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Dr. Anna Colombini was recently recognized as a Business Examiner 40 Under 40, 2008 Honoree.
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The Mediterranean Diet and Heart Health
By Dr. Anna Colombini

My husband and I just recently went to Italy to celebrate his fathers 60th birthday with a large group of family and friends. We stayed on the island of Ischia, which is a 30 minute ferry ride from Naples. The latter part of our trip my husband and I traveled south of Naples to the infamous Amalfi Coast. For 3 weeks we were immersed in Italian culture rich in fresh food markets that lined the streets as numerous as our Starbucks here in Washington State. I felt inspired by the rich flavor and color I experienced in the food to come back and tell my readers and patients about the importance of a diet rich in health.  

The Mediterranean Diet is a modern nutritional recommendation that was patterned after some of the countries of the Mediterranean Basin such as Greece and southern Italy in the early 1960's. Food patterns of these countries include abundant plant foods, fresh fruit as a typical daily dessert, olive oil as the principal source of fat, dairy products such as cheese and yogurt, and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts. This diet is rich in monounsaturated fat and dietary fiber and low in saturated fat. Also, daily exercise in the form of farm work and walking are a large part of the Italian culture.  

We found it refreshing to walk to our destinations on varying terrain rather than driving everywhere. We often enjoyed a delicious lunch of insalata mista (a mixed green salad that is popular in Italy), fresh pasta, olives soaked in pungent extra virgin olive oil and red wine. This diet is somewhat of a paradox in that the people living in the Mediterranean countries consume relatively high amounts of fat, yet they have lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat are consumed.

So the question must be asked, why is this? Well, several factors such as the quality and type of food, not to mention the abundant variety of nutrients. I often teach my patients the value of variety. You may be eating healthy food every day but if it is always the same food you are limiting the variety of nutrients your body needs for optimal function. The Mediterranean diet is rich in variety with monounsaturated fat found in the consumption of extra virgin olive oil, known to lower cholesterol and blood sugar levels in the blood, and to lower blood pressure. Here in the United States we consume a higher amount of saturated fat from red meat and cheese. Also, a variety of multicolored fruits and vegetables, whole grains, legumes, fish, poultry and wine lend to a diet that is rich in essential fatty acids like omega-3 and omega-6 fatty acids, bioflavanoids, and fiber.

So, what are the benefits of the above foods? Essential fatty acids must be consumed to be in our body meaning that our body cannot assimilate them from other nutrients. Essential fats are extremely important in the function of every cell membrane in our body, lowers cholesterol, and is very important in lowering inflammation. To learn more on essential fatty acids read my article, "The Essentials on Fish Oil".   Bioflavanoids are plant nutrients that are powerful antioxidants and are anti-inflammatory. Eating a diet rich in bioflavanoids is important in prevention of heart disease because oxidation of "bad cholesterol" LDL causes plaque to build up in the arteries and inflammation decreases blood flow to the organ the artery supplies. If the blood flow is restricted in one of the arteries that supplies the heart this is called a heart attack. Fiber found in fruits, vegetables, whole grains and legumes also contributes to lowering cholesterol, not to mention its ability to decrease colon cancer by allowing healthy elimination of toxins through our bowels. Therefore, a diet rich in essential fatty acids, bioflavanoids and fiber all contribute to the heart healthy benefits of the Mediterranean diet.  

I must also give due diligence to the cultures ability to take time to eat and enjoy their food. I was struck by the festivity and tradition that surrounds food preparation. This usually consists of walking to the market to get the fresh, vibrant hued ingredients.   How can you not get excited with a mesh bag filled with such beautiful color? Then the food preparation: a work of art, simple, and void of additives that burden our body with toxins. The standard American diet (aka the SAD diet) typically has high saturated and trans fats along with highly processed foods and low plant consumption. I found such delicious meals and festivity at Ristorante da Ciccio on the island of Ischia. A quant restaurant that is ran by a father and two of his sons. They all worked in perfect harmony and true Italian hospitality to create a memorable culinary experience. As if their delicious meal of fresh sea food, vegetables and of course vino was not enough, an accordion player strolled in from the cobblestone street to play a few classics for our enjoyment.  

So, how do we incorporate the Mediterranean diet in our every day lives? Consume large amounts of fresh fruit and vegetables. Replace saturated fats and fried foods with olive oil, fish and organic poultry. Eat whole grains like brown rice, quinoa, millet and multigrain breads rather than bleached white grains. Consume legumes like pinto, garbonzo, cannelini, lentil and black beans. Lastly, sit down, take a deep breath and enjoy your food!