Donna Weihofen, retired Senior Nutritionist spoke about Eating the Mediterranean Way at Wisconsin Women's Health Foundation's 2013 annual Gathering in Marshfield, WI. The Mediterranean diet emphasizes: • Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts • Replacing butter with healthy fats, such as olive oil • Using herbs and spices instead of salt to flavor foods • Limiting red meat to no more than a few times a month • Eating fish and poultry at least twice a week • Drinking red wine in moderation (optional)

1. Eating the Mediterranean Way
Donna L. Weihofen,
RD, MS
Senior Nutritionist
UW Hospital & Clinics

10. Seven Countries Study
Ancel Keys - 1958
• Studied diet, lifestyle, and cholesterol -
• 12,000 healthy middle-aged men
• 7 countries
• Finland
• Greece - Crete
• Italy
• Japan
• Netherlands
• Yugoslavia
• United States

11. Ancel Keys
• The 1st
research physician to
recognize that it was not the total fat
in your diet that promoted heart
disease but it was the saturated fat
that was bad
• He noted that a high fat diet with olive
did not increase risk of heart disease.
– Keys died in 2004 at the age of
100.

12. Mediterranean Diet & 2nd
Heart Attack
1999 Study
• 600 people who have had heart attacks
–½ followed Mediterranean diet
(30% fat, 8% saturated fat)
–½ followed Western diet
(34% fat, 12% saturated fat)
–Followed for 4 years
• Mediterranean group had 50% lower
risk of repeat heart attacks compared to
Western diet

13. Mediterranean diet reduces death
from major chronic diseases –
2008 study
• Researchers assessed 12 international
studies which collectively included 1.5
million participants whose dietary habits
and health were tracked for periods
ranging from 3 – 18 years.
• All studies used a numerical score to
estimate how much people stuck to the
diet, called an “adherence score”

14. What did they find?
• People who stuck strictly to a
Mediterranean diet had significant
improvements in their health
–9% drop in overall mortality from CV
disease
–13% drop in Parkinson & Alzheimer’s
disease
–5% drop in cancer
» British Medical Journal, Sept 12, 2008

15. Diet affects colon cancer survival
• “Western diet pattern” – high amounts
of red meat, fat, and refined grains
• Mediterranean diet – high amounts of
fruits, vegetables, fish and poultry
• Individuals with colon cancer who had
undergone surgery and chemotherapy
had significantly higher risk of
recurrence if they followed a
predominantly Western diet pattern.
– J. Meyerhardt, presentation at ASCO,
June 2007.

16. 'Western' Diet Not the Way to
Age Well (April 15, 2013)
• A new British study provides further evidence
that eating a so-called "Western" diet may not be
good for you in the long run.
• People who eat this kind of diet -- which includes
fried and sweet foods, processed and red meat,
refined grains and high-fat dairy products -- are
at increased risk for premature death. And those
who do make it to old age are less likely to be in
good health when they get there, the
researchers said. The American Journal of Medicine, news
release, April 15, 2013

17. Ray’s Western Breakfast Donna’s Mediterranean Breakfast

18. • The results show how
real people,
• eating real food,
• in their own homes,
can significantly
lessen their chances
of dying of
cardiovascular
disease and cancer.

19. And it will be a good life!
• People following the Mediterranean
diet had a 40% lower risk of
developing Alzheimer’s than those
who ate the conventional American
diet.
• Annals of Neurology, April 2006
–Those who followed a
Mediterranean diet more closely
had less cognitive decline over
time.
– Amer J Clin Nutrition, Dec 2010

20. Mediterranean Diet & Rheumatoid
Arthritis
• Arthritic persons living in
Sweden began following
Mediterranean diet for 3 months
– decrease in pain,
inflammation, and fewer
swollen joints
– Annals of Rheumatic Disease
2003

21. Why??
• Olive oil has anti-inflammatory
properties.
• It is rich in oleic acid, which
when metabolized to
eicosapentaenoic (EPA) acid,
has anti-inflammatory
properties
• Vegetables contain a variety of
antioxidants thought to help
decrease inflammation

22. One more major benefit

23. Mediterranean Diet & Weight
Loss
2001 study (International J Obesity)
• 101 overweight people instructed to follow low-fat
diet or moderate fat Mediterranean-style diet
– Only 20% could stick to low fat diet
– More than 50% could stick to moderate fat diet
– Both groups lost an average of 11 pounds the
first year
– However, the moderate fat group kept off a
significant amount at 2 ½ year follow-up
but low fat group had regained their weight.

24. A Fusion of Flavor & Health
“Motivation and adherence are
very hard to sustain in any
with loss program, but the
results from this study
suggest that the tastier the
food, the greater overall
success of the diet plan -
even if it does include
moderate amounts of fat.”

26. Diet Works! 2013
• 7,500 residents in Spain were put
on one of 3 diets and tracked for 5
years:
– Low-fat diet
– Mediterranean diet with nuts
(almonds, walnuts, and hazelnuts)
– Mediterranean diet with at least 4
tablespoons of olive oil
• Participants were allowed to have up to
7 glasses of wine a week

27. Benefits of good real food
• The 2 groups on the
Mediterranean diets
had a 30% reduction
of cardiovascular
problems
• The study was
stopped early because
data were so
overwhelmingly clear.
– New England J Med 2/2/13

28. Advice from Hippocrates
• Obese people … should
perform hard work…eat
only once a day, take no
baths, sleep on a hard bed,
and walk naked as long as
possible

31. The Mediterranean
Facts
• F Flavorful
• A Aromatic
• C Colorful
• T Tasty
• S Sensory Pleasure

32. E• Enjoy fruits &
vegetables
at every meal
Mediterranean

38. Quercetin
• Quercetin is a flavonoid
which has powerful cancer
fighting properties
• Found in: apples,
cranberries, raspberries,
blackberries, black
currants, lingonberries
• Also in onions, tea, and
red wine

39. An Apple a Day
• Rats with breast cancer were fed
the human equivalent of 1, 3, or
6 apples/ day (Cornell University
study)
• Tumor was reduced by 25, 25,
and 61 percent in rats fed
respectively 1, 3, or 6 apples
• J. Agriculture and Food Chemistry, online Jan. 2005

40. Go for Color

49. Cruciferous Vegetables
• Cabbage, Broccoli,
Brussels sprouts,
Kale, & Cauliflower.
• Sulforaphane &
isothiocyanates =
potential active
compound

51. The Humble Cabbage
• SAUERKRAUT
– Fermenting cabbage produces
isothiocyanates – a class of cancer
fighting compounds
– Fermentation process also
produces organic acids such as
lactic acid which makes cabbage
easier to digest.
» J. Agricultural and Food Chemistry,
Oct. 2002

53. Eat fruits & vegetables
throughout the day

63. How many should I eat??
• More than you are eating now!

64. Mediterranean
•Decrease
saturated fats
D

68. Mediterranean
–Increase
monounsaturated fats
I

73. Virgin olive oil is
special
• Virgin olive oil is more
than fat because it is real
juice with other healthful
micronutrients.
• Olive oil is a natural juice,
pressed from the olives.
– J American College of
Cardiology, Nov 2005.

75. Olive Oil & Breast Cancer
• Greek Study
– Women who eat olive oil more
than once a day have a 35%
lower rate of breast cancer
than Greek women who eat
olive oil less frequently.

76. FAT or OIL %
Monunsat
%
Polyunsat
%
Saturated
Olive oil 77 9 14
Canola oil 62 32 6
Peanut oil 49 33 18
Veg.
Shortening
45 26 25
Corn oil 25 62 13
Soybean oil 24 61 15
Safflower oil 13 77 10
Lard 47 12 41
Butter 30 4 66

79. Avocados – “the good fat”
• Good sources
– Vitamin E
– Vitamin C
– Vitamin B6
– Folate
– Potassium
– Soluble fiber
– Phytonutrients –
lutein

80. Mediterranean
• Target your taste
buds with grains
• Breads, pasta, rice, couscous,
bulgur
T

84. Benefits of high fiber for
diabetes
• Reduces speed of
glucose absorption
• Improves blood sugar
levels
• Lowers cholesterol
and triglyceride levels
• Helps control appetite

85. Whole grain cereals reduced heart
failure risk
• Eating whole grain breakfast cereals was
associated lower risk of heart failure in
Physician’s Health Study
– Decreased 28% if eating whole grain cereal 7 times a
week
– Decreased by 22% if eating whole grain cereal 2 – 6
times a week
– Decreased by 14% if eating whole grain cereal at least
1 time per week
• LucDjousse, Presentation at American Assoc 47th
Conference
on CVD, March 2007

87. Pasta
• ½ cup cooked pasta = 100 calories
• Choose pasta shapes for its ability
to hold and support the sauce.
e.g. Tubes shapes for thick sauce;
flat, long shapes for thin, smooth
sauce

88. Pasta
• Orecchiette = little ears
• Eliche = propellers
• Ditali = thimbles
• Conchiglie = conch shells
• Linguine = little tongues
• Vermicelle = little worms

89. Pasta
• Name ends in
–-ricee = wavy edge
– -nidi = formed into nests
– -rigate = ridged
– -lisce = smooth surface
– -ine = smaller form
– -ette = smaller form

92. Mediterranean
•Eat more fishE

97. Fish Safety
• Health benefits of consuming seafood far out weigh any
risk due to trace amounts of mercury in fish.
• Fish low in mercury and high in omega-3 fats
– Salmon, tuna, sardines, herring
• Only 4 species of fish are significantly high in mercury:
– Shark, swordfish, king mackerel, tilefish
• Harvard Center for Risk Analysis, American J Preventive
Medicine, Nov 2005.

98. Omega 3 Fatty Acid
H H H H H H H H H H H H H H H
H C C C = C C C = C C C =C C C C C C=O
H H H H H H H H
Omega 6 Fatty Acid
H H H H H H H H H H H H H H H
H C C C C C C = C C C = C C C C C C=O
H H H H H H H H H H

99. Approximate Omega-3 Composition of Sea Food
Seafood – 3 ounce Omega–3
(mg.)
Anchovy 1,800
Halibut 400
Salmon 1,000 – 2,000
Scallops 300
Shrimp 300
Swordfish 700
Trout 800
Tuna (albacore) 700

100. Omega – 3 Fatty Acids
Fish Oils
• Acts as an anti-inflammatory agent
• Reduced heart disease
– Reduces blood clot formation
– Contains triglyceride-lowering properties
– Lowers blood pressure
– Promotes arterial relaxation
– Inhibits growth of plaque
– Reduces susceptibility to arrhythmias
• Reduced cancer risks

101. Omega- 3 fats may be of benefit in:
• Asthma
• Arthritis
• Diabetes
• Mood disorders
• Cognitive function
• Pregnancy
  Pre-eclampsia
  Gestational diabetes
  Fetal growth
  Offspring cognition

104. Mediterranean
•Reduce amount of meat
R

108. Mediterranean
•Rediscover
legumes and bean
R

111. Mediterranean
•Add a little cheese
A

115. Mediterranean
•Nibble on nuts
N

118. Walnuts – Source of Omega-3s
Walnuts added to diet :
- Significantly decreased
total cholesterol and LDL
cholesterol
• Bajaram, Experimental Biology,
2006
– Improved bone strength
• Griel, Nutrition Journal, Jan 2007

119. Walnuts protect persons with
Type II Diabetes
• Eating a handful of walnuts
every day can help persons
with Type II diabetes
achieve recommended
intakes for omega-3 fats
which are critical to
protecting the heart.
• J. American Dietetic Assoc. July
2005

120. Almonds
source of antioxidants, vitamin E, protein, fiber,
potassium, calcium, monounsaturated fats
One ounce serving of
almonds contain same
amount of flavonoid-
class of antioxidants as
one ounce serving of
broccoli.
• Milbury, P. J Agric Food
Chem, July12, 2006.

123. Mediterranean
• Enjoy eating out
• Enjoy wine in
moderation
E

127. How about coffee?

129. Coffee may protect
against DNA damage!!
• Drinking a cup of coffee may reduce the
oxidation damage to DNA by 12%
• According to a European study – in 2010.
(Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, Misik, C,
online Sept 2010)

130. Coffee and Colon Cancer
• Harvard School of Public Health analyzed 17 studies on
coffee drinkers and found a lower risk of colon and rectal
cancer is associated with higher levels of coffee
consumption.
• More recent studies compared high versus low coffee
consumption groups and it found no significant association
between coffee consumption and colorectal cancer risk.
• Review of 12 studies with 646,848 participants and 5,403
with colon cancer
– International Journal Cancer, April 2009

131. Caffeine decreases
skin cancer risk
• Large observational
study 113,000 men &
women
• Those consuming the
most caffeine were
significantly less likely to
develop basal cell
cancers

132. Coffee may boost prostate
health
• Study of 50,000 men found that
increased intake of coffee may
reduce risk of lethal and advanced
prostate cancers by 60%.
• Regular coffee has effects on
insulin and glucose metabolism
as well as sex hormone levels, all
of which play a role in prostate
cancer.
• American Assoc Cancer Research
conference Dec 2009

133. Coffee linked to lower ovarian and
uterine cancer risk
• Drinking 3 or more cups of coffee per
day may reduce the risk of ovarian
and uterine cancer by over 20%
• The benefits appeared to be related to
the caffeine content of the coffee. No
benefits were observed from
decaffeinated coffee.
– Tworoger S, Cancer; published online Jan 22, 2008.
Print issue date: March 1, 2008
– International J Cancer, April 1, 2009
– Internaitonal J. Cancer, Nov 15, 2009

134. Mediterranean
• Active lifetime activities
A

136. A Norwegian
Exercising

139. Mediterranean
• Nourish your body with
wonderful healthy food.
N

140. www. CHANNEL3000.com
under the “Home” tab & “Recipe” tab
Click on Donna’s Recipes

144. What are the characteristics of
Mediterranean Diet?
• Above average consumption of
vegetables, fruits, nuts, legumes,
grains, and fish
• Below average consumption of
meat and high fat dairy products.
• Greater that average proportion
of monounsaturated vs saturated
fat consumption

145. The Mediterranean Way
• Simple ingredients
• Bold flavors
• Uncomplicated
recipes
•And it is healthy
too!!

147. Donna L. Weihofen
Nutritionist
donnaweihofen@gmail.com

148. Life should
NOT be a
journey to the
grave with the
intention of
arriving safely in
an attractive
and well
preserved body,

149. but rather to
skid in
sideways,

150. chocolate in one hand,
wine in the other

151. body thoroughly
used up,
totally worn out
and screaming,
“Wow –
what a ride!”

153. A Norwegian
Exercising

154. Watch what you eat!
The real truth.
• Japanese eat very little fat and suffer
fewer heart attacks than Americans.
• Mexicans eat a lot of fat and suffer
fewer heart attacks than Americans
• Germans drink a lot of beer and eat lots
of sausages and suffer fewer heart
attacks than Americans.
• Norwegians eat old dry fish and suffer
fewer heart attach than Americans

155. CONCLUSION
• Eat and drink what you like.
• Speaking English is
apparently what kills you!