As part of a heart rehabilitation program, many hospitals advise their recovering patients to follow the Mediterranean Diet. But can the hospitals do better?

Some doctors think the Mediterranean diet is a step in the right direction but that much more can be done and done more successfully for the patient.

To begin with, the Mediterranean Diet, as it is practiced today, is far different than what it was back in the 1940’s in the Mediterranean region. And one has to question the wisdom of trying to distill hundreds of regional and local differences into one easy-to-use set of guidelines. And what of more current research? Does the Mediterranean diet even consider those recent findings to help patients make even more progress towards future heart health?

Recent scientific hypotheses are developing that indicate some of the food still on that pyramid may be harmful. Underlying the Mediterranean region–back in the days–was the requirement to eat food in scarce, tiny amounts. Deserts were commonly fresh, whole fruits, picked fresh and not sugar treats or cakes like that which we consume in North America.

As for the entire meal itself, a very good friend of mine who hailed from the Mediterranean region, had this to say. “People here eat for convenience and eat large portions. In the Mediterranean region, people used to eat to survive. This is the essential and primary difference, today, when we talk of the Mediterranean lifestyle and diet”. Branislav Popovic. (printed with permission.)

Let’s have a look at today’s medical interpretation of the Mediterranean diet. We’ll use the Mayo Clinic’s chart and guidance as per their website.

At the very base of the pyramid: fruits, vegetables, grains, (mostly whole), olive oil1, beans, nuts2, legumes, seeds, herbs, and spices. Certainly we all know that fresh whole foods are a good thing for our bodies. But olive oil and nuts need their own set of precautions.

The next level up is a bit narrower: fish3, and seafood3.  Fish and seafood have been made popular because of the advice to get lots of “Omega-3 for heart health”. Eating fish and taking fish oil supplements for Omega-3 is a theory that needs its own kick in the pants.

Above that, and slightly narrower: Poultry4,  eggs5,  cheese6, and yogurt7. Each of these foods needs it own set of precautions.

And at the very top, the smallest in width: Meat8, and sweets9. There are plenty of precautions and warning for these two gems.

As you can see, if one were to start imposing all these precautions on each layer of today’s Mediterranean pyramid it would become a complex task to adequately follow for long-term heart health. But closer inspection of the precautions would be worth it to those following it and wanting to learn what more they might want to DISCUSS WITH THEIR DOCTOR AND NUTRITIONIST, a discussion I heartily support and encourage of you.

In their notes under “guidance”, there is the suggestion that we base every meal on foods from the widest section at the bottom of the pyramid. A good suggestion. It then suggests we eat the fish and seafood group “at least two times a week”. The poultry, eggs, cheese and yogurt group ought to be “moderate portions daily to weekly”. And finally, the very top of the pyramid, meats and sweets: less often. Let’s take a look at each level and at some recent scientific hypotheses.

1-OLIVE OIL. In some parts of the Mediterranean olive oil usage was NEGLIGIABLE and in some other parts almost non-existent. So I fail to understand why any nutritionists even refer to olive oil on this chart and especially to give it false credit as “heart healthy”, a claim being rapidly disproved by recent scientific, “evidence-based” studies. Further, we don’t need science to tell us that all oil is just liquid fat. If fat is bad for us, does it really matter to argue that one fat comes from an olive and another comes from corn or canola? Additional wisdom comes from Dr. Caldwell Esselstyn, who is one of the few doctors who is rolling back heart disease and helping to clear plugged arteries in patients being told by their doctors and cardiologists to, “Get your affairs in order”. Esselstyn screams at us to “AVOID ALL OILS!” And for good reason. Recent research is formulating a hypothesis that oils damage the body’s ability to generate and protect the APOEA gene’s protein, the apolipoprotein A-I (apo A-I). [Reference my nugget, “An APO a Day…” by clicking here.]  OILS ARE TERRIBLE. Even olive oil.

2- NUTS. Dr. Barnard recommends restricting nuts to one ounce per day, but that there indeed are some health benefits to eating nuts, not all kinds, but many. Just don’t overdo it.

3- FISH AND SEAFOOD. Bass, crab, cod, mackerel, salmon have more cholesterol per 100 calories than does beef. [p. 125.] “Research published in respected medical journals showing that fish offers no benefit to the heart, and may even be a step in the wrong direction…” [Source: The Starch Solution, p. 125.] Add to that the warning, Dr. Neal Barnard’s comments that, “All fish have fat, much of it saturated fat.” [Source: Dr. Neal Barnard’s Program for REVERSING DIABETES. p. 42.]  Also keep in mind that fish today is quite different than fish as recent as 20 years ago. Much of the fish we consume today comes from fish farms. Fish farms are bounded areas in which fish are raised in crowded conditions that can cause disease among them. As a prophylactic, the industry often treats their farmed fish with plenty of antibiotics. It bears mentioning that in the past few years genetically modified salmon are being farmed with the hopes they never escape into the wild because they are quite genetically different and behave differently than wild salmon. Makes your mouth water, doesn’t it?

4- POULTRY. When you bite into the leanest cut of chicken you are still chomping down on, and ingesting, 23% of its calories from fat, much of it saturated fat. [Source: Dr. Neal Barnard’s Program for REVERSING DIABETES. p. 42.]

5- EGGS. “A single egg has more than 200 milligrams of cholesterol—as much as an 8-ounce steak—plus a load of saturated fat, the kind that tends to raise cholesterol.” [Source: Dr. Neal Barnard’s Program for REVERSING DIABETES. p.73.]

6- CHEESE. Don’t have too much. Though being hyped as a source of calcium it has a high amount of saturated fat and cholesterol. Some cheeses being as high as 60% to 70% fat.

7- YOGURT. Dr. John A. McDougall himself: “…yogurt brings with it all the negative qualities of dairy products: high fat and cholesterol content, allergy-producing dairy proteins…” [Source: Dr. McDougall’s Digestive Tune Up. p.123.]

8- MEAT. Even the leanest cuts of meat have high amounts of bad fats and cholesterol. And, despite good intentions, it is common practice to build one’s plate with large portions of meat as front and center. Since it is the fat in meat that makes it taste so good, and since people have enough discretionary income to spend it on “eating well”, people lose control over portioning and frequency of meats for their meals. The Mediterranean diet back in the 1940s consumed extremely SMALL, very low quantities, of meats and infrequently so. “What people don’t understand is that Mediterranean diet meant, ‘meat only once a week’ and very little at that. In reality, in our family, we hardly had meat. I think I was lucky if we had had meat as often as once a month.” Branislav Popovic (printed with permission.)

9- SWEETS. Enough said. No. Have to make one more comment. Do you really think that part of a healthy, nutritional program in the Mediterranean region intentionally included “sweets” on their dinner plate and with every meal? Maybe the word “desserts” would have been more appropriate. Even at that, the word “desserts” would need to be explained for what it once meant in the Mediterranean region: “fresh fruits”.  Not “sweets”.