Sometimes it seems like a world of endless food choices. But even for those of us who have settled on a particular way of eating — such as the heart-healthy Mediterranean diet — there are many decisions still to be made. Extra virgin olive oil, or virgin olive oil? Salmon or sea bass?
The Mediterranean diet is based on ingredients from plant sources and minimally processed foods, including olive oil, fish and legumes, fresh fruits and vegetables, skinless poultry and low-fat dairy.
Many cardiologists, dietitians and other health care professionals say the Mediterranean diet is the gold standard of heart-healthy diets, says Julia Zumpano, RD, LD, a registered dietitian in Cleveland Clinic’s section of Preventive Cardiology. But, she says, there are some important details to which you should pay attention.
Here are Ms. Zumpano’s tips for eating well within the Mediterranean diet.
Options for olive oil
Olive oil is a primary source of fat in the Mediterranean diet, but there are several kinds. So should you go with light, virgin or extra virgin olive oil?
“Extra virgin olive oil is the best choice because it’s the least processed compared with other oil grades, including light and virgin,” Zumpano says.
Olive oil is produced by grinding olives and extracting the oil by mechanical or chemical means. The word virgin means the oil was produced by the use of mechanical means only.
Extra virgin olive oil, or EVOO, is of higher quality. Among other attributes, it contains no more than 0.8 percent free acidity, and is judged to have a superior taste. EVOO also has a higher nutritional content, with antioxidants that have been linked with better health.
The best use of extra virgin olive oil, which is the most expensive grade, is at room temperature, such as in salad dressings, Zumpano says.
Be careful when cooking with extra virgin olive oil at high temperates, due to its medium-high smoke point.
The smoke point is the temperature that causes oil to start smoking, which produces toxic fumes and harmful free radicals. Different oils have different smoke points, due to their chemical make-up. This means some oils are better suited for cooking at higher temperatures than others. A good rule of thumb is that the more refined the oil, the higher the smoke point.
Heating EVOO higher than 300 degrees can cause oxidation, which kills antioxidants and may create some toxins such as acrylamide, she says.
Acrylamide is a chemical that has been found in certain foods, with especially high levels in potato chips, French fries and other food products produced by high-temperature cooking.
“If you’re going to heat olive oil, do so at the lowest temperature possible and use a more refined version of olive oil such as light, fine, virgin or pure, which is a blend of refined and virgin,” she says. “Or try a more stable oil at high heat such as sunflower, sesame or corn oil.”
Fish and skinless poultry take the place of red meat with the Mediterranean diet. If you’re trying to decide between the two, fish is the hands-down winner when it comes to your heart. But the type of fish does make a difference.
“Omega-3 fatty fish, like salmon and tuna, have been proven to be the most beneficial,” Zumpano says. “Omega-3 fatty acids have been shown to help lower blood pressure and swelling.”
Omega-3 fatty fish also lower your triglyceride levels, which keep the lining of your arteries smooth, allowing your blood to flow well. Other omega-3 fatty fish include mackerel, herring, sardines and lake trout.
Omega-3 fatty fish also lower triglyceride levels, which keep the lining of your arteries smooth, allowing your blood to flow well.
Other white-fleshed fish are a good second choice as they tend to be low in cholesterol or saturated fat. Think sea bass, pollock, catfish and grouper.
Shellfish also can be included in your diet regularly, but be mindful of how they are prepared or what you are dipping them in — avoid butter or cream sauces, Zumpano says.
Cheese is a supplement of the Mediterranean diet. But as anyone who has stood in the grocery store’s cheese section knows well, the options can seem unlimited.
The best choice of all is to use cheese sparingly, Ms. Zumpano says. While cheese is a good source of calcium and protein, it’s also a hefty source of saturated fat, sodium and cholesterol, which negatively affects your cardiovascular health.
Approach cheese as you would a seasoning, Ms. Zumpano says. Rather than using it as the main ingredient in a dish, use it to top salads or add a bit of flavor, she says.
Stay away when the label says “cheese product,” a processed food that contains a slew of artificial ingredients and hydrogenated oils. Natural cheeses, such as ricotta, fresh or part skim mozzarella and feta are best.
An even healthier version of a natural cheese would be one that is reduced-fat, meaning made with 2 percent or part skim milk. The labels on these cheeses usually have the words light, low-fat, 2 percent or reduced fat. Be mindful of ingredients to be sure that the fat is not being replaced with artifical ingredients, salt or unacceptable oils.
The color of olives
This one’s easy – it’s all in the flavor, Ms. Zumpano says. Choose whichever one pleases your palate.
If you’re watching sodium, it’s best to choose water-cured for the lowest in sodium. Some olives may have more sodium than others based on how they were processed or cured.