The Mediterranean Diet

Fields of sunflowers, miles of coastline, and spectacular scenery make the Mediterranean a popular travel destination. Yet, scientists are beginning to appreciate this part of the world for an entirely different reason: its diet. Dozens of studies confirm that a Mediterranean style of eating—one that is rich in fruits, vegetables, olives, and whole grains—is not only healthful for the heart but for overall well being, too. In The Mediterranean Diet, health writer Eve Adamson and registered dietitian Marissa Cloutier join forces to detail many of the reasons why eating like they do in Greece, Italy, France, and other Mediterranean countries can be good for your long-term health and may even help you shed a few pounds in the process.

Eating and living as they do in rural areas of the Mediterranean—with a strong focus on plant foods and a routinely active lifestyle—is no doubt a healthful strategy. It probably can help with weight loss, too. Unfortunately, the book gives short shrift to how dieters can convert a Mediterranean diet into a weight loss regimen. It doesn’t give a lot of practical details on activity, either. To be honest, the information here is organized in a haphazard way. Particularly troubling is the rampant use of Q & A format, which makes it difficult to locate information pertinent to weight loss. Nevertheless, there’s much to be learned here about the Mediterranean approach to eating, which includes sources of monounsaturated fats—like olive oil, nuts, and fatty fish—that harbor heart-healthy omega-3 fats.

Basic principles:

Instead of counting calories, the idea is to approach food the way people in the Mediterranean do. It’s not simply about what foods are best to eat, but how to eat. Mediterranean style means slowing down and savoring foods. As for the foods, forget gyros, high-fat cheeses, or fettuccini. Rather, the focus is on rural or peasant fare. You’ll want to embrace a style of eating rich in fruits, vegetables, and whole grains with small amounts of seafood and healthy fats like olive oil, nuts, and avocados.

How the diet works:

Only a small portion of the book actually talks about weight loss. In that chapter, the authors offer a sample week of menus for weight loss, but dieters are encouraged to consult with dietitians or health professionals for daily caloric intake recommendations or diets tailored to their needs. The rest of the advice is broken down into four general strategies: Enjoy your food; watch portion sizes; drink lots of water; and exercise, rest, and relax.

What you can eat:

There are no food groups or appropriate portion sizes discussed in the chapter on weight loss. Included early in the book, however, are general guidelines for a Mediterranean diet. Design meals around fresh produce and whole grains, using only small amounts of high-fat animal products including meat and dairy. In addition, dieters could look to the general guidelines on how much and what kinds of foods make up a Mediterranean diet. Meat is eaten only a few times a month. Fruit is the best dessert. Olive oil is preferred, but use it carefully since it’s still high in calories. For folks who need precise amounts, a food pyramid lists serving sizes for a variety of food groups. One serving of vegetables, for example, is 1/2 cup, and three servings of vegetables are encouraged per day.

Does the diet take and keep weight off?

Who knows? A small study from Harvard suggests a Mediterranean-style weight loss diet, as long as it controls for calories, might be more satisfying for dieters. When researchers divided dieters into two groups, putting one group on a 1,200-calorie diet plan that was also low in fat (20% fat) and the other on a 1,200-calorie diet with more liberal Mediterranean-style amounts of fat (35% fat), the Mediterranean group was better able to keep weight off and reported feeling more satisfied with their diets. Although the book doesn’t mention it, a new 5-year diet study funded by the National Institutes of Health is currently underway to test the Harvard Mediterranean regimen with a larger group of dieters. That study began in 2004.

Is the diet healthy?

What little there is of it. There’s just one week of weight loss menus with no information about how many calories the menus contain.

What do the experts say?

Kathy McManus, RD, director of nutrition at Brigham & Woman’s Hospital, and one of the primary researchers on the Harvard weight loss study mentioned above, finds a lot of inconsistencies. “In some ways, the book sells short the benefits of olive oil and some of the healthy foods in traditional Mediterranean diets,” McManus says. It encourages keeping fat intake to 30 percent of calories or less on most days. The true Mediterranean approach, she adds, allows for higher amounts of fat as long as it’s the right kind: the monounsaturated fats that keep the heart healthy. “I don’t think the average dieter is going to want to read all of this, but it’s not complete enough for health professionals, either. It’s missing a lot of the latest research on Mediterranean diets,” McManus says. Joan Kanute, MS, RD, of Sherman Hospital in Elgin, Illinois, says she wouldn’t recommend the book to her patients, either, because it seems too technical for the average reader and doesn’t give specific enough advice about what to eat. “It was hard to weed through. If I wasn’t a dietitian, I’d probably think, ‘Well, what the heck are you trying to say here? What exactly should I be eating?’” Kanute asks, adding that the weight loss information is pretty minimal. “They give you a sample week of menus, but when you’re done, where do you go from there?”

Who should consider the diet?

If you want to brush up on the general health benefits of Mediterranean diets, this is an OK (but certainly not the best) tome on the subject. Skip it unless you want a dietitian to serve as your interpreter. While other books about the Mediterranean lifestyle may suggest a less sensible approach to eating, this version doesn’t offer enough information for the do-it-yourself dieter.

Bottom line:

There’s no question that the Mediterranean diet is a healthful one, but this book misses the boat when it comes to making the diet come to life for consumers. It overwhelms with scientific details rather than practical advice.

Lead writer: Maureen Callahan, M.S., R.D.