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What is the Mediterranean Diet?


Introduction

Many chronic medical conditions are related to our lifestyle and environment, not just our genetic make-up.(1) Maintaining a healthy weight is one of the most effective ways of reducing our risk of medical conditions, such as high blood pressure, type 2 diabetes, high cholesterol, heart disease and some cancers.(2, 3) Weight maintenance requires that energy expenditure is equivalent to energy intake.(4, 5) People can lose weight by reducing energy intake in their diet to below their energy output through physical activity.(6, 7) People aiming to gain weight can increase energy intake so that it exceeds energy expenditure.


Diet versus Nutrition guideline

Whether we are looking to maintain, lose or gain weight, the types of foods we eat also play a major role in our health.(8) This is where the concept of diet comes in. Think of a diet more as a long-term nutrition guideline, rather than a strict short-term calorie-counting regime. There are many types of dietary guidelines for weight and health maintenance that scientists have studied. These include low-fat diets, low-cholesterol diets, vegetarian diets, DASH (dietary approaches to stop hypertension) diets, organic diets and the Mediterranean diets. Today, the focus will be on the Mediterranean diet.


What is the Mediterranean diet?

There exists no official definition of the Mediterranean diet. Typically, a Mediterranean diet:(9-14)

  • Is high in fruits, vegetables, whole grains, beans, nuts and seeds

  • Includes olive oil as a source of monounsaturated fat

  • Allows low to moderate wine consumption

  • Contains low to moderate amounts of fish, poultry, dairy products

  • Permits low levels of red meat consumption

It is unclear whether the beneficial effects of the Mediterranean diet stem from the diet as a whole, or from specific components of the diet.


Effects of the Mediterranean diet

Evidence suggests that the Mediterranean diet reduces the risk of stroke compared to a standard low-fat diet.(10) Note that low-fat diets require that fat contributes to less than 30% of your energy intake, which increases energy consumption and promotes fat loss.(15) The Mediterranean diet does not have this requirement. Observational studies have found that the Mediterranean diet is associated with lower overall death rates and death from heart disease.(9, 14) Further studies have found that the Mediterranean diet is associated with reduced rates of Parkinson’s disease, Alzheimer’s disease, and a number of cancers, including bowel, prostate, aerodigestive (lips, mouth, nose and throat) and breast.(13, 14) Additionally, patients with type 2 diabetes also have improved blood sugar control when they are following a Mediterranean eating plan.(11)


Components of the Mediterranean diet


High levels of:

> Fruits and vegetables

Increased fruit and vegetable intake is associated with lower rates of death, heart disease and some cancers.(16-20) A standard 2000-calorie diet should incorporate two daily servings of fruit daily and 3 servings of vegetables.(21) It is possible that whole fruits and vegetables protect against death, heart disease and stroke due to their high fibre content.(22, 23) Higher intakes of fruits and vegetables are also associated with a lower risk of aerodigestive cancers and certain types of breast cancer.(24)

> Whole grains

Increased consumption of whole grains is associated with improved weight management, reduced death from heart disease, reduced death from all causes, and reduced risk of heart disease and cancer.(25-27) Whole-grain foods include brown rice, whole-grain bread, whole-grain cereal and oatmeal. Whole-grains have lots of fibre, iron, B-vitamins and other nutrients and have a low glycemic index.(23) At least one half of daily grain intake should be from whole grains.(28)


> Beans

A healthy source of protein, beans can replace servings of proteins that contain unhealthy fats, such as red meat and processed meat.(28)

> Nuts

Nuts are protein-rich and associated with weight loss. Consumption is also tied with reduced heart disease and stroke.(29) Aim to eat a serving of nuts five or more times per week.(28)


> Seeds

Seed are another rich plant-based source of protein.(28)


Low-to-moderate levels of:

> Olive oil

Olive oil is an important source of monounsaturated fat in the Mediterranean diet.(10)


> Wine

Alcohol is optional and should be consumed in moderation. Guidelines recommend no more than one drink per day for women and two drinks per day for men.(28)


> Fish

Fish and seafood contain protein, vitamins and minerals, including omega-3 polyunsaturated fatty acids.(28) One to two servings of oily fish per week is suggested for most adult patients. A large analysis found that fish consumption at least 4 times per week was associated with reduced risk of blockages in the blood vessels supplying the heart.(30)

> Poultry

White poultry is a healthy source of protein. Poultry can contribute to the 2-3 servings of protein per day recommended in a 2000-calorie diet.(28)


> Dairy

Dairy products are an important source of calcium and vitamin D. Dairy includes animal milk or products made from animal milk, such as cheese and yoghurt.(28) Consumption of three cups of dairy products per day is important for bone health.(31) Dairy intake lowers the risk of colorectal cancer and may reduce the risk of heart disease.(24)


Low levels of:

> Red meat.

Minimise red meat and processed meats. Red meat is associated with weight gain.(25) Large analyses have found that increased consumption of red and processed meat is associated with higher risk of type 2 diabetes, stroke, colorectal cancer and death from heart disease.(32-39)


None of:

> Sweetened beverages

These include fruit drinks, sports drinks, energy drinks and soft drinks. Sweetened beverages contain refined sugars, which should contribute no more than 10% of total calories consumed.(28) These drinks have played a key role in the weight gain and obesity epidemic.(40) Sweetened beverages are also associated with lower intake of key nutrients because they take the place of nutrient-dense foods.(41) They increase the risk of heart disease, type 2 diabetes, high blood pressure.(42-45)


Coffee

Coffee seems to lower the risk of liver and uterine cancers.(24) Up to 400mg/day of caffeine can be incorporated into a healthy diet.(28)

Don’t forget exercise

Evidence suggests that at least 30 minutes of exercise 5-7 days per week prevents weight gain and improves heart health.(46, 47) To lose weight, you should exercise alongside lower energy intake to augment the effects of a healthy diet and to improve muscle mass.(48) Physical activity should be maintained if attempting to gain weight.(49)


Recommendations

Overall, management of weight through diet and exercise requires a lifestyle change. Major changes to your diet and exercise should occur with professional guidance. At Surecell, we can provide tailored education and support as you alter your daily habits. We recommend a variety of nutrition and exercise options to manage weight and health. Even if you are not overweight, settling on a routine of healthy meals and enjoyable aerobic and strength training on most days will benefit your general health.


Support available at Surecell

If you are looking for a tailored nutrition and exercise plan, we offer exercise physiology, personal training and gym facilities, nutrition advice, as well as medical support. Our Surecell doctors are musculoskeletal experts who provide regenerative medicine treatments for osteoarthritis, such as platelet-rich plasma (PRP). Feel free to contact our friendly staff on 03 9822 9996 or submit an enquiry here.


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