• Variety of colorful fresh, baked, grilled vegetables - lots of dark green leafy, red bell peppers, cucumbers, tomatoes, onions, celery, radishes, etc; lots of water to drink
• Fruits in season - fresh and baked into a dessert; juices
• Fish (rarely other meats) - baked, broiled or pan seared, grilled, never fried
• Whole grains, brown rice, beans, legumes (rarely bread products) - limited to a cup a day 
• Goat and sheep dairy products mostly, 1% milk products occassionally, 1/2% cottage cheese 
• Fats - Olive oil, olive oil margarines for baking, olives, walnuts, pine nuts, seeds (sunflower, pumpkin), avocado, sprinkles of Parmesean cheese
• 1-3 times weekly - eggs

We adjust the portions of our daily meals and snacks according to weight we need to lose. Most days, we walk 3-5 kilometers overlooking beautiful Jerusalem, and incorporate strength exercises with weights. My husband likes to have at least one day a week to let loose and eat a chocolate bar or some special treat. Surprisingly, all of our sweet and salty cravings have disappeared. With high blood pressure, I have to observe a fairly strick no-salt rule to the above diet.

A typical day of eating at our house looks like this:

• Breakfast: Turkish coffee, finely minced vegetable salad, 1/2 oz. marinated herring - or - 1/2 homemade no-fat whole wheat banana muffin, fresh fruit - or egg omelet with fresh vegetable salsa & goat chees
• Snack mid-morning: fresh fruit, such as watermelon & low fat goat Feta cheese
• Lunch: 2 oz. baked fish, cooked vegetable, roasted red peppers
• Snack mid-afternoon: Turkish coffee, piece of fresh fruit, whole wheat crackers with thin layer of low fat soft goat cheese spread
• Dinner: homemade vegetable soup, 2-3 oz baked fish, large salad, rice or pasta, steamed or grilled vegetables (more or less, depending on hunger)
• Evening snack: fresh fruit salad, with 2 tablespoons of yogurt, walnuts; fresh baked fruit cobbler

By Peter Jaret

When Ancel Keys turned 100 last year, no one needed to ask him his secret for a long and healthy life. During his distinguished tenure as a scientist at the University of Minnesota, Keys had devoted almost his entire career to proving that good health and longevity depend on what’s on the menu.

Keys’s landmark investigation, called the Seven Countries Study, was launched in the 1950s, when an unexplained epidemic of heart disease was sweeping across the United States. “At the time, few people suspected that diet might play a role,” says Meir Stampfer, M.D., professor of nutrition and epidemiology at the Harvard School of Public Health. Keys showed beyond a doubt that it did. He and his colleagues analyzed the diets of thousands of people in communities in Italy, Greece, Finland, Yugoslavia, the Netherlands, the United States and Japan. Beyond gathering statistics, the researchers sat at people’s kitchen tables to see firsthand what was being served and sometimes even recreated the meals in the laboratory to analyze their ingredients. The results showed that heart attacks were virtually unknown in some regions and the leading cause of death in others—and that the difference was largely a matter of what people ate.

The discovery of a link between diet and heart disease was so new and surprising in those days that it landed Keys on the cover of Time in 1961. Over the next four decades, he helped introduce Americans to the glories of the Mediterranean diet. Among the healthiest and longest-lived people in the world, his research showed, were the inhabitants of the Greek island of Crete, where heart disease was exceedingly rare—and where the menu included an abundance of grains and greens, fresh fruit, fish, olive oil and red wine.

To share the secret of the Cretans’ longevity, Keys and his wife, Margaret—a biochemist in her own right who helped collect blood samples for the Seven Countries Study—wrote the best-selling Eat Well, Stay Well, one of the first cookbooks to introduce the culinary joys and health benefits of a style of eating they dubbed “the Mediterranean diet.” They happily practiced what they preached, buying land on the Mediterranean coast of southern Italy, where they built a second home and started an enclave for visiting scientists. They called it Minnelea: a euphonious combination of Elea, part of the mythical trip taken by Ulysses, and Minnesota, where Keys continued to work. There they followed the diet inspired by the long-lived islanders of Crete, buying fish from local fishermen and cultivating olives, lemons, basil and fresh vegetables.

Keys was tough-minded and often blunt. He railed against what he described to a Washington Post reporter in 2002 as “the North American habit of making the stomach the garbage disposal unit for a long list of harmful foods.” When it came to the Mediterranean diet, however, he waxed rhapsodic, describing “homemade minestrone … pasta in endless variety … served with tomato sauce and a sprinkle of cheese … a hearty dish of beans and short lengths of macaroni … lots of bread never more than a few hours from the oven and never served with any kind of spread; great quantities of fresh vegetables…. always fresh fruit for dessert.”

When Keys died this past November, researchers around the world paid homage to his life and work. But the biggest tribute is the simple fact that the eating patterns he studied and celebrated remain the exemplar of healthy eating. “The Mediterranean diet is the model we look to,” says Sachiko St. Jeor, Ph.D., professor of medical nutrition at the University of Nevada. “Over the years it has come to play more and more of a role in shaping official U.S. dietary guidelines.”

No wonder. Even today, global research, inspired by the original Seven Countries Study, continues to provide fresh evidence of its benefits.

Beyond heart disease

By now there’s universal agreement that the Mediterranean diet is good for your heart. Just how good has startled even the experts. One of the first scientific attempts to transplant the lessons of Crete to new soil was the Lyon Diet Heart Study, launched in the early 1990s. French scientists enlisted 605 heart-attack survivors. Half were given the usual advice to cut back on saturated fat and cholesterol. The other half were put on a Mediterranean-style diet that featured bread, root vegetables, leafy greens, chicken and fish instead of red meat, fruit at least once a day, and a special margarine made with unsaturated canola oil high in omega-3s.

The difference after almost four years was astonishing. The scientists recorded roughly one heart attack or death from heart-related causes out of 100 people in the Mediterranean group each year, compared with more than four in the control group. By adopting a Mediterranean diet, heart-attack survivors were 50 to 70 percent less likely to have recurrent heart problems than volunteers in the control group.

Since those results were reported in 1999, the Mediterranean diet has taken to the road, demonstrating its benefits in very different cultures. Last year, for instance, Swedish scientists reported that when volunteers switched from an ordinary Swedish diet to a Mediterranean-style menu, total cholesterol in their bloodstreams fell by 17 percent and bad (LDL) cholesterol by 22 percent—very close to what cholesterol-lowering drugs can achieve.

In India, researchers tested an Indo-Mediterranean version of the diet in 1,000 volunteers. Half ate the traditional local diet, which favors ghee (made with butter). The other half were encouraged to use mustard-seed and soybean oils, which are rich in the same heart-healthy fats found in olive oil. They were also instructed to help themselves to more fruits, vegetables, rice, legumes, walnuts and almonds. Compared with the control group, their risk of having a fatal heart attack dropped by one-third.

The benefits go far beyond heart disease. In results published last year, Italian scientists at the Second University of Naples tested whether a Mediterranean-style diet might help people with metabolic syndrome, a newly recognized constellation of five factors that signal high risk for developing heart disease and/or diabetes. The five warning signs are excess fat around the abdomen, high blood pressure, insulin resistance, high total cholesterol and low levels of good cholesterol, or HDL lipoprotein. Individuals with three or more of these risk factors are classified as having metabolic syndrome—and are usually counseled to start making changes in their diets and lifestyles.

In the Italian study, 90 volunteers with metabolic syndrome switched to a Mediterranean eating plan that favored fresh fruits and vegetables, fish and generous amounts of fat in the form of olive oil. A second group of 90 followed a low-fat approach similar to the diet recommended by the American Heart Association. After two years, 50 of the 90 people in the Mediterranean group no longer had metabolic syndrome; they’d managed to eliminate at least one of the risk factors that define the condition. In contrast, only 12 people in the control group had improved their risk-factor profiles enough to escape the diagnosis. Other risk factors for heart disease also fell in the Mediterranean group, including levels of C-reactive protein, a marker for inflammation, which is believed to play a role in damaging the lining of blood vessels.

Metabolic syndrome is closely associated with being overweight—and here, too, Mediterranean eating patterns seem to help. In 2004, Spanish researchers surveyed a group of 1,547 men and 1,615 women, using a Mediterranean diet score that awarded points for consuming vegetables, fruits, legumes, nuts, fish, meat, cereals, olive oil and wine. The higher people’s rating, the lower their body mass indexes tended to be. (Body mass index, or BMI, is a ratio of weight to height that is widely used to determine a person’s weight status, from underweight to obese.) People in the highest-scoring group were 40 percent less likely to be obese than those at the bottom of the scoring system. (It’s no coincidence that one of the most popular weight-loss books today, The South Beach Diet, borrows heavily from the Mediterranean diet.)

The good news gets even better with several recent studies that looked at diet and cancer. In findings published in 2003, a team of scientists from Greece, Italy and France reported that people who scored high on a Mediterranean diet scale were 60 percent less likely to develop oral cancer and almost 75 percent less likely to be diagnosed with cancer of the esophagus. A study of 22,043 Greek adults, published the same year in The New England Journal of Medicine, found that higher scores on a Mediterranean diet scale were associated with significantly lower overall cancer mortality. One reason may be the very high antioxidant levels found in many of the foods featured in a Mediterranean diet, from leafy green vegetables to olive oil and red wine. (Antioxidants help neutralize unstable oxygen molecules, which might otherwise damage cells, leading to the kind of mutations in DNA that can turn healthy cells cancerous.) Olive oil turns out to contain its own unique cancer-fighting substances. And omega-3 fatty acids—found in fish, walnuts and some fruits and vegetables—may offer protection as well.

Taking the long view

Add it all up, and following a Mediterranean diet could mean not just a healthier life but a longer one. In fact, that’s precisely what researchers from the Netherlands, France, Spain and Italy recently found. Last year they reported that among a large cohort of volunteers who are being studied, those who followed a Mediterranean diet were 23 percent less likely to die over the 10-year study period than those who ate more Western-style diets. Volunteers who combined a Mediterranean diet with physically active lives (and who didn’t smoke) cut their risk of dying during the study period by two-thirds.

These remarkable numbers shouldn’t really come as a surprise, says Artemis Simopoulos, M.D., president of The Center for Genetics, Nutrition, and Health in Washington, D.C., who has exhaustively researched the diet of Crete. “The traditional Cretan diet was an ancient one. People on the island made use of what was available to them for many centuries—wild plants foraged from the mountainsides, plentiful fish, olives and olive oil, figs, lemons and other fresh fruit. Their diet closely resembled the Paleolithic diet—what humans ate through most of our evolution. It’s the diet our bodies adapted themselves to. No wonder it’s so healthy.”

One of the goals of current research is to understand exactly which components of the Mediterranean diet play the biggest role in bestowing health benefits. There are plenty to choose among. Ancel Keys insisted that the secret of Mediterranean longevity was eating very little saturated fat. Simopoulos thinks the key is the abundance of omega-3 fatty acids, from both fish and wild plants. Other nutritionists point to the exceptionally high levels of antioxidants and the abundance of fiber. And some researchers think the real secret may be nothing more exalted than legumes. A study headed by Australian scientists last year found that the single characteristic that shows up in all healthy traditional diets is an abundance of beans and lentils.

In the end, it’s likely that all these elements work together synergistically, says Henry Blackburn, M.D., a former colleague of Keys’s at the University of Minnesota and one of the investigators in the Seven Countries Study. “Of course it’s useful for researchers to tease out how each nutritional component works,” says Blackburn. “But people don’t eat components. They eat food.”

Happily, the rich variety of foods and dishes that have come to us from the Mediterranean—pastas tossed in olive oil, savory seafood paellas, couscous, lentil soups, olive breads, sautéed greens—have proved remarkably adaptable, finding a welcome place at tables around the world. It’s heartening to know that they’re all part of a recipe for good health and long life. But what matters most is that they’re simply delicious.

Other Views of the Mediterranean Diet

More than a dozen countries ring the Mediterranean, each with its own cultures and cuisines. So what is the Mediterranean diet?

“In fact, there are many Mediterranean eating patterns,” says Harvard University nutrition scientist Meir Stampfer. While the Greeks pour olive oil with abandon, Moroccans rarely use it. Some Mediterranean cultures drink wine with almost every meal; others never touch a drop. Italians build their menus around pasta and rice. The Tunisians prefer couscous. Scientists themselves have had to adapt the traditional Greek diet in order to test it in other countries and cultures. In the Lyon Diet Heart Study, for example, scientists created a canola-based margarine that was high in omega-3 fatty acids, to approximate the high omega-3 content of wild greens consumed by traditional Cretans.

Increasingly, in fact, researchers have to look to the past for the healthiest Mediterranean diet. Sadly, in Greece, Italy, France and other Mediterranean countries—as in many parts of the world—diets are changing as people abandon traditional eating patterns in favor of Western-style fast food and processed foods. And the shift is showing up in disease rates. In Greece, the rate of heart-disease deaths among men almost doubled from 1956 to 1978. This past March, the International Obesity Task Force announced that the global epidemic of fatness is especially severe among Mediterranean countries. Thirty-eight percent of Greek women are now obese, compared with 34 percent of American women. Despite the claims of a recent best-selling diet book that French women don’t get fat, obesity among French women climbed from 8 percent in 1997 to 11.3 percent in 2003.

Even many Mediterraneans, it seems, need to learn the lessons of the Mediterranean diet. The healthiest eating pattern in the world, according to the Seven Countries Study, appears to be the diet of Crete, circa 1950. Of course we can’t all eat like traditional Cretans, foraging for wild greens and snails. And we can’t all expect to be as active as the traditional Cretans were, either. But we can take advantage of the lessons their diet has taught nutrition scientists. Most experts have come to agree on its key features: very generous servings of fresh fruits and vegetables, whole grains, olive oil or other monounsaturated oil, fish, small amounts of red meat and wine in moderation.

12 Ways to Eat Like a Mediterranean

Food is far more than sustenance. The dishes we eat are often imbued with family traditions, cultural history and even personal memories—and that’s as it should be. But as studies around the world have shown, eating patterns as different as those in Sweden and India can be tweaked to take advantage of the health benefits associated with traditional Mediterranean diets. Here’s how:

• Replace butter with olive or canola oil whenever possible
• Snack on nuts, seeds or fruit instead of processed foods
• Add vegetables to each meal, including breakfast! 
• Include a generous leafy green salad with most dinners
• Help yourself to whole-grain bread, pasta, rice and other grains
• Fix at least a couple of vegetarian meals every week
• Add a dish or two that contains legumes (beans and lentils) to your weekly menu
• Have fish (not deep-fried) at least twice a week
• If you eat meat, favor chicken and poultry
• Eat red meat only occasionally, and in small servings
• If you drink wine, have no more than a glass or two with a meal
• Enjoy fruit for dessert
• Set aside enough time to savor every bite

Article from Eating Well website:

http://www.eatingwell.com/articles_recipes/nutrition/med_diet.html