heart healthy

If you're looking for a heart-healthy eating plan, the Mediterranean diet might be right for you. The Mediterranean diet incorporates the basics of healthy eating — plus a splash of flavorful olive oil and perhaps a glass of red wine — among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.

Most healthy diets include fruits, vegetables, fish and whole grains, and limit unhealthy fats. While these parts of a healthy diet remain tried-and-true, subtle variations or differences in proportions of certain foods may make a difference in your risk of heart disease.

Benefits of the Mediterranean diet
The Mediterranean diet is thought to reduce your risk of heart disease. In fact, a 2007 study conducted in the United States found that both men and women who consumed a Mediterranean diet lowered their risk of death from both heart disease and cancer.

Key components of the Mediterranean diet include:

Getting plenty of exercise and eating your meals with family and friends
Eating a generous amount of fruits and vegetables
Consuming healthy fats such as olive oil and canola oil
Using herbs and spices instead of salt to flavor foods
Eating small portions of nuts
Drinking red wine, in moderation, for some
Consuming very little red meat
Eating fish or shellfish at least twice a week
Fruits, vegetables, nuts and grains
The Mediterranean diet traditionally includes fruits, vegetables, pasta and rice. For example, residents of Greece eat very little red meat and average nine servings a day of antioxidant-rich fruits and vegetables. The Mediterranean diet has been associated with a lower level of oxidized low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol that's more likely to build up deposits in your arteries.

Nuts are another part of a healthy Mediterranean diet. Nuts are high in fat (approximately 80 percent of their calories come from fat), but tree nuts, including walnuts, pecans, almonds and hazel nuts, are low in saturated fat. Nuts are high in calories, so they should not be eaten in large amounts — generally no more than a handful a day. For the best nutrition, avoid honey-roasted or heavily salted nuts.

Grains in the Mediterranean region are typically whole grain and usually contain very few unhealthy trans fats, and bread is an important part of the diet there. However, throughout the Mediterranean region, bread is eaten without butter or margarines, which contain saturated or trans fats.

Healthy fats
The focus of the Mediterranean diet isn't to limit total fat consumption, but to make wise choices about the types of fat you eat.

The Mediterranean diet is similar to the American Heart Association's Step I diet, but it contains less cholesterol and has more fats. However, the fats are healthy — including monounsaturated fats, such as olive oil, and polyunsaturated fats, which contain the beneficial linolenic acid (a type of omega-3 fatty acid). These fat sources include canola oil and nuts, particularly walnuts. Fish — another source of omega-3 fatty acids — is eaten on a regular basis in the Mediterranean diet. Omega-3 fatty acids lower triglycerides and may improve the health of your blood vessels. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans-fatty acids), both of which contribute to heart disease.

Choosing oils and fats
The Mediterranean diet emphasizes using olive oil as your primary source of fat, rather than animal or dairy fats. All types of olive oil provide monounsaturated fat — a type of fat that can help reduce LDL cholesterol levels when used in place of saturated or trans fats. "Extra-virgin" and "virgin" olive oils are the least processed forms, meaning they contain the highest levels of the protective plant compounds that provide antioxidant effects.

Wine
The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking. However, light intake of alcohol has been associated with a reduced risk of heart disease in some research studies.

Red wine has an aspirin-like effect, reducing the blood's ability to clot, and also contains antioxidants. The Mediterranean diet typically includes some red wine, but this should be consumed only in moderation. This means no more than 5 ounces (148 milliliters) of wine daily for women (or men over age 65), and no more than 10 ounces (296 milliliters) of wine daily for men under age 65. Any more than this increases the risk of health problems, including increased risk of certain types of cancer.

If you're unable to limit your alcohol intake to the amounts defined above, if you have a personal or family history of alcohol abuse, or if you have heart or liver disease, refrain from drinking wine or any other alcohol. Also keep in mind that red wine may trigger migraines in some people.

Putting it all together
Adopting a Mediterranean diet is easy if you're a smart shopper. Choose plenty of fresh fruits and vegetables, limit your intake of red meat, and eat fish at least once a week. Though avoid fish that's fried or laden with butter or heavy sauces. Use healthy fats, such as olive oil and canola oil, when cooking — but only in moderation because of their high calorie content. Consider nuts as a snack or an addition to a salad. Finally, reduce or eliminate saturated fat and trans fats (also known as hydrogenated or partially hydrogenated oils) from your diet.

Read food labels to see what you're really buying and putting into your body. Here are some specific steps you can take:

Eat natural peanut butter, rather than the kind with hydrogenated fat added.
Use butter sparingly. "Low fat" or "cholesterol-free" on the label doesn't mean a product is necessarily good for you. Many of these items are made with trans fats.
Eat a variety of whole fruits and vegetables every day. Ultimately, strive for seven to 10 servings a day. Keep baby carrots, apples and bananas on hand for quick, satisfying snacks. Fruit salads are a wonderful way to eat a variety of healthy — and tasty — fruit.
Use canola or olive oil in cooking. Try olive oil for salad dressing and as a healthy replacement for butter or margarine. After cooking pasta, add a touch of olive oil, some garlic and green onions for flavoring. Dip bread in flavored olive oil or lightly spread it on whole-grain bread for a tasty alternative to butter.
Season your meals with herbs and spices rather than salt.
Substitute fish and poultry for red meat. Avoid sausage, bacon and other high-fat meats.
Limit higher fat dairy products such as whole or 2 percent milk, cheese and ice cream. Switch to skim milk, fat-free yogurt and low-fat cheese.
Eat fish once or twice a week. Water-packed tuna, salmon, trout, mackerel and herring are healthy choices. Grilled fish tastes good and requires little cleanup. Avoid fried fish, unless it's sauteed in a small amount of olive oil.
Keep walnuts, almonds, pecans and Brazil nuts on hand for a quick snack.
If it's OK with your doctor, go ahead and have a glass of red wine at dinner with your pasta or fish. If you don't drink alcohol, you don't need to start. Drinking purple grape juice may be a healthy alternative to wine.
Once you experience the delicious and healthy choices the Mediterranean diet has to offer, it just might become your favorite diet.