Mediterranean Diet

 The Mediterranean diet do’s and don’ts

The Mediterranean diet is a heart-healthy eating plan that emphasizes whole, minimally processed foods, rich in healthy fats, lean proteins, and fiber. It has been associated with numerous health benefits, such as reduced risk of chronic diseases and improved mental health. Here are some general do's and don'ts for following the Mediterranean diet:

Do's:

1. Prioritize fruits and vegetables: Aim for a colorful variety, as they provide essential vitamins, minerals, and fiber. Aim for at least five servings per day.

1. Craving sweets? Eat berries in low sugar such as blueberries, blackberries, raspberries and strawberries. 

2. Choose whole grains: Opt for whole grain bread, pasta, rice, and other grains, as they provide more nutrients and fiber than refined grains.

1. Treat white bread, regular pasta, potatoes as if they’re deserts. Mainly eat whole grains. 

3. Include healthy fats: Focus on monounsaturated and polyunsaturated fats found in olive oil, nuts, seeds, and fatty fish like salmon, mackerel, and sardines.

1. Minimize foods with saturated fat and pure saturated fats such as butter, cream etc. 

2. Hungry between meals? Consider snacking on portion-controlled nuts.

4. Eat lean proteins: Incorporate fish, poultry, beans, and legumes as your primary protein sources. Limit red meat to a few times a month.

1. Make legumes such as beans and lentils a regular part of your diet. 

5. Consume dairy in moderation: Choose low-fat or fat-free options for yogurt, cheese, and milk.

6. Use herbs and spices: Flavor your food with fresh herbs and spices instead of relying on salt for taste.

7. Enjoy moderate amounts of red wine (optional): If you drink alcohol, a moderate consumption of red wine (up to one glass per day for women, two for men) is allowed.

8. Stay physically active: Regular exercise complements the Mediterranean diet and supports overall health.

Don'ts:

1. Don't consume excessive amounts of red and processed meat: These can be high in unhealthy fats and are associated with increased risk of chronic diseases.

2. Don't rely on processed and refined foods: Limit consumption of sugary beverages, snacks, and pastries, as they often contain added sugars, unhealthy fats, and excess sodium.

3. Don't use unhealthy fats: Avoid trans fats found in some margarines, fried foods, and packaged snacks.

4. Don't overindulge in alcohol: Stick to the recommended guidelines or avoid alcohol entirely if you have a history of alcohol abuse or certain medical conditions.

Remember, the Mediterranean diet is more than just a list of do's and don'ts; it's a lifestyle that encourages enjoying meals with family and friends, being mindful of portion sizes, and staying active. Always consult with a healthcare professional before making significant changes to your diet.

The Mediterranean Diet Checklist (aim for MEDAS score ≥ 8)

Items	Amount	MEDAS scoring (points)
Olive oil as the principal source of fat for cooking	Yes	1
Olive oil frequency per day	≥ 4 Tbsp	1
Vegetables per day	≥ 2 (≥ 1 portion raw or as salad)	1
Fruits per day	≥ 3 pieces	1
Nuts per week (1 serving = 30g)	≥ 3	1
Legumes per week	≥ 3	1
Fish per week	≥ 3	1
Chicken	Preferentially consume chicken, turkey instead of veal, pork, hamburger or sausage	1
Red/processed meat	<1 serving/day of red meat, hamburger or meat products like ham, sausage etc	1
Sweets per week	< 3	1
Wine	≥ 7 glasses per week	1
Sweetened or carbonated beverages	< 1 per day	1
Butter, margarine or cream per day	< 1 serving	1
Sofrito sauce	≥ 2 per week	1
Total score	≥ 8 denotes adherence	14

Source: Wikipedia

Mediterranean diet macros (ref):

• Fats – 35% to 40% (61 grams)

• Carbohydrates – 50% (195 grams)

• Proteins – 15% to 20% (59 grams)

• Fibre – 32 grams

• Calories – 1,527 kcal

• Saturated fats –  less than 10%

• Sugars – 20%

Food ideas:

• Chipotle salad with beans + chicken + salsa without cheese and cream

• Bibibimbop with brown rice

• Tuna sandwich from Jersey Mike’s

• Veggie pattie from Subway

• Lentil dish at home 

• Mixed veggies at home + low fat yogurt

• Salad at home + sardines

Mediterranean diet for MPNs

Mendez et al. explored the feasibility of a Mediterranean diet intervention in patients with MPN in two randomized clinical trials. In the first trial, 75% of participants in the Mediterranean diet (MED) group maintained a MEDAS score of ≥8 throughout the 10-week intervention, indicating successful adoption of the diet with registered dietician (RD) counseling. Approximately half of the MED group experienced a ≥50% reduction in MPN-Total Symptom Score (MPN-TSS) at weeks 9-15, while only 31% in the USDA arm achieved the same reduction at 15 weeks. No significant changes in cytokines or hsCRP were found, and the MPN subtype played a more significant role in microbiome diversity than the diet intervention. In the second trial, participants in the MED group had a 43% chance of achieving a ≥50% reduction in MPN-TSS, compared to 29% in the DASH group. The study concluded that MPN patients can adopt a Mediterranean diet with RD counseling, and a remotely administered intervention is feasible. The Mediterranean diet, which is rich in anti-inflammatory foods, may help manage symptom burden in MPN patients, and the researchers plan to conduct larger randomized studies to further explore its impact.