drinking super sized soda is common even at breakfast.

Learn the secretsItalians Secret # 2: Dark greens daily.

Rome, Italy

• Packed with nutrients, fresh, dark greens are served with most meals, often as a salad course that comes right before dessert.


Rome, NY

• Salads mostly consist of nutrient-poor iceberg lettuce. Overall consumption of dark green veggies such as spinach is low.

Learn the secretsItalians Secret # 4: Fruit for Dessert.

Rome, Italy

• Italians end most meals with fresh fruit, served plain or marinated in wine with a little sugar. Sweets are saved for special occasions.


Rome, NY

• Doughnuts are a daily event for many people. Candy bars and sweets are often eaten daily as a snack.

Ancel Keys – Key Findings

• 1950s – People in the States were suffering from heart disease

• No heart disease in the Mediterranean

• He spearheaded the most influential epidemiological study of our times

The Seven Countries Study

• Goal: To identify CHD risk factors and disease rates

• Population: 13,000 men – 40-55 y.o. during a 5 year period in the following Countries: Greece, Italy, (Croatia, Serbia), Japan, Finland, Netherlands, U.S.A.

• Methods: RDs stationed in the homes of study subjects measuring everything eaten– Far more accurate than any questionnaire

The Seven Countries StudyConclusions (main points)

• This study related saturated fat with CHD• Americans, Dutch and Finns had heart

disease rates:– Twice those of Italians– Four times those of the Greeks,

Japanese and Yugoslavs • Lowest all cause age specific death rates were

found in the Mediterranean region

The Seven Countries StudyConclusions (main points)

• This study revealed the universal risk factors for CHD– Blood cholesterol appears to have the

strongest correlation– Age– Blood Pressure– Cigarette smoking

Discovery of Different Types of FatType of fat Studied effects

Saturated (SFA) ↑ T cholesterol levels (both total and LDL)

Monounsaturated (MUFA)The Mediterranean Fat

↓ T cholesterol levels (both total and LDL) may ↑ HDL

Polyunsaturated (PUFA) ↓ T cholesterol levels (both total and LDL) ↓ HDL

Omega 3 ↓ blood tendency to cloth so ↓ risk of heart attack

Trans ↑ T cholesterol levels (both total and LDL) ↓ HDL

• VitaminsVitamins• MineralsMinerals

• Olive oilOlive oil MUFAMUFA

• FiberFiber• Omega 3Omega 3

• PhytochemicalsPhytochemicals

The Magic is a Combination of Factors

Some Things are Hard to Prove Scientifically

• The effect of mind over body is in the news today– Lifestyle seems to be as important as food– Slower pace, less stress, enjoyment of food– Physical activity and lots of sunshine

• Common sense tells us the above are important

Chapter 2

Comparing Notes

• How does the Mediterranean diet compare to the guidelines of major health organizations?

American Heart Association

• www.americanheart.org• AHA position is updated according to

new research• Fat is always a target especially SFA• Three main risk factor for CHD

– ↑ blood pressure, ↑ blood lipids, obesity

http://www.americanheart.org/

My Pyramid USDA• http://www.mypyramid.gov/py

ramid/index.html

http://www.mypyramid.gov/pyramid/index.html

http://www.mypyramid.gov/pyramid/index.html

Dietary Guidelines 2005• Emphasis on weight control and continued

importance of physical activity. • Recommendation on dietary fats

– trans fats should be as low as possible – saturated fat should be limited. Recommends

between – 20 and 35% of daily calories from fat– recognizes potential health benefits of MUFA

and PUFA• Urge Americans to limit sugar intake and

they stress the benefits of whole grains.

Some things have not changed• It is fine to consume half of our grains as refined

starch. • Red meat, poultry, fish, and beans (including soy

products) are lumped together. • The recommendation to drink 3 glasses of low-fat

milk or eat 3 servings of other dairy per day to prevent osteoporosis ignores the lack of evidence between consumption of dairy and prevention of osteoporosis. It also ignores the possible increases in risk of ovarian cancer and prostate cancer associated with dairy products and the fact that millions of Americans are lactose intolerant

What to do if I am gaining weight?Do you have access to internet?

Learn how much and what to eat for YOUR calorie levelThen go to MyPyramid tracker

Submit age,sex and activity

level for a personalizedMyPyramid

Check here for

more information

on food groups

& related topics


Oldways Preservation and Exchange

• Based in Cambridge, MA• Looks at ways of eating before food

processing• Publicizes own guidelines compatible with

current knowledge of nutritional science• Considers USDA guideline ineffective

Harvard Food Pyramid

Source: Behavioral Risk Factor Surveillance System, CDC.

BMI = Weight (Kg) / Height2 (Meters)

Obesity Trends* Among U.S. Adults1990

Source: Behavioral Risk Factor Surveillance System, CDC.

No data <10% 10%-14% 15%-19% 20%-24% 25%-29% 30% +

Obesity Trends* Among U.S. Adults2005


Documents

The Mediterranean Diet