Eating the Mediterranean way – NEJM article shows it will help you live -to Savour It All – longer

Heart health is mostly in our hands
Heart health is mostly in our hands

Maybe it’s because I’m just back from a beach holiday where I ate fresh fish, fruit and vegetables everyday or maybe it’s because February is “Heart Month” but healthy eating is on my mind.

It could also be that I’m getting older and as The Rolling Stones infamous guitarist Keith Richards, says,

“The older you get, the older you want to get”.

If I have the good fortune to live a long time, I want to do that in health and prosperity. I think there are three things that are going to help me get there.

1. I cook (from scratch) and people who cook for themselves and their families are going to live longer because homemade food will always be healthier. A 2003 Harvard study led by David Cutler showed that most of the increase in obesity in America could be explained by the rise of food preparation outside the home.

2. I’m adopting the principles of the Mediterranean way of cooking and eating.

3. Last but not least, a body in motion stays in motion so you’ll always find me looking for ways to “move it, move it” as exercise is one of the most beneficial things you can do for a long and healthy life.

This post will examine what the mindful choice to eat in a more Mediterranean fashion might look like for a land-locked Albertan. I’ll also include a few articles that provide the evidence of why this really is a great strategy for living a longer and healthier life.

Today, my friend Al-Karim Walli, Associate Director of the Libin Cardiovascular Institute of Alberta, sent me this great article of how to adapt the Mediterranean Diet to South Asian ingredients. Walli knows that I am currently editing an Indian cookbook and he was right in thinking I’d like to include some of these principles in that effort. Here’s that article as follows:

Nutrition Centre: Doing the Mediterranean diet, South Asian style.

That article was no doubt inspired by the landmark study published last year by a group of Spanish researchers in The New England Journal of Medicine (NEJM). The PREDIMED study proved that the Mediterranean lifestyle of walking, cycling, doing lots of gardening and outdoor work combined with eating fish, grains, legumes, lots of fruits and vegetables topped up with a good dose of olive oil and a handful of nuts here and there is effective primary prevention from death from cardiovascular disease. Here’s a link to that study as follows:

Primary Prevention of Cardiovascular Disease with a Mediterranean Diet — NEJM.

In case you aren’t perfectly clear on why it’s important to prevent Cardiovascular disease – that’s deaths from heart attacks and strokes – it’s because Cardiovascular disease is still the number one cause of death worldwide.

People in the NEJM study, were not put on a “diet”. They were asked to include certain factors in their weekly eating habits. Those factors were as follows:

Olive oil – around 4 T./day (on salads and in cooking)
Nuts – 7.5g hazelnuts or almonds or 15g walnuts 3 times per week
Fresh fruits – 3 or more servings/ day
Vegetables – 2 or more servings/ day
Fish, seafood – 3 or more servings/ week
Legumes (peas, beans, lentils, pulses) – 3 or more times/ week
Sofrito* – 2 or more times/ week
White meat – choose white meat over red meat
Wine – this is optional but at least a glass a day can be included for those who enjoy wine without dependency

The factors that participants were discouraged to eat included the following:
Soda – no more than 1/day
Commercially prepared (not homemade) baked goods, pastries, and sweets – no more than 3/week
Spread fats – no more than 1/day
Red and processed meats – less than 1/day

*Sofrito is a sauce made with tomatoes and onion and often including garlic, herbs and simmered in olive oil

Between receiving the article from Walli and reviewing the PREDIMED study again, I thought it would be fun to outline how we can eat in a more Mediterranean fashion in Alberta. Here’s what I came up with credit to the article from the Ismaili Nutrition Centre Newsletter for inspiring this as follows:

Adopting a Mediterranean in Alberta Way of Eating

Choose extra virgin olive oil or Alberta’s abundant canola oil (preferably organic) instead of using butter in your cooking.

Snack on a small handful (about 16 nuts) of unsalted roasted nuts because nuts contain natural fats and minerals that are “heart-healthy”. Be portion savvy as more than that small handful will add too many calories to your daily intake which will in turn negate the benefit. For other snacks, throughout the day turn to fresh fruits, low fat and low sugar yogurts or vegetables.

Try to eat a vegetable at each meal and two different vegetables with your main meal. A vegetable filled soup before your main course or a salad with olive oil and vinegar to finish a meal add vegetables to your diet and lengthen the time it takes to consume your meal. People that spend 20 minutes or longer eating their meal end up eating less overall because they have greater satiety having given their brains time enough to register fullness.

Vegetables grown in Alberta are naturally sweeter and tastier due to the concentration of sugars during our cold nights
Vegetables grown in Alberta are naturally sweeter and tastier due to the concentration of sugars during our cold nights

Serve whole grains and breads instead of white and processed grains and breads. We live in the bread basket of the world and have access to amazing wheat and other grains freshly milled.

Eat fish (especially fatty fishes like salmon, halibut and mackerel) at least twice a week. If you find access to fish a difficulty consider subscribing to Skipper Otto’s Community Supported Fisheries. I order a share at the beginning of each year directly from this British Columbia small scale fishery and they deliver it to me late summer to early fall each year. It is fantastic.

Salmon is a heart healthy choice  photo - Karen Anderson
Salmon is a heart healthy choice
photo – Karen Anderson

Eat poultry and vegetarian meals more often. Some people make Monday meatless so that they can build it into their weekly routine with ease.

Eat more legumes. Did you know that Alberta grows most of the world’s legumes in the form of pulses which are dried seeds like dried peas, edible beans, lentils and chickpeas. Calgary’s own Julie Van Rosendaal and Sue Duncan wrote a beautiful award-winning cookbook called Spilling the Beans that would inspire anyone to cook with more of these healthful foods.

Eat red meat less often — some recent research suggests that it be eaten only a few times per month but then again, the rest of the world does not have access to the red meat we do in Alberta. Bison and elk are amazingly lean sources of protein and cattle completely raised and finished on grass have less total fat, more heart-healthy omega-3 fatty acids, more conjugated linoleum acid – a type of fat that’s thought to reduce heart disease and cancer risks and more antioxidant vitamins, such as vitamin E. I’ve written about grass-finished beef here.

Grill, stir fry or bake foods when cooking and avoid deep-fried foods.

Drink a litre or two of water daily rather than juice or soda. The sugar in soda (over one small can a day) has been recently shown to be an independent risk factor for cardiovascular disease. Besides, as David Suzuki says, we have the highest quality tap water in the world here in Canada so let’s celebrate it and drink more of it.

Choose fresh fruit to satisfy sweet cravings and leave baked goods for special occasions only. I’ve written about the abundance of Prairie hardy fruits available in Alberta and with a freezer and some modest preserving skills we can enjoy them year round.

Choose locally grown fruit, vegetables and herbs from farmer’s markets or grow your own if possible because local food is fresher and will always taste better.

Enjoy a glass of wine a day but don’t get carried away. More is not better and with over a couple of drinks per day the risk of death from cirrhosis rises to outweigh health benefits of alcohol.

Utilize Mediterranean cookbooks but substitute Alberta’s abundance of local ingredients. Here’s a few of my current favourites.

Alberta has endless possibilities for recreation so at your next gathering with friends choose an activity as well as a meal to focus your gathering on.

Me - I like to move it, move it!
Me – I like to move it, move it!

I hope I’m still writing this blog well into my 90s but even if I don’t enjoy the gift that life is until then, adopting and living a heart healthy lifestyle will help me Savour It All for each and every day that I am alive. I wish the same for you. Happy Heart Month.


  1. lucidhealth

    Good post. It is such a great way of eating, rich delicious food in moderation. The amount of research coming out on it is just ridiculous, with the diet being linked to longer life span, reduced risk of stroke and host of other diseases, and the strong impact on cardiovascular health as you summarize so well.

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