A Low-Fat Mediterranean Diet – Is It Possible?

by Paul Rogers on January 23, 2009

Mediterranean dietThis may seem like a contradiction in terms for anyone who has been used to the propaganda that the traditional dietitians’ low-fat diet and the traditional Mediterranean diet are poles apart. Frankly, it’s bunkum. In fact, the differences between the early Mediterranean diets of Crete and similar regions, and a well-constructed low-fat diet are not much at all.

Here’s what it all boils down to. Take a look at the Oldways diet pyramid and recommendations. The people at Oldways have been studying and promoting Mediterranean diets for 20 years. They note that the Mediterranean diet was not highly specific, but a variable eating pattern within which a range of consistent food consumption and lifestyle behaviours were evident. Here’s what they list:

  1. An abundance of food from plant sources, including fruits and vegetables, potatoes, breads and grains, beans, nuts, and seeds.
  2. Emphasis on a variety of minimally processed and, wherever possible, seasonally fresh and locally grown foods (which often maximizes the health-promoting micronutrient and antioxidant content of these foods).
  3. Olive oil as the principal fat, replacing other fats and oils (including butter and margarine).
  4. Total fat ranging from less than 25 percent to over 35 percent of energy, with saturated fat no more than 7 to 8 percent of energy (calories).
  5. Daily consumption of low to moderate amounts of cheese and yogurt (low-fat and non-fat versions may be preferable).
  6. Weekly consumption of low to moderate amounts of fish and poultry (recent research suggests that fish be somewhat favored over poultry); from zero to four eggs per week (including those used in cooking and baking).
  7. Fresh fruit as the typical daily dessert; sweets with a significant amount of sugar (often as honey) and saturated fat consumed not more than a few times per week.
  8. Red meat a few times per month (recent research suggests that if red meat is eaten, its consumption should be limited to a maximum of 12 to 16 ounces [340 to 450 grams] per month; where the flavor is acceptable, lean versions may be preferable).
  9. Regular physical activity at a level which promotes a healthy weight, fitness and well-being.
  10. Moderate consumption of wine, normally with meals; about one to two glasses per day for men and one glass per day for women (from a contemporary public health perspective, wine should be considered optional and avoided when consumption would put the individual or others at risk.)

I don’t necessarily agree with some minor points in this list, but note item number 4. This suggests a range of total fat consumption —  from less than 25% to 35%. The low-fat diets of the American Heart Association (AHA), traditionally regarded as the devil itself by the low-carbohydrate crowd, are in the range 25% to 30% — not much difference.

At number 8, consumption of red meat is very limited — by much more than most people would assume in a Mediterranean diet. So, let’s not pussyfoot around with this: the real Mediterranean diet is quite a restrictive diet for those who are used to eating large amounts of red meat. The idea that you can  splash olive oil on everything, eat some walnuts, drink red wine with the lamb shanks and baklava every night and go to Corfu in 1965 in your dreams is exactly that. Although I would suggest that slightly more red meat in the diet would not necessarily be unhealthy. (Limiting red meat in the diet has received much impetus in recent years from studies showing increased risks of bowel cancer in individuals who eat diets high in red meat.)

Quality Fats, Protein and Carbohydrate Is the Key

The big mistake the AHA and associated nutritionists and dietitians made with early low-fat diet recommendations was that they made little attempt to recommend quality macronutrients — fat, protein and carbohydrates.  Keep saturated fat very low (poly and monounsaturated fats are best); eat a high-fibre diet with nuts and seeds;  concentrate protein on fish, chicken, low-fat dairy, beans and pulses; choose wholegrain cereals and bread; and keep added sugars and refined carbohydrates to a minimum. We’ve known this was a healthy diet for 40 years. They mucked it up. People gorged themselves fat on low-fat cookies, soft drinks and junk food. How stupid was that!

I suspect it’s not the red wine or the olive oil but the abundance of whole, fibrous, natural plant foods and a diet low in animal fats and cholesterol that works in Mediterranean diet studies to reduce heart disease — and probably cancer. Substituting canola oil or even soy or peanut oil for olive oil would probably make little difference. In any case I’d rather keep added oils to a minimum and get healthy fats from whole foods like nuts, seeds, avocados, peanuts and beans.

A low-fat diet of 25% to 30% of mostly good fats within the above eating pattern IS the low-fat Mediterranean diet.

Regular Exercise Rules

Number 9 is a recommendation for regular physical activity. It’s not that the early practitioners of this Mediterranean eating pattern put on their jogging shoes or headed off down to the gym every day to work out. No, they were too busy doing hard manual labour much of the day in the fields and gardens or out on the fishing boats. Try working out how much extra energy you would use working in a job like farming/gardening every day compared to sitting in an office. Don’t worry I’ve done it for you: six hours at walking pace is about 1200 kcalories. Many would have worked much harder and longer than that. What does your regular gym session or run use? Average about 400 to 600 kcalories for 45 minutes.

The thing is, if you work or play hard enough, you can get away with eating and drinking a few refined carbohydrates and sugars. In fact, you may need  them to fuel your work or play. A nice sourdough white bread is a real treat. Honey or even modest amounts of sugar in fruits, juices and desserts is not going to be an issue for those who workout or work hard. Physical activity really is an essential part of any diet pyramid these days. And it should not be an add-on but an integrated component that possibly affects the macronutrient composition of the diet. Try telling a marathoner that he can only eat a 35% carbohydrate diet! Or a hand cane cutter or woodchopper.

The Diet Wars Are Over

Yes, they are, as that article says. Call it Mediterranean, low-fat high-fibre, semi-vegetarian or whatever you like. The principles are pretty much laid out now. All you need  is the will to do it. And the thing is, it’s probably the easiest healthy diet to implement compared to the stringency of low-carb, very low fat and all the other extreme ideas. Go to it.

{ 94 comments… read them below or add one }

Leave a Comment

{ 66 trackbacks }

Previous post:

Next post: