Pharmacology Book

Nutrition

  • Mediterranean Diet

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Mediterranean DietAka: Heart Healthy Diet

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  1. See Also
    1. Low Fat Diet
    2. Cardiac Risk Management
  2. Guidelines
    1. Smaller portions are assumed as integral to the diet
    2. Increase Omega-3 Fatty Acid intake
      1. Eat fish twice weekly or
      2. Supplement with Omega-3 Fatty Acids
      3. Hu (2002) JAMA 287:1815
    3. Increase fruit and vegetable intake
      1. Four servings per day: Slight drop in CAD risk
      2. Eight servings per day: 20% drop in CAD risk
      3. Fruits and Vegetables with greatest risk reduction
        1. Green leafy vegetables
        2. Cruciferous vegetables (broccoli, cauliflower)
        3. Fruits and vegetables high in Vitamin C
      4. References
        1. Joshipura (2001) Ann Intern Med 134:1106
    4. Effect of Mediterranean Diet
      1. Lower all cause mortality: 25% reduction
      2. Lower cardiovascular mortality: 33% reduction
      3. Lower cancer mortality: 24% reduction
      4. Trichopoulou (2003) N Engl J Med 348:2599
  3. Mediterranean diet: Key components
    1. Vegetables (2-3 servings daily)
      1. One serving: 1/2 cup raw or 1 cup cooked vegetables
    2. Fruits (2-3 medium whole fruits daily, 2 cups/day)
      1. Limit dried fruit to 1/2 cup daily
    3. Protein from vegetables should exceed that from meat
      1. Legumes (1/2 cup 2-4 times weekly)
        1. Lentils, chickpeas, peas, peanuts
        2. kidney beans, black beans
        3. Soybeans and soy products (e.g. tofu)
      2. Tree Nuts and seeds (1/4 cup daily)
        1. Nuts: Almonds, hazelnuts, pistachios, walnuts
        2. Seeds: Sesame seeds, pumpkin seeds, flaxseed
        3. Includes avocados and olives
        4. Natural peanut butter (2 tablespoons or less daily)
    4. Increase soluble fiber (decreases LDL Cholesterol)
      1. Whole grains (6 serving daily, 5 grams fiber/serving)
        1. Whole grain cereals (whole wheat pasta)
        2. Brown rice
        3. Oatmeal
        4. Corn
      2. Wheat fiber (not soluble but improves GI motility)
        1. Whole grain breads, corn tortillas
        2. At least two grams fiber/serving
  4. Mediterranean diet: Foods to use in moderation
    1. Fish: 1 or more 4 ounce serving per week
      1. Fatty fishes contain more Omega-3 Fatty Acids
    2. Lean meats (skinless poultry, fish): <6 ounces daily
      1. Also consider tofu or legume-based meat substitute
    3. Choose non-hydrogenated plant oils
      1. Cooking oils: Monounsaturated oils
        1. Olive oil, Canola oil, peanut oil
      2. Oils for cold foods: Oils with Omega-3 Fatty Acids
        1. Flaxseed oil or walnut oil
      3. Plant Stanol margarines (Take Control) are beneficial
      4. Avoid oils with saturated fats or trans-fatty acids
    4. Wine (1-2 drinks per day)
      1. Wine in moderation lowers cardiovascular risk
      2. However, do not enable excessive Alcohol intake
        1. Heavy Alcohol use increases cardiovascular risk
      3. See Alcohol Related Cardiac Effects
    5. Calcium (1000 to 1500 mg daily)
      1. See Calcium Supplementation
      2. Cheese (<3 grams fat per serving)
      3. Soy or rice drinks
      4. Skim milk
      5. Low fat cottage cheese
    6. Other
      1. Garlic
  5. Mediterranean diet: Foods to limit
    1. Saturated fats, butter, eggs (unless egg whites)
    2. Red meats
    3. Starches (white rice, white bread, potatoes, pasta)
    4. Sweetened beverages or full-strength juices
    5. Desserts: Preferred options follow
      1. Desserts with Non-nutritive Sweetener
      2. Dark chocolate
      3. Non-fat or low fat frozen yogurt, ice cream, sorbet
      4. Baked goods with <4 grams fat (unsaturated)/serving
  6. References
    1. Hu (2002) JAMA 288:2569
    2. Leaf (1999) Circulation 99:733
    3. Olendzki (2006) Am Fam Physician 73:257
    4. Willet (1995) Am J Clin Nutr 61:1402S

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