Bestermann is an internal medicine physician who also supervises a team of medical experts at Holston Medical Group treating people at a high risk of heart attack and stroke. Bestermann, who has been a physician for 40 years, says about 10 years ago he began recommending a different way of eating to his patients.
What he still recommends a decade later is a style of eating based on the diet of those living in the countries that border the Mediterranean Sea — Morocco, Spain, southern Italy, Greece, Crete, Turkey and the Middle East.
“I kind of got started with the South Beach Diet and a couple of other references. But what I recommend is almost exactly the Mediterranean diet,” Bestermann said.
The Mediterranean diet is made up of plenty of plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. It also replaces butter with healthy fats such as olive oil and canola oil and suggests the use of herbs and spices instead of salt to flavor foods. Red meat is limited to no more than a few times a month while fish and poultry should be eaten at least twice a week. Drinking red wine in moderation is also encouraged.
Studies indicate that the Mediterranean diet may reduce the risk of heart disease, cancer and cancer mortality, and Parkinson's and Alzheimer's diseases. Many scientific organizations encourage healthy adults to adopt a style of eating like that of the Mediterranean diet for prevention of major chronic diseases.
“Two things make people sick with cardio-metabolic kinds of diseases. It’s basically cigarettes or food,” Bestermann said. “If you live in other parts of the world where they don’t have a crazy American, or western diet, and they don’t smoke cigarettes, you don’t see nearly as much heart disease. Here in our country, we’ve got 30-year-olds dropping dead with heart attacks.”
Lisa Gilreath is a registered dietitian and certified diabetes educator at Mountain States Health Alliance’s Indian Path Medical Center’s Health Resources Center and says the Mediterranean way of eating should be thought more of as a lifestyle choice rather than a diet.
“Periodically, organizations like the World Health Organization (WHO) will look to see who’s living the longest, who’s the healthiest and try to figure out why,” she said. “Studies like these are how we discovered omega-3 fatty acids because the Eskimos were eating a lot of salmon. In this case, they looked at the Mediterranean population and not just the way they were eating, but their whole lifestyle.”
Gilreath says their diet is just their natural way of life because they eat foods that are naturally available to them — foods such as fish, olive oils and red wines.
“But there are some other pieces of this lifestyle that play an important role. One is the physical activity. They get out with their families and friends. They walk to work. There’s regular physical activity, whether it’s part of their lifestyle or part of their culture. The strong social support they have among each other is another big piece. Whether you want to call it stress management or whatever, they sit down and they have a relaxed meal around a big table with their family and friends. And along with their meal, they relax with a glass of wine,” she said.
In 2011, Gilreath says the United States Department of Agriculture (USDA) made the decision to replace the Food Guide Pyramid that was familiar to so many Americans with ChooseMyPlate.
ChooseMyPlate is actually based on the Mediterranean diet, Gilreath says.
ChooseMyPlate recommends to make half your plate fruits and vegetables; switch to fat-free or low-fat (one percent) milk; make at least half your grains whole grains; go lean with proteins; compare sodium in foods like soup, bread and frozen meals, and choose foods with lower numbers; drink water instead of sugary drinks; find a balance between food and physical activity; enjoy your food, but eat less; and avoid oversized portions.
“This is not complicated. It’s what I recommend to my patients along with incorporating more physical activity and stress management into their daily lives,” Gilreath said.
And although the Mediterranean diet is not touted as a “weight loss” diet, Bestermann says if you follow the diet and restrict your intake of carbohydrates and sugar, you can lose weight.
And he has the proof.
“In my practice, I started to see a fair number of patients who were actually losing weight and keeping it off by eating this way. So, I went through my list of patients and recorded their starting weights when I first saw them and then their current weights. I’ve identified over 500 patients that have lost an average of 25 pounds with the average age of 65 years old. And most of these people are keeping the weight off,” Bestermann said. “When we talk about these things, we tell them it’s not our job to give you something that you can lose 30 pounds in 30 days. That’s just not going to work for you. What we’re going to do is help you learn how to eat in a way you can eat for the next 40 years. Anybody can benefit from this way of eating. It’s a very balanced approach.”
This following recipe includes some of the key elements of a Mediterranean diet.
Mediterranean-style Grilled Salmon
4 Tbsp. chopped fresh basil
1 Tbsp. chopped fresh parsley
1 Tbsp. minced garlic
2 Tbsp. lemon juice
4 salmon fillets, 5 ounces each
Cracked black pepper, to taste
4 green olives, chopped
4 thin slices lemon
Prepare a hot fire in a charcoal grill or heat a gas grill or broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source.
In a small bowl, combine the basil, parsley, minced garlic and lemon juice.
Spray the fish with cooking spray. Sprinkle with black pepper. Top each fillet with equal amounts of the basil-garlic mixture.
Place the fish herb-side down on the grill. Grill over high heat. When the edges turn white, after about 3 to 4 minutes, turn the fish over and place on aluminum foil.
Move the fish to a cooler part of the grill or reduce the heat. Grill until the fish is opaque throughout when tested with the tip of a knife and an instant-read thermometer inserted into the thickest part of the fish reads 145 degrees F. (about 4 minutes longer).
Remove the salmon and place on warmed plates. Garnish with green olives and lemon slices. Makes 4 servings.