A traditional Mediterranean diet has been shown
to have significant health benefits. But can you follow it if you live
nowhere near a Greek island?
We're always being told a traditional Mediterranean-style diet is an incredibly healthy way to eat.
As
well as its proven benefits in preventing heart attacks and promoting a
longer life generally, it has specifically been shown to help ward off
diabetes as well as bowel and prostate cancers. (And it was the only
eating plan achieving the maximum score of five out of five in the ABC Health & Well being guide to weight loss diets, reviewed by nutritionist Dr Rosemary Stanton.)
But
adopting a truly Mediterranean approach to eating, especially that
which stems from the island of Crete in Greece, is not as simple as many
cookbooks would have us believe.
While plenty of recipes are
promoted as Mediterranean, they aren't necessarily the ones research has
shown to be so good for us, says Associate Professor Catherine
Itsiopoulos, from La Trobe University in Melbourne. In fact in most
cases they're not, she says.
That's because cookbooks tend to
focus on festive foods and desserts from the region, says the head of La
Trobe's department of dietetics and human nutrition, who is an expert
on the Mediterranean diet.
"When people think of the Mediterranean
diet, they always think of the souvlaki and the yiros and all the other
meat dishes," she says.
But the diet, made famous by the
ground-breaking health studies dating back to the 1960s, was a peasant
diet that was largely vegetarian, she says.
"It was a poor man's
diet. There wasn't a lot of meat. There was a bit of fish because fish
was more available... but primarily they subsisted on plant foods and
legumes as they main source of proteins," Itsiopoulos says.
"[There
were] lots of casseroles where in a serve you would get 60 to 70 grams
of meat but lots of vegetables. So the casserole was filled with peas
and carrots and artichokes and zucchini and then there's a salad on the
side. There was half a kilo of fruit and half a kilo of vegetables eaten
per person per day."
The 10 commandments
Itsiopoulos,
also an adjunct Associate Professor at the University of Melbourne, is
compiling a cookbook based on the exact meals she has used in numerous
studies showing the diet's protective effects against diabetes and heart
disease.
In addition to the recipes, she has developed "10
commandments" of the Mediterranean diet which can help you get a handle
on what it involves. (These can also be used to apply the health-giving
principles of the Mediterranean diet to other kinds of cuisine, she
says.)
The commandments are:
- Use olive oil as the main added fat (aim for around 60 mls /day);
- Eat vegetables with every meal (include 100g leafy greens and 100g tomatoes, and 200g other vegetables/day);
- Include at least two legumes meals (250g serve) per week;
- Eat
at least two servings of fish (150-200g serves) per week and include
oily fish:for example Atlantic and Australian salmon, blue-eye trevalla,
blue mackerel, gemfish, canned sardines, and canned salmon. Canned
tuna is not as high in the important fish oil omega-3, but still a good
choice to include in your fish serves.
- Eat smaller portions of meat (beef, lamb, pork and chicken) and less often (no more than once or twice a week);
- Eat fresh fruit every day and dried fruit and nuts as snacks or dessert;
- Eat yoghurt everyday (about 200g) and cheese in moderation (about 30 to 40 grams per day);
- Include wholegrain breads and cereals with meals (aim for 3-4 slices of bread per day);
- Consume
wine in moderation (one standard drink a day, which is about 100 mls),
always with meals and don't get drunk. Try and have a couple of alcohol
free days a week;
- Have sweets or sweet drinks for special occasions only.
Some recipes for a typical day's meals on a traditional Greek Mediterranean diet can also be found here.
A healthy switch
Itsiopoulos
admits it's quite a different eating style to the one most Australians
have today. But her experience introducing the diet to novices has been
positive.
One study involved feeding traditional dishes, prepared
and cooked by her team, to Australians who had type 2 diabetes. (It
turned out to help them control the disease). Some enjoyed the
experience so much that they wanted the recipes at the end of the study.
"We
had middle aged people of Anglo-Celtic origin who'd never eaten
eggplant in their life and they ate this dish and said it was their
favourite," she says.
Interestingly, while the people in the study
were not restricted in the volume of food they ate – they were told to
eat until they were full – they didn't gain weight.
They also reported "a very positive change in well being, in mood and in the levels of energy they had."
A diet for busy lives?
But
what if you have to prepare all the meals yourself? Is this an eating
style the time-poor can adopt? Itsiopoulos insists it is.
It's
true some of the casseroles have up to 20 or 30 ingredients if you count
all the herbs and spices. However, modern day conveniences like slow
cookers make preparing these meals easier than was once the case, she
says. Meals like simple bean soups are quick and easy to make.
"You
do have to be prepared. It doesn't take a lot of effort to pop
leftovers in a container for lunch at work the next day but you've got
to plan for it the day before. Something like a stuffed tomato or
pepper, or a layered vegetable dish, you make on the weekend because
it's a bit fiddly."
Most of the dishes are suitable for preparing
ahead and freezing and she suggests enlisting the help of older children
to prepare vegetables and even make themselves some of the simpler
meals.
But taking time to "be in touch with food" and make at
least some recipes from scratch, is an important part of any healthy
eating style, Itsiopoulos believes. (Research has shown takeaway and
restaurant meals, and even ready-made meal bases such as sauces, are
almost always higher in unhealthy ingredients like fat and salt.)
"That's a culture you have to build in your family. It doesn't belong to any particular ethnic background."
What about the dairy?
If
you think the Mediterranean diet looks a little low on dairy foods,
you're right. It's certainly lower in dairy than is currently advised in
the National Dietary Guidelines
(which recommend 2.5 to four serves of dairy foods every day
(preferably low fat), depending on your age and sex. A "serve" is equal
to a glass of milk, a tub of yogurt or two slices (40 g) of cheese.)
But
traditional Greek Mediterranean populations got calcium from other
sources: sardines and other small fish which were eaten with their
bones, and from leafy greens (which contain only a little calcium but
the large volume of the greens eaten meant the amount added up).
Slow-cooking
meat, including chicken, with bones also causes calcium to leach out of
the bones, Itsiopoulos says, and this is then eaten as part of the
dish.
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