Why your Heart Yearns for the Mediterranean (Med Diet)
Amongst all the current controversy surrounding fat intake and heart disease, the Mediterranean diet stands strong as the gold standard for cardiovascular health. Dr Aseem Malhotra, leading cardiologist, strongly advocates adopting a Mediterranean diet, claiming that it has shown to be “three times as effective at reducing cardiovascular deaths as [the cholesterol-lowering drugs]statins”.
In further support, a five-year study of 7,447 subjects carried out between 2003 and 2011 found that a Mediterranean diet reduced the incidence of major cardiovascular events (cardiovascular death, heart attack or stroke) by 30%, compared to a control group following a low-fat diet. In addition to its proven benefits for heart health, research has also shown that following a Mediterranean diet can help to lower cholesterol, support weight loss, improve rheumatoid arthritis, and reduce the risk for developing Alzheimer’s disease, Type II diabetes, and various types of cancer.
What are the key components of the Mediterranean Diet?
The traditional Mediterranean diet is high in olive oil, fruit, nuts, vegetables and wholegrains, with moderate amounts of fish and poultry, and low amounts of red meat, dairy food and sweet foods.
In this article we will focus on the key individual components of the Mediterranean diet, and their specific health-boosting properties.
1) Raw nuts – including walnuts, pecans, almonds, cashews, pistachios and Brazil nuts. These nutritional powerhouses are packed with heart-healthy vitamins and minerals including vitamin E, magnesium and zinc. One of the most important nutrients for heart health is magnesium, a mineral that helps maintain muscular function, and regulates blood pressure. Nuts (especially pistachios) are also rich in L-arginine, used by the body to make nitric oxide, a gas that relaxes blood vessels and supports blood flow.
One large study found that individuals who reported eating nuts 5 times per week were 29% less likely to die from heart disease than those who didn’t eat nuts at all.
2) Wholegrains – such as brown rice, rye, spelt, barley and oats. These contain antioxidants, phytoestrogens and phytosterols that can all help to protect heart disease. They are also an excellent source of fibre, and a Harvard study of females found that those consuming a high-fibre diet had a 40% lower risk of heart disease than those on a low-fibre diet.
3) Fruit & vegetables– of every shape, size, colour and variety! For optimal health, vegetables or salad should take up 50% of your plate at every mealtime. The phrase “eat a rainbow” holds great significance here, with every colour representing a different disease-fighting antioxidant. The B vitamins, and in particular folate, play a vital role in keeping homocysteine levels down, which is a key marker for increased risk of heart disease.
Rich dietary sources of folate include romaine lettuce, spinach, asparagus, parsley, collard greens, broccoli, cauliflower and beetroot. The orange vegetables (carrots, sweet potato and squash) are packed with beta-carotene, which is vital for a robust immune system and good eye health.
Tomatoes are rich in the powerful antioxidant lycopene (the red pigment), important for prostate health and lowered risk of prostate cancer.
4) Olive oil –rich in healthy monounsaturated fats and polyphenols, compounds that are anti-inflammatory in the body and may reduce the risk of blood clotting. These healthy fats can also be found in avocados and nuts. To get the full health benefits of olive oil, choose cold-pressed extra virgin, and drizzle over salads and vegetables after cooking, as heating the oil to high temperatures can damage some of the good fats. Other plant-based oils, such as cold-pressed rapeseed oil and walnut oil, are also rich in heart-healthy monounsaturated and beneficial omega-3 fats.
5) Fish – packed with protein and a rich source of omega-3 fatty acids, which have been shown to improve blood vessel function, decrease risk of blood clotting, lower blood pressure and reduce inflammation. Oily fish (salmon, mackerel, trout and sardines) in particular contain high amounts of the omega-3 fatty acids DHA and EPA, which have shown to be cardio protective. Low levels of DHA have also been linked to both memory loss and a higher risk of developing Alzheimer’s disease.
Oily fish is also a good dietary source of iodine, which is known to improve mental clarity.
6) Herbs & spices – the use of fresh herbs and aromatic spices for flavouring is an integral part of Mediterranean cooking, and these confer a wide range of health benefits. Herbs and spices common to the traditional Mediterranean Diet include basil, chilli, cumin, fennel, garlic, mint, oregano, parsley, pepper, rosemary, sage and thyme.
Sage contains powerful antioxidants and compounds similar to those found in Alzheimer’s medications.
Mint is anti-inflammatory by nature and is also a natural decongestant. It is a calming and soothing herb, which is beneficial for digestion. And the list of fantastic therapeutic properties goes on.
7) Eggs– egg yolks are rich with choline, a B vitamin that aids memory and brain function. Choline is also required for the synthesis of acetylcholine, a messenger in the brain that relays communication between the brain and the nerves and muscle. Eggs also contain the antioxidants lutein and zeaxanthin, known to have powerful protective effects on the eyes, and have been shown to reduce the risk of cataracts and age-related blindness.
Eggs are one of the few food sources of vitamin D.
We rely largely on sunshine to get enough vitamin D, but sadly due to our lack of it in the UK, it is believed that well over 50% of the population may be vitamin D deficient. Studies have shown an association between low vitamin D levels and various mood disorders including depression and Seasonal Affective Disorder (SAD), with other known roles in bone health, immunity and cardiovascular function.
8) Water– staying well hydrated is a fundamental part of the Mediterranean diet. Many of us wait until we are thirsty before we reach for the bottle of water, but evidence suggests that our thirst sensation doesn’t actually occur until we are 1- 2% dehydrated, and by this time it may already be having a negative impact on how the body and mind perform.
On top of this, our thirst sensations start to diminish with age, meaning that we don’t always register we are thirsty until having reached a significant level of dehydration. Regularly sipping on water throughout the day is important, and there are also a number of fresh fruit and vegetables with high water content. Incorporating these “juicy” foods into our diets can help to ensure that we stay well hydrated. Cucumber, lettuce, celery, radishes, tomatoes, peppers, spinach and watermelon are all at least 90% water.
9) Red wine– the Mediterranean diet recommends a moderate intake of red wine may be beneficial for the heart. This means no more than 5 ounces (148 ml) of wine daily for women of all ages and men older than age 65, and no more than 10 ounces (296 ml) of wine daily for younger men. Red wine is rich in polyphenols, a type of antioxidant that can help protect blood vessels, lower blood pressure and reduce LDL (bad) cholesterol.
10) Physical activity- it’s not a dietary component, but that doesn’t mean it’s not a vital part of a healthy Mediterranean lifestyle. Regular exercise has been proven to reduce stress, lower feelings of anxiety & depression, boost self-esteem and improve sleep. It’s also vital for heart health by strengthening the heart, lowering blood pressure and decreasing risk of cardiovascular disease.
For a flavour of the Mediterranean, here are some recipes to inspire you.
Mediterranean Fish Pie
2 tbsp olive oil
1 large onion, finely sliced
3 cloves garlic, finely chopped or crushed
5 sprigs fresh thyme, leaves only
120g chorizo, sliced
100g kale leaves, chopped (other greens such as spinach or chard work equally well)
400g tinned chopped tomatoes
300g fish pie mix (or fish of your choice) skinned and diced
3 medium potatoes, sliced in 3mm rounds
salt & pepper
1. Pre-heat oven to 180°C
2. In a medium pan, gently heat the olive oil and add the onion and sauté for 5 minutes.
3. Add the chorizo and sauté for a further 3-4 minutes.
4. Add the garlic and thyme and cook for a further 2 minutes.
5. Add the tinned tomatoes and heat through for a few minutes before adding the kale and stir through.
6. Add the mixture to an ovenproof dish. Add the fish and mix to combine.
7. Top with the sliced potatoes, season well with salt & pepper and drizzle with 2 tbsp olive oil.
8. Cover with tin foil and cook in oven for 40 minutes.
9. Remove the foil and cook for another 15-20 minutes until the potato browns.
10. Serve with steamed green vegetables or a green salad.
Fish Stew with Fennel, Orange & Thyme
1tbsp olive oil
450g mixed fish, skinned and diced (fish pie mix)
1 medium onion, diced
1 clove garlic, finely chopped
1 small chilli, seeds removed, finely sliced
1 small bulb fennel, core removed and diced
5-6 runner beans, sliced into 1cm pieces
handful fresh thyme, leaves only
1tbsp tomato puree
200g (or half can) tinned chopped tomatoes
juice of 1 orange
500ml fish stock
1. Heat the olive oil in a heavy bottomed saucepan and then add the onion, fennel, chilli and garlic. Cook on a low to medium heat for 10 minutes until vegetables are softened but not coloured.
2. Add the thyme and beans and continue to cook for 2 minutes.
3. Add the tomato puree and cook for a further minute before adding the chopped tomatoes and stock.
4. Bring back to the boil and leave to simmer, half covered with a lid, for 15 minutes until the beans are tender.
5. Add the fish and the juice of the orange, bring back to the boil and cook for 5 minutes more.
6. Divide into warmed bowls and serve immediately.
Roasted Cherry Tomato, Red Pepper & Lentil Soup
3 tbsp rapeseed oil
2 punnets cherry tomatoes, on the vine
1 red pepper, left whole.
1 onion, finely sliced
1 red chilli, finely sliced (optional)
1 tsp ground cumin
1 tsp ground coriander
½ tsp turmeric
4-5 cloves garlic, unpeeled
2 medium carrots, diced
150g red lentils
3-4 handfuls kale or cavalo nero, torn, hard stalks removed
1.5 pints veg stock (or chicken stock)
1. Pre-heat oven to 180°C
2. Place the tomatoes in a large roasting pan and drizzle with 1tbsp rapeseed oil. Add the pepper to the pan and nestle in the garlic cloves. Place in the oven and roast for 30 minutes.
3. When ready, remove from the oven. Place the pepper into a sandwich bag and seal. Leave for 10 minutes.
4. Meanwhile, heat the remaining oil in a large saucepan. Add the onion and chilli and cook gently until just starting to colour.
5. Add the spices to the pan and cook for a further minute.
6. Add the carrots, lentils and stir to combine.
7. Remove the pepper from the bag and the skin should peel away easily. Chop the pepper, discarding the seeds. Add pepper and the cherry tomatoes to the pan, together with all the juices from the roasting pan. Squeeze the garlic from the papery cases and mash with the back of the spoon or spatula before adding the stock. Bring to a gentle simmer for 15 minutes.
8. Add the kale and continue simmering for another 10 minutes.
9. Season with salt and pepper if required.
10. Serve in warmed bowls and enjoy!
Grilled Mackerel Fillets with Mango Salsa
The beauty of this dish is in its simplicity. The mango salsa is also delicious combined with all other types of fish, curry, prawns, chicken, or even on its own on an oatcake!
4 pre-cooked mackerel fillets
1 large mango
200g baby plum tomatoes
1 small red onion
1 red chilli
juice of 1 lime
NOTE- There will be plenty of salsa left over from these quantities for you to have the next day.
1. To make the salsa, finely dice the mango, plum tomatoes, red onion, cucumber & red chilli and combine. Squeeze over the lime juice and mix together well.
2. Grill the mackerel fillets for 4-5 minutes or until heated through
3. Serve. Yes it’s that easy! Can we served accompanied with salad or vegetables
Baked Tomato & Kale Eggs
This dish is cheap, easy, and very delicious. It would also work well as a breakfast dish. Be creative with the ingredients – switch kale for spinach, kidney beans for butter beans, add fresh tomatoes, the possibilities are endless!
1 large onion, finely chopped
3 garlic cloves, finely chopped
1 red pepper, diced
1 tsp cumin
2 tsp smoked paprika
1 can kidney beans
1 can plum tomatoes
1 tbsp olive oil
salt & pepper
1. Pre-heat oven to 200°C
2. Heat olive oil in a deep heavy-bottomed pan. Add onion and gently sauté on a low heat, for about 10 minutes.
3. Add the red pepper, garlic, cumin and paprika. Continue to cook gently on a low heat for a further 10 minutes, or until the pepper starts to soften.
4. Add the tinned tomatoes, kidney beans, and half a tin of water. Season with salt and pepper, and stir well. Turn up the heat slightly and allow to simmer for a further 10 minutes.
5. 5 minutes into this cooking time add the kale. Stir in, and allow to wilt.
6. Once the kale has fully wilted, remove pan from the heat.
7. Transfer the contents of the pan into a ceramic baking dish (unless the pan is ovenproof!)
8. Make 4 wells in the tomato mixture, and gently crack in the eggs. Crumble feta over the top. Season with black pepper.
9. Bake in the oven for 10 minutes, or until the eggs are cooked, but still have a runny yolk.
10. Serve and enjoy!
Naomi Mead is a Cheltenham-based registered nutritional therapist at Food First.