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 cause^1-2, increased to 50% in people 70-90 years old (https://jamanetwork.com/journals/jama/article-abstract/199485)
• 9% less likely to die from cardiovascular disease^1-3
• 6% less likely to die from cancer^1-3

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 disease^{1, 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

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.

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References

1. 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.
2. 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.
3. 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.
4. 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.

Today marks the end of my first week on the Mediterranean Diet. My first impressions are that the Mediterranean Diet is heavy in fish and beans, nuts, seeds, grains, fruits, vegetables, and olive oil. Those things are all basically free-for-alls.* The diet includes a decent allotment of dairy products, and then some limited amounts of other animal-based proteins like chicken, beef, and pork.

Following the Mediterranean Diet was not a major struggle, but not entirely a walk in the park either. Read on to find out about my first week!

What went well

The biggest win of the week was the fact that I stayed within my grocery budget – I was very concerned about how expensive all that fish was going to be! It was so pleasantly surprising that groceries were comparable cost to my normal budget of $100 per week. Likely that was because the expensive seafood and the cheap beans in this diet balanced each other out.

I really enjoy fish and plant-based proteins so it wasn’t hard to eat those. I swapped my typical canned chicken for canned salmon to use on sandwiches and salad. I also learned a thing – canned salmon (at least the brand I bought) contains bones and skin! Who knew? Probably you – but not me (until last week). For breakfast proteins, I used Morningstar brand veggie sausage patties to avoid processed meat in the mornings. All that worked really well!

Challenges

The major challenge I faced this week was trying to navigate conflicting and/or vague recommendations from different sources. For example, the American Heart Association (AHA) and American Journal of Clinical Nutrition (AJCN) recommend low to moderate intake of fish, while the Mediterranean diet pyramid by the Fundación Dieta Mediterránea (FDM) recommends ≥2 servings of fish and seafood per week. The detailed guidelines from the FDM provided more specific guidance (which my type A brain appreciates), so I chose to follow those.

The AHA and AJCN also provide more generalized, less specific guidelines (e.g. low to moderate intake of fish and poultry). The Fundación Dieta Mediterránea gives very detailed recommendations in their Mediterranean Diet pyramid (e.g. <2 servings red meat per week). These types of differing messages are frequent sources for confusion for my clients. When you’re dealing with more generalized recommendations, you wonder “what does “low to moderate” mean, exactly?” When you have specific detailed guidelines, it can be difficult to count and keep track of them all. I struggled with this a bit, particularly since some of the recommendations are daily and others are weekly.

The detailed guidelines are a bit more restrictive than my typical diet in some areas. The biggest struggles were sweets and processed meat, believe it or not. Since there was no definition for these categories, I found myself wondering “what qualifies as a “sweet”? Obviously cookies, candy, etc. but what about beverages with added sugar, fruit juice, a few chocolate chips, a waffle with syrup?” I ended up deciding that I would only count dessert-like items in this category.

I had the same struggle with the “processed meat” category. Technically, all meat from the store is processed to a point…it’s been butchered and cut, sometimes seasoned, pressed or shaped, frozen, canned, etc. I assumed that any meat that has been ground and pressed with additives would count as processed meat – hot dogs, lunch meat, sausage, ham, etc. I did not include canned plain meats (chicken, salmon, tuna) as processed.

These two categories (sweets and processed meat) also proved most difficult for me to limit within the recommendations. Both of these things surprised me! I don’t generally consider myself a sweets person (I prefer salty all the way!), but limiting these to twice weekly was a challenge. The very first night I went to my grandma’s house for dinner and we ate ham (my processed meat for the week!) and dessert (one of my two sweets allotments for the week).

It was all totally worth it – it was made by my grandma, after all – but it was an early lesson in how quickly those allotments can go!

How I did

Following the Mediterranean Diet recommendations was a little tougher than I anticipated, partly because of the challenges mentioned above, but not extremely difficult.

The 2-4 egg per week, 2 servings dairy per day, and 2-3 servings fruit per day allotments pretty much reflect my typical intakes, so that wasn’t tough at all. I do pretty well with veggies in general, but I couldn’t quite average two servings per main meal.

Possibly TMI reality

Digestive disturbances. Normal with any diet change, but ever obnoxious. Let’s leave it at that.

All in all, my last week has gone pretty well. I’m looking to get a bit more organized and try to balance the seafood with more plant-based proteins this week since the AHA and ACJN recommendations are to moderate those also. Stay tuned!

*Based on the FDM recommendations I chose to follow. AHA and ACJN limit fish to “low to moderate” amounts.

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On Monday, I did my grocery shopping for my first week following the Mediterranean Diet recommendations – you can see the food and ingredients I bought in the picture below. In addition to these, we already had olive oil, canned and dried beans, dry pasta/rice, bread, fresh vegetables, and canned/frozen fruit that I expect I’ll be using.

Mediterranean Diet staples

Below is a summary of the nutrition staples I made to guide my grocery shopping throughout my time on the Mediterranean diet.

• Proteins: fish (fresh, canned, or frozen), shellfish, canned or dried beans, nuts, seeds
  • Limited chicken, pork, and beef (1-2 servings of each per week)
• Low- or non-fat dairy products: milk, yogurt, part-skim mozzarella cheese
• Vegetables: select a variety – fresh, frozen, or canned (no salt added)
• Fruit: select a variety – fresh, frozen, dried, or canned (in juice)
• Grains (preferably whole grains): pasta, rice, bread, crackers
• Beverages: tea, water, wine (if desired)
• Other: olive oil, vinegar, herbs, spices, olives

The Cost of Following a Mediterranean Diet

Originally I was concerned that the Mediterranean Diet would be particularly expensive because of its emphasis on seafood. I was pleasantly surprised that I was still able to meet our normal grocery budget of $100 per week for our family of four (check out my series on Eating Well on a Budget if you want to know about how I do that) while shopping for the Mediterranean diet.

There are probably a few reasons I was able to easily stay within budget:

• I had several Mediterranean Diet staples already in my pantry.
• My family eats the same dinners, but lunches and breakfasts are often individual, so I wasn’t necessarily buying Mediterranean diet foods for all four of us for three meals per day all week. In addition to the foods pictured above, I purchased several items for the rest of my family that I won’t be eating.
• While the Mediterranean Diet has some more expensive aspects (seafood, olive oil), it also has some lower-cost aspects (beans, pasta, rice, bread) and limits other higher-cost options like red meats. Altogether, they may balance each other out.

Since this is only the first week of shopping for a Mediterranean Diet, I’ll see in the upcoming weeks if it continues to match our normal grocery budget and keep you posted!

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You voted, and my next diet feature is the Mediterranean Diet!

The Mediterranean-style diet is often praised for its associations with improved longevity and low rates of chronic disease and certain cancers. The diet is based on the eating patterns of countries bordering the Mediterranean Sea, particularly Greece and southern Italy.¹ The exact parameters of the Mediterranean diet are not entirely clear and vary somewhat depending on who you ask.² Part of this stems from the fact that there are several different Mediterranean countries – each with their own unique culture. Their diets are distinct and therefore have different characteristics.

In general, however, there are some trends that are consistent. According to the American Heart Association and the American Journal of Clinical Nutrition, the Mediterranean Diet includes:

• high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
• fresh fruit as a daily dessert
• olive oil as the prominent fat source
• dairy products, fish and poultry in low to moderate amounts
• less than 2 servings of red meat per week
• 0-4 eggs per week
• wine in low to moderate amounts^1-2

The Fundación Dieta Mediterránea developed a food guide pyramid reflecting Mediterranean Diet recommendations as well:

Starting next Monday, I will be following these recommendations for 3 weeks and detailing the experience for you! I’ll be keeping tabs on how much it costs to follow, the challenges of following it, and more. Comment below with what you’d like to know about the Mediterranean Diet!

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References

1. Willet W C, et al. Mediterranean diet pyramid: a cultural model for healthy eating. June 1995. 61:6(1402S-1406S). https://doi.org/10.1093/ajcn/61.6.1402S.

2. American Heart Association. Mediterranean Diet. Reviewed April 2018. Accessed September 2019 at https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet.

Thanks to all of those who voted in the poll for my next featured diet! Your voices have been heard – my next feature will be…

the Mediterranean diet!

This diet, touted for its benefits for longevity and cardiovascular health, is a popular diet recommended by many doctors. In the coming weeks, I will be blogging about the research behind the Mediterranean diet. I will also follow the diet myself for 3 weeks to assess how easy it is to follow, how much it costs, and other lifestyle factors.

You can have the opportunity to win my favorite personal blender to have for your very own! Visit Dietitian on a Diet on Facebook and check out the giveaway post (pinned to the top of the page) to find out how!

Giveaway ends Tuesday, September 10th at 7 pm. Hope to have you join in!

Today we’re continuing our series looking into what food and nutrition experts typically eat. If you haven’t read part 1 or my What I Eat in a Day as a Registered Dietitian post, be sure to check those out too! Altogether, you’ll see 10 days worth of dietitian food. Hopefully it helps you to see how varied and delicious a healthy life can be – everyone’s healthy life looks different! Enjoy!

Kayci Sterzer, MSN, RDN, LDN, CEDRD

Allison Davies, MS, RD

Allison lives in Vancouver, WA. She worked as a primary practice RD for about four years but has stayed home with her 14-month old son for the last year. She loves going for walks and reading historical fiction books. Her favorite foods are tacos and Thai red curry and her favorite candy is Skittles.

Best nutrition advice: Make a meal plan for the week before grocery shopping. It’s a good way to make sure you’re eating a variety of different foods and also cut down on food waste.

What she ate in a day:

My typical day usually revolves around my son’s nap schedule and some sort of outing in the afternoon. On this day, I packed a lunch to eat at my parents’ house. There are a few things I do every week that keeps the stress off of meal prep while trying to tend to my son. On Sundays I sit down and meal plan every meal. There are definitely meals that repeat, especially breakfast, but it takes the guesswork out of what to make and ensures that I buy enough ingredients at our weekly grocery store stop. I will also prep veggies and cut up meats in the evening after my son goes to bed to be ready for the next day. My son and I eat at the same times and primarily the same foods, except for choking hazards like nuts (and I do cut his foods differently). One part of this day that is not so typical is actually the cup of coffee! I only have coffee drinks once or twice a week and it’s usually a vanilla latte. 🙂

For breakfast at 7 am I ate scrambled eggs with 1 slice turkey bacon (the bacon was cooked the night before), an apricot, 1/2 bagel with cream cheese, and a cup of coffee with splash of whole milk. My lunch was around 11:30 am and included a turkey and Swiss sandwich on Dave’s Killer thin sliced wheat bread with 1/2 avocado and some sour cream and onion Pop Chips. Around 2:30 I ate a snack of homemade trail mix made of walnuts, almonds, peanuts, sunflower seeds (all unsalted), and dark chocolate chips. I prepped the trail mix earlier in the week.

We ate dinner around 5-5:30 pm. The dinner included chicken sausage and zucchini I had prepped the night before, as well as red beans and rice. Around 7:30 I snacked on one or two clusters of these dark chocolate nuggets from Costco.

Diana Reid, MPH, RDN

Diana currently lives in Europe with her husband and three children, in the tiny country of Luxembourg. She provides nutritional counseling and coaching both in-person and online or via telephone to clients throughout the world through her practice The Global Dietitian. She also spends part of the summer (and often the December holidays) in the Seattle, WA area. Diana holds a Masters of Public Health degree in nutritional sciences from the University of Washington. Additionally, she has a Bachelor of Arts degree from Western Washington University in the field of marketing and business administration.

Best nutrition advice: Focus on what you can add to your diet rather than always worrying about what to take out. Can you add more fruit and veg? Can you drink more water? These are underestimated, powerful tools.

What she ate in a day:

My day started with fruit, Greek yogurt, granola, and a bit of cottage cheese for breakfast. I was on the run during lunch and ended up eating lentil salad with some sriracha sauce for extra flavor. Later for an afternoon snack, I had cherries and a protein bar to get me through until dinner. Dinner was shrimp, rice and quinoa salad with tomatoes and avocado. Finally, to top it all off, ya gotta have dessert! Tonight’s was a fruit plate topped with some chocolate sauce for good measure. 🙂

Jessica Forsman, RD, CD

Jessica Forsman has her bachelor’s degree in Food Science & Human Nutrition and has been a Registered Dietitian for 11 years. She initially practiced as a clinical dietitian before transitioning into hospital dietary management and later into healthcare administration. She is currently an Executive Director over Physician Services at a hospital in western Washington. Outside of work, she loves having downtime at home with her husband and spending time with family.

Best nutrition advice: Keep it simple. Focus on fruits and vegetables. Don’t go to extremes or overly restrict. Enjoy what you eat!

What she ate in a day:

I chose a fairly typical Monday to highlight. I woke up late, but had prepped lunches the night before and had blueberries and almonds on hand for an easy breakfast. I’m not always motivated to prep our lunches a day ahead, but I’ve found that it makes all the difference when it comes to getting out the door on time and eating well throughout the day. Plus, it just feels good to be organized.

Breakfast included blueberries & roasted almonds and coffee with half & half. Later for lunch I ate ½ sandwich with 2 slices of smoked turkey, 1 slice cheddar & a thin layer of mayo on Dave’s Killer Bread. On the side were fresh veggies, kettle cooked chips, cherries and sparkling water. Nutrition tip: when buying deli meats, I usually look for natural brands without added nitrates/nitrites and where I can recognize all of the ingredients on the label. I especially like Applegate Naturals.

Later in the afternoon I ordered a double tall iced white chocolate mocha without the whipped cream. It’s important to choose foods that are satisfying – and for me, that usually means opting for the real thing. I rarely eat light or diet foods simply because I don’t enjoy them. By not restricting the foods that I enjoy, I find that I’m usually content with less. For an afternoon snack I ate string cheese & the rest of the cherries that I didn’t finish at lunch.

After work I snacked on seasoned tortilla chips. I do my best never to get too hungry and will frequently opt for snacks. In this case, dinner was only about 20 minutes away, but I still felt like I would be too hungry by the time dinner was ready if I didn’t eat something. Snacks are a tool that I use to avoid overeating.

We had company over the day prior and had two crab cakes, asparagus and roasted potatoes left over. Not enough on its own to feed two of us, so I added salad with Annie’s Papaya Poppy Seed Dressing, ½ piece of toast on Dave’s Killer Bread with a 50/50 butter/canola oil blend, and blueberries. I usually only have time to cook 2-3 nights in a given week, but I try to leverage (and even plan for) leftovers whenever I can. I also try to keep easy dinners on hand for those days when things don’t go as planned. Finally, I topped the night off with an evening snack of chocolate peanut butter granola with milk!

More to come?

I would like to sincerely thank each of these dietitians who were willing to take the time to help me with this project and allow us a peek into their day-to-day. This is a series I would love to continue to show the variety of options out there in regard to healthy eating. Within the community of Registered Dietitians, there are men, women, vegan/vegetarians, dietitians with food intolerances, dietitians from all different cultures, and more. If you or someone you know is a Registered Dietitian who would be willing to share their “what I eat in a day,” I would love to feature it! Let me know with this contact form.

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