It’s feature time again, folks, and it’s finally time to talk about the diet everyone is going on about – keto! The keto (aka ketogenic) diet has gained a lot of popularity in the last few years as a weight loss diet, and proponents tout that you can lose weight quickly without cravings.1 Interestingly enough, the ketogenic diet started as a therapeutic diet for children who suffer from epilepsy. The high fat content of the diet is linked with decreased occurrence of seizures in these kiddos.2
Keto curiosity is rampant! Questions about the keto diet top the list of FAQs from my weight loss clients. Even those who don’t directly ask about keto are often asking about how to limit their carbs to encourage weight loss. Over the next few weeks, I’ll be posting info about the keto diet – what it is, how it works, and the pros/cons of the diet. I won’t actually be following this one (we’ll talk about why throughout the feature), but we’ll be diving into the research and practicality as always!
What is the keto diet?
The keto diet is a high fat, moderate protein, low carbohydrate diet.2 The diet is designed to cease your body’s reliance on carbohydrates (broken down into glucose) for energy and instead shift to your body’s alternative fuel source – ketones. In the absence of glucose (aka blood sugar), your body begins to convert fat that you’ve eaten and stored body fat to ketones, which your brain can use for fuel! If you were privy to the Atkins kick, you may be noticing some similarities between the two. You’d be right! The keto diet is something of a reincarnated version of Atkins.
The keto diet includes plenty of vegetables and many high fat and protein foods such as:
beef and pork
poultry
fish
processed meats like bacon, sausage, etc.
cheese
avocado
nuts and seeds
butter and oils
To limit carbohydrates (usually to around 20-60 g per day), the diet restricts consumption of the following foods:
fruit
beans
certain vegetables such as corn, peas, carrots, and potatoes
bread and grains (pasta, rice, cereal)
milk and yogurt
sugar, honey, and syrups
Keeping the carbohydrate intake low keeps the body from coming out of ketosis, therefore promoting fat loss.
Stay tuned – we will talk more about the research behind keto and pros/cons of following the diet in future posts!
A couple of weeks ago, I wrapped up a three week stent on the Mediterranean Diet. The guidelines of the Mediterranean Diet recommend that your primary fat source be olive oil, supplemented by fatty fish, nuts, and seeds. Olive oil is an excellent choice of fat – it’s loaded with monounsaturated fatty acids (MUFAs).1 Benefits of diets high in MUFAs include:
improved blood sugar and insulin sensitivity2
lower total cholesterol and LDL cholesterol2
blood vessels less prone to blockages2
possibly lower blood pressure2
reduced inflammatory responses3
The discovery and publication of these benefits led to a surge in the use of olive oil in all kinds of cooking and baking, for good reason! Who wouldn’t want to reap these benefits? There was, however, one concern looming regarding the use of olive oil in promoting health.
Smoke Points and Health
‘Smoke point’ is a term frequently discussed in the culinary world. Different oils have different temperatures at which they begin to create smoke and their aromas and flavors begin to change. This temperature is unique to each oil depending on its chemical composition and level of refinement/processing (and even varietal of the plant source4). They can also vary depending on what foods are being cooked in the oils.
Culinary experts recommend not cooking an oil beyond its smoke point largely because of the change in flavor. In addition, some voice concerns about the change in chemical composition that occurs when oils are heated beyond their smoke points.5-7 The general school of thought is that if an oil is heated beyond this point, it produces inflammatory, potentially carcinogenic compounds and some of the oil’s healthful properties can be diminished.8-9
Here’s where things start to get a bit dicey. Depending on who you ask, the smoke point of olive oil can be anywhere from 390-468° F, with the smoke point of extra virgin olive oil (EVOO) being anywhere from 325-410° F.5, 7, 10 Pretty significant ranges! Different cooking methods require different cooking temperatures, shown below.
Saute: 300-320° F
Pan-Fry: 350-400° F
Deep Fry: 350-400° F
Now you might conclude that olive oil is a good choice for a saute and possibly not the best choice for a good hot fry (depending on whose smoke point you go with). A 2018 study by Modern Olives Laboratory Services found that the negative changes that can occur with oils in heating are not so much related to their smoke points as to their general chemical stability.11 After heating many different oils and testing their chemical compositions at high heats for over 24 hours, the researchers found that EVOO was the most stable cooking oil, producing the lowest amounts of oxidative compounds when heated. I’m always hesitant to trust studies whose authors have significant financial stock in the outcome, but this claim is backed by other studies which found that virgin and extra virgin olive oils contained fewer harmful compounds and more antioxidants after frying for several hours, though the antioxidants are less effective after heating.4, 9, 12-14
So, should I cook with olive oil or not?
Yes – it turns out cooking with olive oil (particularly extra virgin olive oil) seems to be both a safe and nutritious way to saute or to fry foods. This newer information about olive oil’s stability helps to reconcile the health of those who follow a Mediterranean Diet with previous health concerns about the potential dangers of heating it. As a general rule, try not to use more heat than is necessary for your cooking job and limit time spent on the heat when you can.
Writing this post has actually changed the recommendations I will make to my clients, because I previously subscribed to the “smoke point” theory until I updated myself with this new research. That’s one of the many reasons I make sure to continue to keep up with this blog – it forces me to stay up to date and back up my recommendations!
During my time on the Mediterranean Diet, I actually ended up eating out several times. My husband and I make a point to have date day once a week, and then a couple of other family outings and lunch meetings worked their way in as well. It gave me lots of opportunities to see how eating out at different types of restaurants worked with the general Mediterranean diet guidelines.
General tips for eating out on a Mediterranean Diet
Base your choices around your overall diet – how big a piece of your life is restaurant eating? If you go out once or twice a month, don’t stress too much about your choices. If you eat out a few times a week, you might want to be more intentional about your choices because they make up a much greater percentage of your overall diet.
Choose a vegetarian entree – this is certainly not your only option, but will often put you smack in the middle of Mediterranean Diet recommendations. Vegetarian entrees will usually have a plant-based source of protein, a grain or starch, and plenty of veggies. That checks most of the Mediterranean boxes!
If you’re planning to get alcohol, wine is a great way to go – other alcohols aren’t too prominent on the Mediterranean Diet, and wine in moderation (4 oz. or less per day for a woman, 8 oz.or less for a man) contains some heart protective antioxidant benefits.
At most restaurants, plan to eat half the plate – take the rest home or share with a friend. Eating the entire amount of a meat served at a restaurant is almost always going to be more than one serving. I found that if I ate primarily plant-based or seafood-based proteins at home, then I could choose whichever protein I wanted when eating out and still eat the leftovers the next day.
Let the oil go – one of the components of the Mediterranean Diet is incorporating primarily olive oil as your fat source. When you’re eating out, you rarely know what cooking oil is being used. You can ask, but most likely the answer is not olive. Either try to avoid dishes made with lots of oil (go for grilled, baked, or roasted) or just accept that you’re unlikely to be getting olive oil in this particular meal.
Mexican
Mexican food can actually be a really great cuisine to choose foods within Mediterranean guidelines. Plant-based proteins like beans are used widely in Mexican cuisine. Pair those with some brown rice or a corn tortilla, lettuce, fajita vegetables,and salsa and you’re good to go! Add fish if desired. Of course, feel free to go for white meat or red meat if you are eating those sparingly overall.
One day after church hubby had a hankering for the taco truck. The taco truck serves monstrous portions and their typical burritos are very heavy on rice, beans, and meat and very light on veggies. I opted for the bowl-rito (all the stuffins’ without the tortilla) which contained chicken, rice, beans, fajita vegetables, salsa, and avocado. I ate half and saved the rest for another day.
A week or so later I met a friend for lunch at Chipotle – she needed gluten-free, I needed veggies! I opted for basically the same meal as I got at the taco truck: chicken, brown rice, black beans, fajita veggies, corn salsa, pico de gallo, and lettuce. I ate half and brought the rest home.
Mediterranean
This seemed like a bit of a no-brainer…one of my favorite restaurants is The Bocatta in Centralia, WA which boasts delicious Mediterranean cuisine. Hubby and I were in the area at lunchtime and it was an obvious choice! Interestingly enough, most of the sandwich meats offered were processed, so I opted for the vegetarian eggplant marinara sandwich with a side of balsamic marinated mushrooms. It was DEE-LICIOUS. No leftovers this time.
Breakfast
I chose one of my favorite breakfasts at the local McMenamin’s Spar Cafe – huevos rancheros! The dish includes corn tortillas, eggs, black beans, pico de gallo, cheese, avocado, and hash browns. I ate half and took the other home!
Burger
On a date lunch my husband and I decided to go to Red Robin. I figured I would choose the veggie version of the burger I normally get – the Bleu Ribbon. Delicious blue cheese and fried onion straws (not exactly sure how those factor in to the Mediterranean Diet…probably not particularly included. Didn’t stop me.) However, Red Robin is now carrying the Impossible Burger. I had not tried this item yet but it is a plant-based burger patty that supposedly famous chefs are raving about as the most meat-like non-meat burger they’ve ever cooked or eaten. I definitely wanted to try it, more to review it than anything. Paired the burger with sweet potato fries – again, I ate half and took the rest home for later. Stay tuned for the Impossible Burger review coming up! The non-Mediterrean downside of this meal was the low vegetable content – a handful of shredded iceberg on the burger does not a vegetable serving make.
Indian
When we went to Indian food, I had already eaten a bit of chicken for the week (which is what I usually get when we go there), so I chose the vegetarian lunch option which contained chana masala (spiced chickpeas and vegetables), palaak paneer (spinach and goat cheese), salad, lentil dahl soup, naan bread, and a sweet rice pudding called kheer. This meal is HUGE and I always take leftovers home and usually get one or two more meals out of them.
Overall, it wasn’t too hard to eat out and meet the Mediterranean Diet recommendations. I will say, as is always the case with strict portion “limits” as found on the Mediterranean Diet pyramid, it did at times leave me feeling a bit disappointed when ordering, because I didn’t always order the food I really wanted. That being said, everything I ate was delicious and I thoroughly enjoyed it so I didn’t end up feeling restricted overall. If you are someone who really gets your kicks out of meat-based entrees or you aren’t a big fan of plant-based proteins, this could be tougher for you. A better approach might be to limit eating out overall or to really make a point to keep your animal protein portion reasonable and take the rest home for later.
Monday was my last day following the Mediterranean Diet recommendations. My goals throughout this week were to work on increasing the variety of my plant-based proteins to deal with the boredom I was experiencing after the first two weeks. I also wanted to really try to make sure that I met my vegetable recommendations.
What Went Well
I met my goals! Instead of just beans and nuts this week, I incorporated tofu stir fry for lunch as well as hummus, tuna, and salmon throughout the week. It definitely helped with the boredom factor. I also managed to meet my veggie goals and actually met the recommendations each day individually, though I did end up eating one more serving of white meat in the whole week than I should have (gasp!).
Overall, following the eating pattern got easier as time went on. I was pleased to see that over the course of the 3 week experiment my grocery budget averaged the same as normal ($100 per week). The Mediterranean Diet, using a meal plan, was easily doable on a budget of $100 per week for four people. Eating a lot of plant-based proteins was actually a great way to save on groceries (and helped to balance out the cost of seafood).
Without specifically trying, I lost 2 lbs over the course of the 3 weeks on my normal level of activity (possibly a tiny bit less even in the third week). That is a normal, healthy rate of weight loss, so the evidence that the Mediterranean Diet can promote healthy weight loss was backed up in my case.
What Could Have Gone Better
While the variety of plant-based proteins helped, I still just came to the conclusion that I don’t enjoy most plant-based proteins as much as I enjoy chicken. I really didn’t miss beef and pork that much – I don’t think I really eat more than 1-2 servings of those per week normally, they aren’t really my thing. Chicken though, is a staple in my diet. While I do enjoy plant-based eating and I aim for it often, my biggest struggle over the three weeks was limiting my white meat intake to two servings per week.
That leads into one of my least favorite things about the Mediterranean Diet pyramid: the restrictions. For example, no more than 2 servings of sweets or 1 serving of processed meat per week.I’m a little torn because I am a type-A person who appreciates tracking and having concrete details and recommendations, but the psychology of restrictions still causes me to feel deprived and want more. That’s no way to live your food life! Skim the recommendations and use them as a guideline, but don’t stress if you eat a little outside them here and there. Eating more plant-based meals and fewer sweets than you do now is a great step, even if you don’t hit the exact limits on the Mediterranean Diet pyramid.
How I Did
Mediterranean Diet Goal*
Week #1
Week #2
Week #3
# of days nutrition recommendations met
7
5
4
7
Grains (daily average)
3-6 servings
4 servings
4.5 servings
4.5 servings
Potatoes (weekly)
≤3 servings
3 servings
2 servings
2 servings
Legumes (weekly)
>2 servings
3 servings
9 servings
10 servings
Dairy (daily average)
2 servings
2 servings
2 servings
2 servings
Fruits (daily average)
2-6 servings
2.5 servings
5 servings
3.5 servings
Vegetables (daily average)
4-6 servings
3 servings
3 servings
4 servings
Olives/nuts/seeds (daily average)
1 serving
1 serving
1 serving
1 serving
Eggs (weekly)
2-4 servings
3 servings
3 servings
4 servings
Seafood (weekly)
>2 servings
7 servings
4 servings
3 servings
Red meat (weekly)
<2 servings
1 serving
1 serving
2 servings
White meat (weekly)
2 servings
2 servings
1 serving
3 servings
Processed meat (weekly)
≤1 serving
1 serving
1 serving
1 serving
Sweets (weekly)
≤2 servings
2 servings
2 servings
2 servings
Weight change
-1 lb
0 lb
-1 lb
Grocery Budget Change
$0
-$33
+$35
Stay tuned for more posts about the Mediterranean Diet – we’ll talk about eating out, tips for making the Mediterranean Diet easier, and more!
Meal planning takes many forms depending on your lifestyle, budget, and personality. It doesn’t necessarily have to be a fully written-out meal plan. Some people prefer to plan only a couple of days in advance. Others prefer to buy groceries for a few different meals then have a bit more flexibility.
For the last two weeks I’ve been following a Mediterranean Diet (you can read more about it here). I’ve learned some tricks to make following this eating pattern a bit easier with meal planning. If you’re new to meal planning, first check out this post for my step-by-step instructions on making a meal plan. In today’s post, I’ll give you some ideas I’ve picked up in the last few weeks for meal planning on a Mediterranean Diet.
Keep Track
The Mediterranean diet pyramid has specific guidelines for how many servings of different items to eat per day or per week. When making a meal plan, it can be helpful to keep track of these groups (particularly the protein sources) to make sure you’re aiming in the right directions. I’ve created a free printable Mediterranean Diet checklist that you can download here to help. Even if you don’t follow these guidelines exactly (in fact, I’d recommend that you give yourself a little wiggle room), this checklist can keep you from straying too far from recommendations.
Leave yourself some flexibility
Some of the recommended serving amounts are quite limited (like 1 serving processed meat and 2 servings sweets per week). Because of that, I find it helpful to plan for fewer servings than the recommendations allow. This gives you the opportunity to have flexibility throughout the week in different social situations (or if you’re just tuckered out). For example, I didn’t include processed meat in my weekly plan and I only included one serving each of red meat and chicken (2 each are allowed). This meant that if I ended up in a place where processed meat was on the menu (high school football game hot dog, anyone?), I had the opportunity to choose it. One day when my son scored his first job, we wanted to celebrate with some DQ blizzards, and since I didn’t build sweets into my meal plan, I indulged without having to go over, go without, or change my meal plan.
Plan around your life
Along those lines, check out your calendar when you’re making your meal plan. If you know that you’re going to be eating a soul dinner (hello, football game!), try to load the rest of your day with the nutritious foods you’re not likely to get there. On the Friday I knew I was headed to the game, I knew I would get nachos and a hot dog for dinner (not much in the way of veggies or fruit) so I had a veggie scramble for breakfast, plenty of salad with veggie soup for lunch, and a couple of fruits for snacks.
I tried to check all those boxes before I went to the game to make it easier to follow Mediterranean Diet recommendations while still enjoying my social life!
Work with Family Dinners
Even if you decide to aim for a Mediterranean Diet eating pattern, the people you eat with may or may not be on board to eat the same way. These differing preferences can be a struggle – family members or partners don’t always make healthy changes in the same ways or at the same paces. Try to work with this when making your meal plan. If there are meals where you won’t be eating with your family members (lunches are commonly eaten separately, for example), plan for those to include the protein sources that aren’t limited like seafood or legumes. Shared meals (often dinners) can use some of the more limited protein sources like chicken, pork, or beef that your family members would want to enjoy.
Another trick for meal planning with a family is to include a balance of what I call “combo dinners” and “compartment dinners.” Combo dinners are meals like casseroles or soups where everything is mixed together. These are the types of meals where it makes the most sense to use the limited proteins like chicken or beef. Compartment meals are meals where each item is separate (usually in a meat + starch + vegetable configuration). These are good opportunities to make yourself a different protein from the rest of your family. It’s helpful to choose one that can be prepared and cooked in the same way as the rest of your family’s meal. For example, if the meal is baked chicken with vegetables and mashed potatoes, simply bake enough chicken breasts for the rest of your family and on the same pan, bake yourself a fish fillet. You’re not making an entirely separate dinner, just giving yourself some flexibility to eat with your family and still meet Mediterranean Diet recommendations.
Hopefully these tips are helpful to you as you aim to improve your health! The key is to make changes gradually, never expect perfection, and work with your lifestyle and personality, not against them. You can do it!
Week two of following the Mediterranean Diet is done and I’m learning a lot! The experiences I’m having help me provide tips to my clients for following a Mediterranean Diet.
What went well
This particularly week, grocery shopping was significantly cheaper than my normal grocery budget. I only spent $67 on groceries this week! Now, it’s pretty normal for my shopping trips to alternate from a more expensive “stock up” week to a cheaper “fill in” week (averaging $100 per week), so it’s likely that this next week’s shop will be quite a bit more expensive, but we’ll see. Regardless, I’m excited that the Mediterranean Diet is turning out to be so affordable so far!
My goal from last week was to try to increase plant-based proteins in my diet, and decrease fish intake a little. This is only because some Mediterranean Diet recommendations limit fish (others don’t) and I wanted to try not to go crazy with it since it seems to vary depending on the recommend-ers. Anyway, I succeeded! I swapped 7 servings of seafood last week for 4 this week, and 3 servings of legumes last week for 9 this week.
Challenges
One of my go-to proteins pre-Mediterranean diet was chicken, which is limited in the “white meat” category to twice weekly. That is significantly less than I’m used to…which is probably more like 5 times weekly (or more). I’ve found logistical ways to swap out chicken (mostly tuna, salmon, and beans), but I’m finding myself bored with these limited options since I’m having them so frequently. I need to work on incorporating more variety – there are other options, I just haven’t explored them as much as I could be yet.
The limited protein options I’ve been choosing has caused me, primarily out of boredom, to eat less protein overall. Since protein is very satisfying, this causes me to be hungrier overall and to be more likely to avoid eating when I’m hungry because I’m tired of my options. That isn’t very fun. As I mentioned, this limiting of my proteins is only partly due to the nature of the diet and partly due to my lack of effort in finding and using other protein options. I hope to remedy that in the upcoming week by picking up some hummus, pistachios, a different veggie breakfast sausage, and some tofu.
How I did
This week I did better on individual recommendations and succeeded in swapping seafood for more legumes. I also ate quite a bit more fruit (still within recommended ranges). I did, however, have two soul meals this week (celebrating my son getting his first job and enjoying some delicious nachos at a football game). These are not “cheat days,” by the way. They are living life, and living life is not cheating. These two meals threw off my count for days that I met recommendations.
Next week I’m going to focus on upping my veggie intake – it’s been low both weeks. I’m planning to get some snacking veggies and some hummus to up my protein and veggie munching next week.
Mediterranean Diet Goal*
Week #1
Week #2
# of days nutrition recommendations met
7
5
4
Grains (daily average)
3-6 servings
4 servings
4.5 servings
Potatoes (weekly)
≤3 servings
3 servings
2 servings
Legumes (weekly)
>2 servings
3 servings
9 servings
Dairy (daily average)
2 servings
2 servings
2 servings
Fruits (daily average)
2-6 servings
2.5 servings
5 servings
Vegetables (daily average)
4-6 servings
3 servings
3 servings
Olives/nuts/seeds (daily average)
1 serving
1 serving
1 serving
Eggs (weekly)
2-4 servings
3 servings
3 servings
Seafood (weekly)
>2 servings
7 servings
4 servings
Red meat (weekly)
<2 servings
1 serving
1 serving
White meat (weekly)
2 servings
2 servings
1 serving
Processed meat (weekly)
≤1 serving
1 serving
1 serving
Sweets (weekly)
≤2 servings
2 servings
2 servings
Weight change
-1 lb
0 lb
Grocery Budget Change
$0
-$33
In case you were wondering…
My digestive disturbances have resolved…thank you for asking.
That’s two weeks, folks! One to go and much more to learn…
*Based on the FDM recommendations I chose to follow. AHA and ACJN limit fish to “low to moderate” amounts.
For the two weeks I have been following recommendations for the Mediterranean Diet. For many years scientists have been trying to pin down and research the eating patterns of countries with the best overall health. Over time, the Mediterranean people have been one of a few groups with some of the most noteworthy health outcomes and lowest rates of disease. Closely following the Mediterranean eating pattern (with slight variations based on differing guidelines) has been shown to provide people with the following benefits:
Improved Overall Longevity
9% less likely to die of any cause1-2, increased to 50% in people 70-90 years old (https://jamanetwork.com/journals/jama/article-abstract/199485)
9% less likely to die from cardiovascular disease1-3
6% less likely to die from cancer1-3
Better Heart Health
improvement in the ratio of “good” to “bad” cholesterol2
lower incidence of major cardiovascular events in high risk populations2
9% less likely to die from cardiovascular disease1, 3
Improved nutritional intake
meeting recommendations for daily fiber consumption2
consuming more healthful monounsaturated fats and fewer inflammatory saturated fats2
Weight Management
decreased calorie intake compared to participants’ baseline intakes2
gradual weight loss averaging 5 lbs per year2
Tighter Blood Glucose Management
lower fasting blood glucose and lower insulin levels in diabetic participants2
Preserved Cognitive Function
lower incidence of Alzheimer’s disease4
13% combined lower incidence of Parkinson’s Disease and Alzheimer’s disease1
Improved Cancer Outcomes
6% reduced incidence of or death from cancer1
This is by no means an exhaustive list of the documented benefits of the Mediterranean Diet – there are many more! This gives a good overall impression of what the research says about this eating pattern. Stay tuned as I continue to share about my experience following the Mediterranean Diet, and tips for making it easier.
Sofi F, et al. Adherence to Mediterranean Diet and Health Status: A meta-analysis. BMJ. 2008. 337. Accessed from: https://www.bmj.com/content/337/bmj.a1344.long.
Trichopoulou A, et al. Adherence to a Mediterranean Diet and Survival in a Greek Population. N Eng J Med. 2003. 348:2599-2608. Accessed from: https://www.nejm.org/doi/full/10.1056/nejmoa025039.
Knoops K, de Groot L, Kromhout D. Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women. JAMA. 2004. 292(12):1433-1439. Accessed from: https://jamanetwork.com/journals/jama/article-abstract/199485.
Scarmeas N, et al. Mediterranean diet and risk for Alzheimer’s disease. Ann of Neurology. 2006. 59(60):912-921. Accessed from: https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.20854.
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