The Mediterranean Way | by Kelly Francis, Registered Dietitian
Striving for a traditional Mediterranean diet is a great way to achieve optimal health because of its nutrient dense, socially feasible and fairly economical dietary recommendations.
There are many studies to prove the effectiveness of the Mediterranean diet in reducing risk for heart disease, type 2 diabetes and stroke. A stroke, if not fatal, can have devastating consequences, all of which rapidly reduce quality of life and an increased health care burden. Type 2 diabetes, if not well managed, is associated with long term complications that may lead to unnecessary end of life suffering.
Based on whole plant foods with a splash of plant oils eaten together with moderate portions of lean protein, a Mediterranean style diet is packed with all the goodness we need for optimal functioning of the body. The human body has 11 major organ systems, each of which are fueled by energy and use varying combinations of vitamins and minerals. Consuming a variety foods is essential for the support of the organ systems which keep us alive.
The circulatory system is responsible for the transport of nutrients, oxygen, carbon dioxide, wastes, electrolytes and hormones throughout the body, effectively interacting directly with every other organ system. The digestive system delivers nutrients into the blood stream for transport. Supplying adequate nutrition reduces the risk for the development of vitamin or mineral deficiencies which can disturb the equilibrium of the functioning of the body and result in various symptoms and disease conditions.
Literally taking a leaf from the populations eating a true Mediterranean diet can promote health with limited compromise to dietary diversity, social activities and food budgeting. One of the best things about Mediterranean eating is that it is easy to adhere to when eating at restaurants or entertaining friends. The options are many and the limitations are few!
What is a Mediterranean Diet?
When reading food labels, the ingredients of any product are listed in descending order of mass, meaning that the ingredient listed first is the dominant ingredient. Putting a label on a Mediterranean diet, in a South African context, would read something like this:
Nuts, seeds and plant oils are listed at the end, not because they are bad but because they are very energy dense. Small portions are sufficient.
Healthy cooking methods are essential to preparing these foods for maximum nutrient quality. The following tips will help you to optimize the nutrient quality of family meals:
Cook vegetables in minimal water or none at all. Steaming and roasting prevent nutrient losses.
Include raw salads as starters of lunch box fillers
Include fruit in meals and snacks
Use fresh or dried herbs and salt free spices to make meals tasty
Leave the skin on potatoes
Extend meat dishes by adding legumes such as lentils or butter beans
Choose high fibre starches, limiting highly refined grains and low fibre grain products
Add plain yoghurt to dishes instead of cream
Use low fat, unsweetened dairy products
Avoid deep frying any foods in large volumes of oil
Avoid highly processed cheese (eg. cheese slices or spreads)
Avoid cooking or baking with hard margarine (bricks)
Limit processed and smoked meat products
If snacks are required to stabilize blood sugar levels, keep hunger at bay, support the demands of physical activity or supply adequate nutrients for growing children, the following options are advised:
Baby carrots with hummus
A closed handful of unsalted nuts
Apple wedges with peanut butter
Green apple slaw
Green Apple Slaw = grated apple, shredded cabbage, plain yoghurt with a little mayonnaise for tang
There is much controversy surrounding these two spreads that look similar and essentially serve the same purpose but it is well worth knowing the difference, and more importantly, the facts that will hopefully put this debate to rest.
Firstly, the reason for the creation of margarine in the 1860’s is a very simple one. In war times, butter was difficult to get hold of and somewhat of a luxury in terms of cost. The margarine invented as an affordable substitute butter is however not the same margarine sold as the heart healthy tubs of soft ‘margarine’ we see in supermarket refrigerators today.
On a closer look, these soft ‘margarines’ are not actually even labelled as ‘margarine’ but rather as fat spreads with varying fat compositions reflected by percentages. The fat content requirement for a butter substitute to be labeled as a margarine is 80% which is equivalent to that of butter.
What are the fats?
While margarine is still available in solid bricks, the general rule is, the more solid the fat, the more trans fats it contains. Knowing that trans fats increase the risk for heart disease, brick margarine is never advocated as a healthy fat choice.
The reduction of trans fats in soft fat spreads sold in tubs is due to the addition of palm oil and or coconut oil as an ingredient. These are the only saturated plant fats and due to the fact that they are solid at room temperature (full hydrogenated), the need for the hydrogenation (a process that produces trans fats) of the vegetable oil is eliminated.
As a result, the fat found in these fat spreads is comprised of saturated fats, monounsaturated fats and polyunsaturated fats. Regular fat spreads contain 60 % fat while the lowest fat spread available contains 35 %. The reason for this is simple switch between the vegetable oil content and the water content.
The ingredients list taken from a tub of 60% fat spread is as follows:
Vegetable oils and fats (60%) [sunflower seed and / or rapeseed and /or linseed and /or soya bean oil, fully hydrogenated fats (palm, palm kernel and/ or coconut)], water (39%), salt, whey powder, emulsifiers (E471, E322), preservative (sodium benzoate and/or potassium sorbate), citric acid, flavouring, beta-carotene, vitamins (A,D,E).
It seems significant to highlight that the additives listed after the oils, fats and water make up only 1 % of the fat spread ingredients.
Butter is higher in saturated fats with 100 g of butter containing about 50 grams of saturated fat compared to the 15 grams of saturated fats contained in a 60 % fat spread. While there is still debate regarding the health effects of saturated fat, the World Health Organization, recommends that saturated fat be limited to no more than 10 % of total energy intake.
Butter or Margarine for weight loss?
While butter is purely butter with perhaps a little salt added for flavour, being 80 % fat, makes it much higher in energy that fat spreads sold in tubs and labelled as heart healthy. A teaspoon of butter will add 152 kilojoules while a teaspoon of 60 % fat spread will add 114 kilojoules and a teaspoon of a 35 % fat spread will only add 67 kilojoules.
While a high fat meal might result in feeling fuller for longer and hopefully curb unnecessary snacking, a high fibre meal can have the same effect without the additional kilojoules.
Is margarine plastic?
Many argue that margarine (a generalization used for all fat spreads save butter) is virtually plastic, and far from natural but a brief look at the ingredients list on a tub of fat spread will tell you that this is not true. It is even possible to make margarine in a home kitchen.
Early margarine was did not display as much ‘plasticity’ as butter, simply meaning that it can be molded and retain its new shape. Milk and water were therefore added to vegetable oil shortening and it was named ‘margarine’ based on its scientific properties.
If it were even possible to add one molecule to margarine and convert it to hard plastic, it would no longer be margarine but plastic. One molecule makes a huge difference and is wonderfully illustrated by the difference between hydrogen peroxide and water which differ chemically by only one molecule, oxygen!
Which should you choose?
In moderation, neither is harmful but neither, margarine nor butter should be used in large quantities, especially when the alternatives to both are far more tasty and nutritious. Think nuts, nut butters, olives, olive oil, avocado and seeds!
For some, there is no choice as fat spreads are not only kilojoule sparing options, they remain a cost effective substitute for butter. The aim of this article is to highlight the importance of making health choices based on reason rather than rhyme.
Sweet potato fries have a reputation for being healthier than French fries, but you may wonder whether they’re really better for you.
After all, both kinds are usually deep-fried and served in oversized portions.
This article reviews the nutrition of sweet potato and French fries, as well as their potential health effects.
Detailed nutrition information is most readily available for store-bought, frozen fries.
The following nutritional comparison is for a 3-ounce (85-gram) serving — or 10–12 pieces of frozen fries — which can be baked as-is from the freezer (1):
*Fat and sodium content may vary between different brands of either type of fries.
Sweet potato fries are slightly higher in calories and carbs but also more nutrient dense than French fries.
The greatest nutrient difference is that French fries have no vitamin A, while sweet potato fries are high in this nutrient. Vitamin A is important for your vision and immune system (2).
SUMMARY Sweet potato fries are a bit higher in calories and carbs than French fries. However, sweet potato fries are also more nutrient dense and particularly high in vitamin A.
Serving Size and Cooking Methods Matter
The table in the previous chapter shows that a 3-ounce (85-gram) serving of baked French fries has 125 calories, compared to 150 calories for the same serving of baked sweet potato fries.
In contrast, fries at restaurants are typically deep-fried — which nearly doubles the calorie content.
Here’s a comparison of the average calories, fat, and carbs in different size orders of deep-fried fast food fries (1):
A large serving of each kind of fast food fries has as many calories as some people need in an entire meal.
Additionally, the carb and fat content are about doubled if you choose a large rather than a small serving — regardless if they’re French or sweet potato fries.
SUMMARYDeep-frying nearly doubles the calories in both French and sweet potato fries compared to baking. When deep-fried, a large serving of either type of fries contains a full meal’s worth of calories.
Concerns Over Frying
Two issues that have made news headlines over the past few decades are trans fat and acrylamide in fries.
Is Trans Fat Still a Problem?
Trans fat in fries and other processed foods became a big concern in the 1990s, as studies linked it to increased heart disease risk (3, 4).
Fortunately, new FDA rules ban the use of partially hydrogenated oil — the primary source of trans fat — in the U.S. food supply as of June 2018, though some may remain in the food supply until January 2020 as inventories are depleted (5).
Therefore, you should no longer see “partially hydrogenated oil” in ingredient lists of fries, nor should you find any trans fat listed in their nutrition information.
However, it’s likely still wise to limit your intake of deep-fried foods, as two studies suggest that small amounts of trans fat may form when oil is repeatedly used in a deep fryer (6, 7).
Acrylamide Forms in Both Types of Fries
Acrylamide is a potentially harmful compound discovered in 2002 in cooked, starchy foods — including fries. In fact, fries are one of the major dietary sources of acrylamide (8, 9, 10).
It’s formed through a reaction between the amino acid asparagine and certain sugars when starchy foods are fried and — to a lesser extent — when they’re baked or roasted (11, 12).
Though most studies on acrylamide levels in fries have tested French fries, this compound also forms in sweet potato fries and is what makes fries brown (13).
Acrylamide is classified as “probably carcinogenic” in humans. However, this is based on studies of animals given high doses of the compound (14).
A review of human observational studies suggests that typical acrylamide intakes are unlikely to be related to the most common causes of cancer — but more research is needed (15, 16, 17, 18).
Additionally, food suppliers may use several strategies to reduce acrylamide levels — such as treating fries with certain additives — though this isn’t required by law (13, 19, 20).
If you’re making fries from scratch, you can reduce acrylamide formation by avoiding refrigerating potatoes, baking instead of frying, soaking potato slices in water for 15–30 minutes before cooking, and heating them just until golden, not brown (12, 13, 21, 22).
SUMMARY New FDA rules have largely eliminated trans fat content in fries. However, acrylamide, a potentially carcinogenic byproduct in fried starchy foods, occurs in fries. Still, a typical intake through a normal diet is unlikely to be problematic.
Regular Consumption May Increase Disease Risk
French fries have come under increasing scrutiny due to new studies suggesting that higher intake may raise your risk of obesity, type 2 diabetes, and high blood pressure.
One study associated an additional daily serving of French fries with gaining 3.35 pounds (1.5 kg) over a four-year period (25).
Studies also suggest that eating French fries at least once or twice a week may double the risk of food addiction in adults and children (26, 27).
These observational studies don’t prove that French fries were what really contributed to weight gain or food addiction, but they do suggest that it may be wise to limit your intake.
Type 2 Diabetes
French fries and sweet potato fries are both rich in carbohydrates, which raise your blood sugar.
The glycemic index (GI) — a measure of a food’s potential blood sugar impact — is 76 for fried sweet potatoes and 70 for fried white potatoes on a 100-point scale (28).
These are moderately-high values and suggest that both types of fries may raise your blood sugar similarly (29).
In an observational study, people who reported eating 3 or more servings of French fries per week had a 19% higher risk of type 2 diabetes, regardless of their body weight (30).
Additionally, a review of eight studies linked each daily 5.4-ounce (150-gram) increase in the consumption of French fries with a 66% higher risk of type 2 diabetes (31).
Though these studies don’t prove that fries increase diabetes risk, it may be wise to cut back on both types if you’re trying to lower your blood sugar.
Some observational studies suggest that a higher intake of fried foods may increase heart disease risk — though studies haven’t been able to pinpoint French fries as a culprit (24, 32, 33, 34).
Still, if you frequently eat fries, you may be more likely to develop heart disease risk factors, such as obesity and high blood pressure (24).
In a large observational study, people who ate 4 or more servings of French fries per week had a 17% higher risk of high blood pressure, compared to people who ate fewer than one serving per month (35).
The reasons behind these findings are uncertain but may be related to weight gain, which may increase high blood pressure risk (36, 37, 38).
SUMMARY Regularly eating French fries may increase your risk of some diseases, including obesity, type 2 diabetes, and high blood pressure. It’s uncertain if regularly eating sweet potato fries would similarly increase disease risk.
Which Type Should You Choose?
To make the best choice, it would be ideal to have studies that directly compare the health effects of sweet potato and French fries when eaten in the same quantities. However, such studies are unavailable.
Still, many people’s diets fall short of meeting the Reference Daily Intake (RDI) for vitamin A. Sweet potato fries boost your vitamin A intake whereas French fries lack this vitamin (39).
SUMMARY While sweet potato fries may be slightly healthier than French fries, neither is healthy if eaten in large amounts.
Sweet potato fries are slightly higher in calories and carbs than French fries but also high in vitamin A — giving them a nutritional edge.
Still, deep-fried fries of any kind served in over-sized portions — as in many restaurants — may increase your risk of weight gain and related health problems.
A better choice is to bake frozen or homemade fries — regardless of what kind they are. This gives you more control over your serving size and helps limit your calorie intake.
While getting your child to eat nutritious foods can be challenging, finding healthy — yet appealing — beverages for your little ones can prove just as difficult.
Most children have a sweet tooth and are prone to asking for sugary beverages. However, guiding them towards more balanced options is important for their overall health.
Here are 7 healthy drinks for kids — as well as 3 beverages to avoid.
When your child tells you they’re thirsty, you should always offer water first.
This is because water is critical to health and necessary for countless vital processes in your child’s body, including temperature regulation and organ function (1).
In fact, in relation to body weight, children have greater water requirements than adults due to their rapidly growing body and higher metabolic rate (2).
Unlike many other drinks, water won’t provide liquid calories, making it less likely that your child will feel full and refuse solid food. This can be especially important if you have a picky eater.
What’s more, drinking enough water is linked to healthy body weight, reduced risk of dental cavities, and improved brain function in children (3).
Additionally, dehydration can negatively impact your child’s health in many ways, potentially reducing brain function, causing constipation, and leading to fatigue (4).
SUMMARYWater is essential to your child’s health and should make up the majority of their fluid intake.
2. Naturally Flavored Water
Because plain water may seem boring, it’s possible that your child may dislike this essential fluid.
To make water more interesting without adding extra sugar and calories, try infusing water with fresh fruits and herbs.
You can try out many flavor combinations to find one that your child enjoys.
Plus, your child will get a boost of nutrition from the fresh fruit and herbs used in the water.
Some winning combinations include:
Pineapple and mint
Cucumber and watermelon
Blueberries and raspberries
Strawberries and lemon
Orange and lime
Get your child involved by letting them choose a favorite flavor pairing and help add the ingredients to the water.
Stores even sell reusable water bottles with built-in infusers, which can help your child stay hydrated when away from home.
SUMMARYTo make water enticing for your child, add fresh fruit and herbs to provide fun colors and flavors.
Although coconut water does contain calories and sugar, it makes a healthier choice than other beverages like soda and sports drinks.
Coconut water provides a good amount of several nutrients, including vitamin C, magnesium, and potassium — all of which are important for children (5).
It also contains electrolytes — such as potassium, magnesium, calcium, and sodium — which are lost through sweat during exercise.
This makes coconut water an excellent hydration alternative to sugary sports drinks for active children (6).
Coconut water is also beneficial when your child is sick, especially if they need to rehydrate after a bout of diarrhea or vomiting.
However, it’s important to carefully read the label when purchasing coconut water, as some brands contain added sugars and artificial flavors.
Plain, unsweetened coconut water is always the best choice for children.
SUMMARYCoconut water is rich in nutrients and electrolytes, making it an excellent choice for helping children rehydrate after sickness or physical activity.
4. Certain Smoothies
Smoothies are a scrumptious way to sneak fruits, vegetables, and other healthy foods into your child’s diet.
While some premade smoothies are loaded with sugar, homemade smoothies — as long as they’re rich in nutritious ingredients — make excellent choices for children.
Smoothies can be especially helpful for parents dealing with picky eaters. Many vegetables — such as kale, spinach, and even cauliflower — can be blended into a sweet-tasting smoothie that your child will love.
Some kid-friendly smoothie combinations include:
Kale and pineapple
Spinach and blueberries
Peach and cauliflower
Strawberries and beets
Blend the ingredients with unsweetened non-dairy or dairy-based milk and use healthy add-ins like hemp seeds, cocoa powder, unsweetened coconut, avocados, or ground flax seeds.
Avoid purchasing smoothies at grocery stores or restaurants, as these may contain added sugars, and opt for homemade versions whenever possible.
Since smoothies are high in calories, offer them as a snack or alongside a small meal.
SUMMARYHomemade smoothies are an excellent way to increase your child’s consumption of fruits and vegetables.
5. Unsweetened Milk
Even though many children prefer sweetened milk drinks like chocolate or strawberry milk, plain, unsweetened milk makes the healthiest choice for kids.
Plain milk is highly nutritious, providing many nutrients that are critical for growth and development.
For example, milk contains protein, calcium, phosphorus, and magnesium — essential nutrients for bone health that are especially important for growing children (7).
Additionally, milk is often fortified with vitamin D, another important vitamin for bone health.
While many parents tend to give children fat-free milk, milk with a higher fat content may be healthier for younger children, as fat is needed for proper brain development and overall growth (8).
In fact, children have a higher need for fat than adults, due to an increased rate of metabolism (9).
For these reasons, higher-fat milk choices, such as 2% fat milk, makes a better choice than skim milk for most children.
However, it’s important to note that drinking too much milk can cause children to become full, potentially causing them to consume less of their meal or snack (10).
To ensure that your child doesn’t become overly full on milk before eating food, only offer a small portion of milk at mealtime.
While milk can be a nutritious drink choice, many children are intolerant to dairy milk. Signs of milk intolerance include bloating, diarrhea, gas, skin rashes, and abdominal cramps (11).
Speak to your pediatrician if you suspect a milk intolerance.
SUMMARYUnsweetened dairy milk provides a number of nutrients that growing children need. However, some children may be intolerant to milk.
For children who are intolerant to dairy milk, unsweetened plant-based milks are an excellent alternative.
Like sweetened dairy milk, sweetened plant-based milks can contain loads of added sugar and artificial sweeteners, which is why it’s best to choose unsweetened versions.
Unsweetened plant-based milks can be used on their own as a low-calorie beverage or as a base for kid-friendly smoothies, oatmeals, and soups.
For example, 1 cup (240 ml) of unsweetened almond milk has under 40 calories (12).
Providing low-calorie beverages with meals decreases the likelihood of your child filling up on liquids alone. Plus, many plant-based milks provide a variety of vitamins and minerals and are often fortified with nutrients like calcium, B12, and vitamin D (13).
SUMMARYUnsweetened plant-based milks — such as coconut, hemp, and almond milk — are versatile and make excellent substitutions for dairy milk.
7. Certain Herbal Teas
Even though tea isn’t usually thought of as a kid-friendly drink, some herbal teas are safe and healthy for children.
Herbal teas — such as lemongrass, mint, rooibos, and chamomile — are fantastic alternatives to sweetened beverages, as they are caffeine-free and provide a pleasing taste.
Additionally, herbal teas offer nutritional benefits and may even provide relief for children who are sick or anxious.
For example, chamomile and lemongrass teas have long been used to calm and soothe both children and adults with anxiety (14).
Chamomile has also been used as a natural treatment for intestinal symptoms — including nausea, gas, diarrhea, and indigestion — in both children and adults (15).
Research shows that chamomile has anti-inflammatory properties and may help reduce symptoms related to intestinal inflammation (16).
While some herbal teas are considered safe for children, it’s important to consult with your pediatrician before giving your child any herbal teas.
Keep in mind, too, that herbal teas are not appropriate for babies and should be served to children at a safe temperature to prevent burning.
SUMMARYCertain herbal teas, such as chamomile and mint, can be used as a child-safe alternative to sweetened beverages.
Drinks to Limit
Although it’s perfectly acceptable for children to occasionally enjoy a sweetened drink, sugary beverages should not be consumed regularly.
Frequent consumption of sweetened beverages — such as soda and sports drinks — may lead to health conditions like obesity and dental cavities in children.
1. Soda and Sweetened Beverages
If any drink should be limited in a child’s diet, it’s soda — as well as other sweetened beverages, such as sports drinks, sweetened milks, and sweet teas.
A 12-ounce (354-ml) serving of regular Coca-Cola contains 39 grams of sugar — or almost 10 teaspoons (17).
For reference, the American Heart Association (AHA) recommends that added sugar intake be kept under 6 teaspoons (25 grams) per day for children aged 2–18.
Plus, drinking too many sweetened beverages can contribute to weight gain and cavities in kids (20, 21).
What’s more, many sweetened drinks, such as flavored milks, contain high-fructose corn syrup, a processed sweetener linked to weight gain in children (22).
SUMMARYSweetened beverages are high in added sugar and may increase your child’s risk of certain conditions, such as obesity, nonalcoholic fatty liver disease, and diabetes.
Even though 100% fruit juice provides important vitamins and minerals, intake should be limited to the recommended amounts for children.
Professional associations such as the American Academy of Pediatrics (AAP) recommend that juice be limited to 4–6 ounces (120–180 ml) per day for children aged 1–6 and 8–12 ounces (236–355 ml) per day for children aged 7–18.
When consumed in these amounts, 100% fruit juice is not usually associated with weight gain (23).
However, excessive fruit juice consumption is associated with an increased risk of obesity in children (24).
Plus, some studies have linked daily fruit juice consumption to weight gain in younger children.
For example, a review of 8 studies found that a daily serving of 100% fruit juice was associated with increased weight gain over 1 year in children aged 1–6 (25).
Because fruit juice lacks the filling fiber found in whole, fresh fruit, it’s easy for children to drink too much juice (26).
For these reasons, kids should be offered whole fruit over fruit juice whenever possible.
The AAP recommends that juice be completely restricted in infants under one year of age (27).
SUMMARYAlthough juice can provide important vitamins and minerals, whole fruit should always be offered over fruit juice.
3. Caffeinated Beverages
Many young children drink caffeinated beverages — such as soda, coffee, and energy drinks — which may have adverse effects on health.
One study reported that about 75% of U.S. children aged 6–19 consume caffeine, with an average intake of 25 mg per day in children 2–11 years old and double that amount in children aged 12–17 (28).
Caffeine can cause jitteriness, rapid heart rate, high blood pressure, anxiety, and sleep disturbances in kids, which is why beverages containing caffeine should be restricted based on age (29, 30).
Children’s health organizations like the AAP suggests that caffeine should be limited to no more than 85–100 mg per day for children older than 12 and should be completely avoided in children under 12 (31).
Parents should keep in mind that certain energy drinks can contain over 100 mg of caffeine per 12-ounce (354-ml) serving, making it necessary to restrict energy drinks for all children and adolescents to avoid excessive caffeination (32).
SUMMARYCaffeine can cause jitteriness, anxiety, rapid heart rate, and sleep disturbances in children, which is why you should restrict or forbid your child’s intake of caffeinated beverages.
The Bottom Line
You can offer a wide array of healthy drinks to your children when they’re thirsty.
Infused and plain water, dairy- and plant-based milks, and certain herbal teas are examples of kid-friendly beverages.
Use these drinks in place of sugary, high-calorie options, such as soda, sweetened milks, and sports drinks.
Although your child may protest swapping their favorite sweetened beverage for a healthier option, rest assured that you’re doing the right thing for your child’s health.