The ultimate guide to the Mediterranean diet for women over 50

When you think about the word diet, what images come to mind? Is it of the young, enthusiastic face telling you that their new magic supplement is going to help you shed 20 pounds? Or the less-than-appealing plate filled with portion-controlled servings? Endless days of cayenne and lemon juice fasting? I’m here to suggest that what you should be more likely envisioning is a long table in Spain peppered with celebration and filled with delicious food.

I’ve written a lot about healthy eating habits on the Age Sister blog site, but so far have been hesitant to recommend a specific diet. Lately, many readers have told me that they would feel better if they had a framework to follow when it comes to better eating. The idea of providing a better recommendation has led me to develop this post about what I consider (and research supports) to be the best eating pattern for older women – the Mediterranean diet.

Unlike many of the popular diet trends, research on the Mediterranean diet has consistently shown positive health outcomes and the prevention of disease. Lifestyles of populations of people living in the Mediterranean area were originally studied because of their low levels of cardiovascular disease and increased longevity. As a result, researchers became interested in the specific eating patterns of those living a Mediterranean lifestyle.

Volumes of research have been conducted to understand the contribution of Mediterranean dietary habits to health outcomes. Many of the studies tease out some of the other health-promoting variables of folks living in the Mediterranean area.

What is the Mediterranean diet?

The Mediterranean diet typically consists of a high intake of fruits, vegetables, non-refined grains, fish, nuts and seeds, moderate amounts of dairy, and low consumption of red or processed meat and sweets. The diet also includes olive oil as the primary fat (minimal butter or margarine) and moderate amounts of red wine (a caveat - alcohol is a known carcinogen and any amount of alcohol increases a women's risk for some cancers). I should also emphasize that the typical Mediterranean diet is not a program, nor is it about restriction or counting calories – instead, it is just part of an overall healthy lifestyle.

The benefits

The Mediterranean diet is associated with many health benefits. These include a reduction in risk for cardiovascular disease, Type 2 diabetes, obesity, and certain cancers. People following a Mediterranean diet have also been found to have a lower risk for mild cognitive impairment and potentially for Alzheimer’s disease (but more research needs to be done in this regard).

Cardiovascular health  

Although lower cardiovascular disease rates are well established in the Mediterranean region, researchers have worked on teasing out other confounding Mediterranean lifestyle factors that might help reduce heart disease risk (e.g., more exercise, increased social support). As a result, there have been many studies that have isolated the Mediterranean diet from lifestyle in order to understand the impact on heart disease risk (but these studies were typically done in the general population).

In 2016, researchers set out to test a Mediterranean diet in a small sample of post-menopausal women living in the US. The women in the pilot study were directed to follow a Mediterranean-style diet (MedSD), based on the results of a much bigger study conducted in Spain. The participants followed a diet that had four components. These included: olive oil three times daily (which replaced dietary butter), fatty fish (e.g., salmon, tuna) three times a week (which replaced red meat), 1.5 ounces of nuts daily, five servings of fruits and vegetables per day, and a switch from processed grains to whole grains.

Women in the study successfully improved their blood lipid profiles (cholesterol and other fats) and in turn, reduced their risk for cardiovascular disease.[1] Although this was a small study, given that the risk for developing cardiovascular disease goes up substantially post-menopause, taking on the principles of a Mediterranean diet seems like a good start to lowering your heart disease risk. And, there are other benefits…. 

Body composition 

In many other studies (including an extensive review of research related to the Mediterranean diet and metabolism), participants who adhered to the MedSD principles typically were far less likely to be overweight or obese. Researchers studying the impact of the Mediterranean diet in peri and post-menopausal women found that women who followed the MedSD diets had lower body weight overall. The researchers suggested that implementing the MedSD diet while maintaining a healthy body weight may also be useful in reducing symptoms related to menopause.[2] 

Combined with exercise

You know that I can’t write a blog post without talking about exercise, but this one is truly a win. If you are engaging in regular physical activity and you follow the Mediterranean diet, you not only deliver a one-two punch to your cardiovascular disease risk; you may also increase what’s called your “exercise tolerance.” Exercise tolerance is your ability to exercise to exhaustion. This test is used in assessing heart disease, COPD risk etc. Better exercise tolerance typically means lower risk overall.[3]

Combining the MedSD diet and exercise also improves your muscle mass. Remember my post on weight-training and sarcopenia for post-menopausal women? Add in more Mediterranean-style eating, and your risk for sarcopenia goes even lower.[4] Following a more Mediterranean approach means no calorie counting or point systems, just a change in what you choose to eat.

How to implement the Mediterranean diet successfully

Again, simple rules apply to follow a Mediterranean style diet in your everyday life: 

1. Choose a fruit or vegetable to have with every meal.

2. Swap out red meat for fish.

3. Add in more nuts, seeds, and legumes.

4. Replace your butter and margarine with olive oil (virgin or extra virgin) wherever possible.

5. Replace processed or refined grains (think white flour) with whole grains.

6. Enjoy a glass of red wine (if your cancer risk is low).

Example recipe

Here is a basic recipe to help you get started:

Weekday Power Bowls

This is a go-to recipe for my family. It’s one of those dishes that can be hearty and satisfying in the winter or used as a light side dish beside grilled fish in the summer. This dish is meant to be “free-styled” (no rigid recipe). Use your imagination to tweak it to your taste.

Here is the basic plan (you can also find a more detailed example in one of my favourite cookbooks, Oh She Glows)

1. Start with a grain: This can be rice, brown rice, quinoa, couscous, or whatever works for you. I typically go for quinoa because it cooks quickly and adds a nutty flavour. Just make sure that you buy the pre-rinsed version or rinse before cooking. I usually make 1.5 cups of dry grains for four hungry people.

2. Add a legume: Canned beans, chickpeas, or lentils are just as nutritious as dried. Just make sure to rinse before adding to your meal. One regular size can will do.

3. Pick out at least three of your favourite veggies and chop them into bite-size pieces: All year you can typically get tomatoes, cucumber, mushrooms (yummy sautéed in olive oil), and red peppers (at least in my part of the world), but if you have access to other things like artichokes, sundried tomatoes, mixed greens, beets etc. chop them up and throw them in too. I always encourage clients to try out a vegetable that they have never had before. Jicama anyone?

4. Choose a nut or seed: I am partial to roasted pumpkin seeds, but almonds, walnuts or hazelnuts also work well. You choose. Just remember that studies on the benefits of the Mediterranean diet are usually of participants eating no more than a small handful of nuts per day.

5. Add a protein if you like: My favourites are grilled salmon or feta cheese. Tuna works well too.

6. Dress: Your choice, but of course, dressing made with virgin oil is best. One of my favourites is from the recipe that I linked to above:

Tahini Lemon Garlic Salad Dressing

Ingredients:

1/4 cup tahini

1-2 garlic cloves

1/2 cup fresh lemon juice

1/4 cup nutritional yeast

1/2 cup extra virgin olive oil

1 tsp kosher salt

Fresh ground black pepper, to taste

Directions: In a food processor, process all ingredients until smooth. Makes about 1.5 cups.

7. Assemble it all: Start by lining a bowl with your cooked grain, cover with a thin layer of your legumes, add veggies on top, add your protein, sprinkle with nuts or seeds, and dress. The best-case scenario is that you sit down with friends or family and enjoy your meal with good conversation and laughter.

Salud!

Your sister in health,

Kate