The Mediterranean Diet: A Heart-Healthy Way to Eat

Date: Feb 7, 2023

Nearly half of all adults in the U.S. have cardiovascular disease, making it one of society’s most prevalent health conditions. Fortunately, people can prevent cardiovascular disease in many ways. What is the easiest way to prevent cardiovascular disease? Pay attention to what we eat.

But how do you know the best eating habits?

Danny Eapen, MD, who directs the preventive cardiology program at Emory Saint Joseph’s Hospital, says the Mediterranean diet can greatly improve your overall heart health.

“I recommend it to pretty much everyone. Not only does it reduce the risk of cardiovascular disease, including heart attack and stroke, but it also helps reduce risks for cancer, dementia, gastrointestinal illnesses, and possibly even Parkinson’s and Alzheimer’s,” says Dr. Eapen. “As an overall eating pattern, I think everyone would benefit.” 

What is the Mediterranean Diet?

Physiologist Ancel Keys first coined the term “Mediterranean diet.” The name came from his famous Seven Countries Study, which observed the eating habits of people in Mediterranean-bordering countries like Greece, Italy, and Spain, as well as South Africa, Japan, and Finland.

The study revealed that fats play an important role in cardiovascular health. The polyphenols and monounsaturated fatty acids found in foods common in the Mediterranean can protect against inflammation and heart disease. Other studies have reinforced this conclusion and shown that the Mediterranean style of eating reduces the risk of cardiovascular events like heart attack and stroke.

The Seven Countries Study also associated certain eating habits in countries like Greece and Italy with a lower risk of heart disease. These habits inspired key tenets of the Mediterranean diet we know today.

But do not let the word “diet” mislead you. “Following the Mediterranean diet doesn’t mean you need to be hyper-focused on doing this and not doing that like other diets,” says Dr. Eapen. “Instead, it’s more of a pattern of eating and living. It’s also very easy to incorporate into different diet plans.” 

What’s Included in the Mediterranean Diet?

Dr. Eapen highlights five pillars, or features, of a Mediterranean habit of eating.

Pillar 1: Remove certain foods from your diet

The first step in a Mediterranean eating pattern: cut out processed and ultra-processed foods, fast foods, saturated fats, and added sugars from your diet. Researchers have linked these foods to increased rates of heart disease, as well as conditions like diabetes, hypertension, and even cancer.

“Adding good to a lot of bad isn’t going to help, so it’s important to start by cutting out these food groups,” says Dr. Eapen. “Unfortunately, many of those foods are pervasive in Western society.”

Pillar 2: Add fresh fruits, veggies and seeds

Once you’ve removed processed foods from your diet, you can start reorganizing your meals around new foods. Dr. Eapen emphasizes the importance of fruits and vegetables.

“I like to tell people: when you choose meals, have a lot of color on your plate. That’s usually an easy way to ensure you get enough fruits and vegetables,” he says.

Pillar 3: Pour on extra virgin olive oil

Olive oil is a defining feature of a Mediterranean diet. It’s rich in high-end polyphenols and monounsaturated fats, and getting enough in your diet is easy.

“Generally, just a tablespoon of olive oil a day has health benefits,” says Dr. Eapen. “I also recommend people increase their intake by cooking with it, such as when sautéing or using it in salad dressings.”

However, Dr. Eapen says to be mindful of olive oil’s shelf life to protect its heart-healthy benefits.

“People don’t realize when olive oil comes into contact with oxygen, it destroys the healthy polyphenols and fats. Extra virgin olive oil, especially, can easily oxidize,” says Dr. Eapen. “I recommend purchasing small batches in dark bottles and storing them in cool places. It’s like wine – once you open it, you only have a few days to use it.”

Pillar 4: Include nuts

Nuts are another easy, heart-healthy food you should incorporate into your daily diet. Common heart-healthy nuts include:

  • Almonds
  • Brazil nuts
  • Hazelnuts
  • Pistachios
  • Walnuts

Dr. Eapen says you don’t need more than a handful of nuts daily. Overindulging can have consequences.

“Avoid eating too many nuts because they are so high in fat,” says Dr. Eapen. “You can have too much of a good thing.”

Pillar 5: Make fatty fish a staple

The final pillar of the Mediterranean diet includes fatty fish. But which fish count as healthy, fatty fish? The MASH acronym can help:

  • Mackerel
  • Anchovies
  • Salmon or sardines
  • Herring

However, salmon is by far the most common and popular fatty fish option. Dr. Eapen recommends about three servings of fatty fish per week. 

But wait, what about red wine?

You’ve probably heard a Mediterranean-style diet includes red wine. While it’s been a recommended component in the past, new research on the health effects of red wine has changed what doctors recommend.

“We used to focus on the heart benefits of alcohol. But we’ve found in the last few years alcohol in general, no matter what you drink, increases your risk of cancer,” says Dr. Eapen. “So even though alcohol has some heart benefits, what’s the point if it just increases your risk of cancer? If you do already drink alcohol, only do it socially and try not to do it every day.”

Ultimately, these pillars offer a foundation to guide healthier eating habits and create an opportunity to find what works for you.

“With these pillars, you can construct a unique Mediterranean way of eating for yourself,” says Dr. Eapen. “My biggest advice is to be flexible. Try to do good 80% of the time, and give yourself some grace the other 20% if you slip up.”

Take the Next Step in Your Heart Health

Changing how you eat can substantially improve your health, but it can be hard to know where to start.

If you’re looking for ways to prevent or reduce your risk of cardiovascular disease, you will want to consult with doctors who are at the top of their fields. Emory providers lead the way in cardiovascular care, especially when it comes to prevention. We can help you confidently start on a new path toward better heart health today.

Emory Heart & Vascular Center brings together more than 175 physicians, offering comprehensive medical and surgical treatments for the full range of heart and vascular conditions. The Center includes 18 specialized programs in cardiology, cardiac surgery, vascular surgery, and cardiovascular imaging.

We see patients at six hospitals with more than 23 community locations. Depending on your need, we can see you as early as the next day.

For more information or to find a provider near you, call 404-778-7667.

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