This way of eating first attracted attention in America in 1945, because of the work done by Dr Ancel Keys, stationed in Salerno, Italy. It became popular only in the 1990s when further supporting research was carried out such as the DART ( Diet and Re-infarction Trial) which looked to the reduce the chances of a second coronary incident occurring in people with existing heart disease. It was noticed that although Mediterranean countries consume relatively high amounts of fat, they have far lower instances of cardiovascular disease.

A closer look revealed that the type of foods was far healthier for the heart as it was rich in omega 3 essential fats, monounsaturated oils and antioxidants. The vegetables were not overcooked and there was a choice of raw vegetables and fruits. A large amount of the protein came from vegetarian sources, thus reducing the amount of saturated fat which often accompanies animal protein. Total amounts of saturated fats and trans fat which are known to raise blood cholesterol levels were low. These bad fats were replaced by monounsaturated fats, thought to be beneficial in the treatment of heart disease.

Prominent among these countries are large amounts of plant-based foods such as fruits and vegetables. These contain a variety of anti-oxidants - vitamins A, C and E which prevent the hardening of bad cholesterol in the arteries. They are also a great source of potassium which assists in regulating blood pressure and folic acid which helps to reduce the formation of homocysteine which can contribute to heart disease.

Complex carbohydrates such as wholegrain bread and other cereals, potatoes, beans, nuts and seeds may also beneficial due to the cholesterol lowering properties of the soluble fiber.

A key feature of the Mediterranean way of eating is the inclusion of plenty of oily fish such as mackerel, sardines, salmon and fresh tuna. Such fish contain omega 3 which have special heart protective properties. Such properties include reducing heart arrhythmias, reducing the stickiness of the blood and reducing injury to artery walls. Try to include 2 portions per week - try grilling salmon fillets with slices of ginger and garlic, or mashing up some tinned sardines with lemon and black pepper and spreading over toasted bread.

Olive oil is a key ingredient in Mediterranean cooking. The monounsaturated fats in this fruity oil reduce the risks of heart disease, through decreasing the amount of bad cholesterol and increasing the good cholesterol which helps to clear the arteries. It has compounds called phenols that have anti-inflammatory, antioxidant and clot-preventing powers. Studies published by the Journal of the American College of Cardiology show that virgin or extra virgin olive oils are best because they have the highest phenol content.

The people of this region consume a moderate amount of wine with meals. Wine contains compounds which appear to moderately increase HDL (good) cholesterol levels. It is although though to contain some anti-oxidant substances - it is important that excessive amounts of alcohol are avoided however as this will cause more harm than good.
As with any other dietary change choosing a Mediterranean way of eating will produce maximum effect in reducing heart disease when coupled with other positive lifestyle changes such as quitting smoking and increasing exercise. However increasing your intake of roasted Italian vegetables, barbecued Spanish sardines plus the odd glass of French wine certainly sounds like a pleasurable way to reduce heart disease!

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