You have probably heard of the Mediterranean diet and the benefits it has for our health, especially heart health. While there is no one typical Mediterranean diet, the dietary pattern consists of abundant fruits and vegetables, breads and cereals (preferably whole grains), potatoes, beans, nuts and seeds. Very little red meat is consumed in the Mediterranean diet. Dairy products, fish, poultry and eggs are consumed in low to moderate amounts, as is wine.

Fat is not eliminated in this diet, rather it is the type of fat that is important. The Mediterranean diet views two types of fat, omega-3 fatty acids and monounsaturated fats, as healthy and has no restriction on their consumption. Omega-3 fatty acids are found in fatty fish such as salmon, tuna, sardines, trout, and also in some plant sources such as walnuts, flaxseed and various vegetables. Monounsaturated fat is another important fat in the Mediterranean diet and is found in olive oil, nuts and avocados.

One of the components that renders this diet healthy is the fact that it’s low in saturated fats. Saturated fats should be avoided as much as possible. They are primarily found in red meat, butter, cheese and milk which are foods consumed in very low amounts in a true Mediterranean style diet. Saturated fats should be limited in heart healthy diets (<10% of total calorie intake according to American Heart Association (AHA) Step I diet) since they can increase risk for heart disease.

Another type of fat to avoid is trans- fatty acids. Trans-fatty acids are produced when vegetable oils undergo a hydrogenation process causing liquid fats to become more solid (e.g. partially hydrogenated oils).

It is thought that trans-fatty acids increase the risk of heart disease at least as much as saturated fats (N Engl J Med 1999;340:1994-8.) Therefore, food labels are now required to list the amount of trans-fatty acids on the label, in addition to the amount of saturated fat. Because the Mediterranean diet focuses on eating whole, natural, unprocessed foods, it is very low in trans-fatty acids. The Mediterranean eating pattern has heart healthy effects due to its inclusion of 5 important dietary factors: consumption of fish rich in omega-3 fatty acids, olive oil, nuts, moderate amounts of alcohol (e.g. red wine) and excluding trans-fatty acids (Ann Intern Med 2001;134:1106-14.)

Research has confirmed that consuming a Mediterranean diet is associated with a reduced risk of heart disease. One study found eating a Mediterranean diet for 3 months can lower cardiovascular risk by 15% (Am J Clin Nutr 2005;82:964-71). Over 200 men and women with moderate risk for heart disease consumed either a Mediterranean diet or a low-fat diet for 3 months. Those consuming the Mediterrianean diet saw a 7.5% drop in total cholesterol compared to a 4.5% drop in the low-fat diet group. Authors of the study translated this into a 15% reduction in risk for heart disease.

Note: the Mediterranean diet group consumed fish four times a week and wine daily (1 glass/day for women or 2 glasses/day for men). Moreover, the Lyon Diet Heart Study tested the effectiveness of a Mediterranean-type diet on the rate of heart events in persons who already had a first heart attack. Results from this study suggest that a Mediterranean diet may help reduce recurrent events in patients with established heart disease. (Circulation 2001;103:1823-5.)

Consuming a Mediterreanean type diet has shown to be beneficial for heart health and may be beneficial for other conditions such as metabolic syndrome (JAMA 2004;292:1440-1446.).

If you are unable to consume these types of foods on a regular basis, consider adding supplements to give your diet a Mediterrannean edge! For example, fish oil is a great source of omega-3 fatty acids (EPA and DHA) found in fish. Flaxseed oil provides omega-3’s (alpha-linolenic acid) that have heart healthy benefits as well. Antioxidants are important and abundant in fresh fruits and vegetables. The Mediterranean diet food pyramid recommends consuming at least 9 servings of fresh fruits and vegetables daily. Supplemental antioxidants such as beta-carotene, vitamin C, vitamin E-- to name a few--can help provide key amounts of these powerful nutrients that are beneficial to overall health.