Does anyone know of a consistent and authoritative source for the Mediterranean diet?

MmeZeeZee

I was prescribed this diet due to high cholesterol.

5 weeks in, I'm struggling with the lack of protein and seeming lack of guidance.

Advice online ranges from basically what I was eating already, to vegan-lite. Guidance on fish is all over the place.

Very rarely do the Mediterranean meal plans given on the web match the guidance of the website they are on, for example, "eat chicken sparingly" but the first week's menu has chicken twice. Avoid eggs but eat an egg on avocado toast on day 1. I understand that life happens but I want to save my exceptions for special occasions and not plan them into my diet.

Can anyone recommend a resource in which:

• Guidelines are consistent with a scientific source. How much fish can I really eat while lowering my cholesterol, according to the evidence? Can I eat seeds? Did the ancient Greek really toss egg yolks?
• Recipes match guidelines. If it says eggs rarely or never, I don't want to see an egg on day three and then I have to figure out the rest of the month without eggs.
• Accounts for a reasonable protein intake. Like beans are mostly carbs, if nuts and fish and dairy are limited where am I getting fresh protein from?

Sorry if I sound peevish. I'm hungry and protein starved, and sick of hummus already.

Everyone raves about the Mediterranean diet so I figured maybe I'm doing it wrong or looking at the wrong sources. Advice welcome.

neanderthin

The Mediterranean Diet is a made up myth, no such thing. It's basically a curated, idealized version of eating habits of around 22 countries where most authorities in their wisdom announce some version of food consumption that they believe is ideal with these same authorities self anointed to rate it as the #1 diet in the media, pretty funny stuff really, but this is just my opinion. Is a diet where mostly whole foods are consumed a good starting point, sure. It's also a free get out of jail card for most PCP's where they don't and can't spend the time or the resources to research root causes and statins are also another one that's really popular. You could actually request a Coronary Artery Calcium (CAC) test which would actually show if you are at risk.

AnnPT77

https://community.myfitnesspal.com/en/discussion/comment/48560457#Comment_48560457

Some others here will differ, but that makes more sense to me.

Neanderthin's advice about a CAC test is reasonable, if you can get it approved. Beyond that, I'll double down on recommending the registered dietitian option. You're eating a lot of healthy foods, and are at least moderately active, and it sounds like you're at a healthy weight. If your doctor won't refer you to a dietitian, and you can consider a self-pay option, you may be a good candidate. In the US, sometimes universities, gyms, grocery chains, drugstore chains or the like have some kind of registered dietitian service. Even your local health department might have referral lists, I don't know. Don't accept nutritional advice from a "trainer" or "nutrition coach" who is not a registered dietitian.

There may be serious certifications for nutrition advice in the cardiac realm short of RDs, but I'm not familiar with what they are, if they exist. There are a lot of poorly-educated, low experience hucksters claiming to be "nutritionists" in most US states, because in a lot of places claims like that aren't licensed/regulated.

sollyn23l2

I think you're trying to be too restrictive with it. At its core, it's about eating whole foods (vegetables, fruit, whole grain, and a protein source). Limit added sugar, refined grains, and red meat. Try beans and lentils sometimes as your protein source, but chicken and fish is also fine. If you're coming from a steak and pitatos diet, it will be an adjustment. Take it day by day, and don't try to be perfect.

MmeZeeZee

Thank you so much @sollyn23l2. I appreciate it!

My challenge is that I was pretty much a flexitarian before. Yes, I ate red meat and chicken, but once a week or so. I usually had a salad for lunch or a rice bowl. Definitely no Paleo or keto. Dinner was usually fish and veggies. Dessert maybe 1-2 times a month. We cook with EVOO and grapeseed oil (always have).

So I'm looking for something that reflects the change I need to make to lower my cholesterol but without drastically cutting protein.

I'm worried if I keep eating the same things it won't change. I just need clear, consistent guidelines that make sense.

Really appreciate your encouragement. <3

AnnPT77

I'm with Sollyn: It's not a magic formula with a precise definition. I don't have an exact source for the Mediterranean diet, I'm sorry. I actually doubt that there is a definitive one, though I'm sure there are some dogmatic sites out there that will claim to be definitive. 😉 The sources I've seen are more guidelines, as you describe.

If you need more help, would your doctor give you a referral to a registered dietitian? They can review your diet in detail and make suggestions for improvements that could help lower cholesterol. As Neanderthin suggests, the Mediterranean diet is a pretty generic recommendation coming from a doctor: They aren't nutrition experts.

Though the genetic tendency to high cholesterol isn't the issue in a majority of cases, only around 1 in 250, do you know whether your lineage includes people with high cholesterol who were not overweight, which might give hints at the possibility?

It sounds like you were already eating some good things, but it's hard to tell what overall eating is like from a brief summary.

Do you have weight to lose? That can make a difference. For me, that seemed to be the whole key. I had high cholesterol and triglycerides, didn't change the range of foods I eat to reduce calories, but cholesterol dropped into the normal range when I approached a healthy weight, and has stayed solidly normal for almost 10 years while maintaining a healthy weight.

How much of your eating, if any, has been more processed or refined foods? That can make a difference. You've been eating fish, but are they types of fish higher in Omega-3s? Omega-3s can potentially improve HDL cholesterol. Do you eat nuts, seeds, nut butters? Legumes?

Even exercise can make a difference.

MmeZeeZee

https://community.myfitnesspal.com/en/discussion/comment/48559676#Comment_48559676

https://community.myfitnesspal.com/en/discussion/comment/48559644#Comment_48559644

Thanks both. @neanderthin you are spot on. I have been coming to the same conclusion myself. But it's the guidance I have so I'm trying to work with it. I've learned it's not smart to talk straight back to doctors without at least putting in effort. Thanks for the tip on the CAC. My triglycerides were normal too so I'll ask!

Other than looking at labels or in MFP regarding saturated fat, any tips on more specific guidance?

@AnnPT77: No, I don't think my mom or dad has high cholesterol. Everyone in my family loves butter and cheese. My BMI when healthy ranges from 19 (summer) to 20.5 (end of the holiday season). I live in Seattle so salmon, cod, trout and pollock are my mainstays, with some tilapia and halibut thrown in. I do love tuna as a snack food as well. I'm the type of gal to make my own trail mix from unsalted nuts and dark chocolate. I love vegetables and I have a kitchen garden. In hindsight, I think the cholesterol was coming from my overwhelming love of butter, cheese, yoghurt, cream, plus coconut and sesame oil. And yes, the occasional crab po boy or Seattle dog at a baseball game. Just typing it out brings tears to my eyes, but I'm trying to change my mindset about fatty foods, especially fish and butter and seeds. I cycle 5 days a week, yoga 2x a week, and hike and ski for fun. Think Northwest outdoorsy stereotype… All my other numbers are perfect. Just high HDL.

When I have a goal, especially with a number, I go after it. This has been a big adjustment but it's good to have a wake-up call.

As to this: If you need more help, would your doctor give you a referral to a registered dietitian?

I'm going to try really hard to follow advice up to my next test and if I don't make progress I will ask for a dietician as well. Good call. Thanks.

AnnPT77

https://community.myfitnesspal.com/en/discussion/comment/48560363#Comment_48560363

Wait, what? High HDL? And your doctor is fussed about that? Um, I don't think that medical opinion is universal.

There are some sources that think very high HDL increases some health risks somewhat, but there's controversy, IMU.

How high is your HDL and your total cholesterol, if you're willing to say? Mine is consistently above the normal range (lower 70s mostly, with a reference range that tops out at 60), and my relatively young, relatively up-to-date-on-stuff primary care doctor called it "phenomenal". I understand that there are some cautions at very high levels, but "above reference range" and "too high" are not necessarily synonymous.

MmeZeeZee

@AnnPT77 I mixed up HDL and LDL! Bad cholesterol is high. Not good cholesterol. Sorry about that. I am new to this cholesterol discussion.

neanderthin

@MmeZeeZee

[quote]Other than looking at labels or in MFP regarding saturated fat, any tips on more specific guidance?[quote/]

Unfortunately I have a different take on cholesterol and saturated fat that is not widely understood, so unless you want me to get into the science and details I'll just say I've used a ketogenic diet for a dozen years which if your not familiar is mostly an all animal product diet and high in fat, natural fat, but I do use extra virgin olive oil and unrefined avocado oil but use these fairly sparingly. Basically my diet wouldn't ever conform to the ideology of most authorities dietary guidance which it far exceeds on both animal and saturated fat consumption. I lost 65 lbs and my health markers are outstanding and continues to be. I also don't count calories and most on a very low or keto diet don't. I'll leave it there. Good luck with whatever you finally end up doing.

Hobartlemagne

Lasagna is from the Mediterranean