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Yesterday the New England Journal of Medicine published results of the PREDIMED study (Etruch et al. 2013), which examined the effects of an energy-unrestricted, Mediterranean diet, supplemented with either olive oil or nuts, against a low-fat diet on major cardiovascular events, including myocardial infarction, stroke or death by cardiovascular causes. Briefly, following 7447 persons since 2003 showed reduced events in those persons who followed either Mediterranean diet over those on the low-fat diet. 

In a 1997 article in the American Journal of Clinical Nutrition,
Barabara Haber traced the Mediterranean diet back to 1614 and an Italian named Giacomo Castelvetro who, unsuccessfully, promoted the consumption of olive oil, vegetables, fruits and limited animal products to the British in exchange for their rather bland, roasted meat-and-potatoes fare. In a parallel article to the PREDIMED study (Something New Under the Sun? Mediterranean Diet and Cardiovascular Health), Sarah Tracy notes that the Mediterranean diet is not a novel approach for Americans, having first been advocated by Ancel Keys in the 1950s and having recurrent appearances since promoting heart health and weight loss.

The virtue of the Mediterranean diet is that it is simple, based in the consumption of fresh vegetables and fruits, nuts, legumes, and cereals, simply prepared  and lightly dressed with olive oil, salts, and vinegars. The main sources of protein are fish and poultry with only rare consumption of red meat. And don’t forget the alcohol, the diet accounts for the occasional glass of wine or beer with meals, up to 5-7 per week with no more than two per day. The combination of fats, carbohydrates, and protein in itself is filling and limiting when built into a complete meal. 

Eat. Real Food. Not Too Much. These are the seven words I live by when it comes to diet. Eat because we have to; Real food is that which is simply prepared; and with portion control so that I never feel overly full. From salads to roasted vegetables to pasta sauces, I can count on one hand the number of ingredients used to prepare these dishes. I focus on creating a complete menu at every meal that consists largely of vegetables, a portion of protein, and some way to tie it all together as a pasta, stir-fry, or sandwich. I cook so that I can control preparation and portion size and I am constantly searching for healthier ways to prepare my favorite dishes. Yes, there are exceptions. I have my favorite marinades, salad dressings, and sweet treats that satisfy my palate. But these make up only a small portion of my overall intake 

Like the PREDIMED study and Giacommo, I am not innovative or novel in my approach. I have my own influences and study multiple recipes by chefs far more knowledgeable and skilled than myself. Furthermore, the PREDIMED study is not the answer to all of our questions on heart health and it did not even consider weight loss as an endpoint (although other studies have shown it to be beneficial in this area as well). The PREDIMED study does reaffirm the need for simple principles when dieting for health because living longer and healthier it is not just a food thing, it’s a lifestyle thing.





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    Meet Justin Steggerda, MD

    As a general surgery resident, former college-athlete turned triathlete turned runner, and self-proclaimed food enthusiast, I am constantly striving for balance in all aspects of my life. Here I write about my observations and lessons learned from the road, the hospital, and the dinner table to stimulate discussion about healthy living and improving the world.

    Soccer is misery... Some joy, but much misery.
                -Maldini

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