ave you decided what to give yourself for Valentine's Day? How about a trip to the Mediterranean?

February is American Heart Month and since heart disease kills more women and men than all cancers combined, a gift of heart health is truly an act of love. I suggested a figurative visit to the Mediterranean because the diet and lifestyle of that region have been shown to proffer significant health benefits to its adherents.

Inhabitants of the Mediterranean region, which includes parts of Greece, Spain, Portugal, Italy, France, Morocco, Tunisia, Turkey, Lebanon, and Syria, enjoy 25% lower overall death rates if they closely adhere to their native diet. Specifically, they have lower rates of heart disease and hypertension, as well as fewer deaths due to coronary artery disease. Cancer deaths are also significantly lower among those who follow a traditional diet. Mediterranean eaters live an average of one year longer than their less traditional counterparts. Studies among those who live outside the region show promise, too. Westerners who switch to a Mediterranean diet following their first heart attack reduce their risk of having a second heart attack by 50-70%. People who suffer from Metabolic Syndrome seem to successfully rid themselves of the condition when they switch from a low-fat diet to a Mediterranean-style diet.

For all of the health reasons cited above, many researchers and health professionals recommend that people adopt the Mediterranean Diet and lifestyle. There are many different diets that are healthy, but this is one that has the most evidence that it can lower the risk of chronic disease for entire populations. One key factor in all of this is that there is not one component in particular that offers more of a benefit than another. Therefore, you can't pick and choose parts of the diet to incorporate. You must follow all of the aspects of the diet.

As you can see from the Mediterranean Diet Pyramid (page 3), the diet is generally rich in vegetables, beans, nuts, fruits, grains, olive oil, and fish. It is high in fiber and fat, low in saturated fat and meat, and moderate in dairy and alcohol. The Mediterranean Diet limits processed foods, saturated fat, salt, refined sugars and trans fats, and is rich in antioxidants and other phytonutrients that help fight chronic diseases.

The Daily Diet
Olive Oil

I hope I didn't scare you away when I said the diet is high in fat. People who follow the diet tend to weigh less than those who follow a more "western" diet that is lower in fat but higher in saturated and trans fats, which shows that you can eat a lot of fat and still be thin and healthy as long as it is the right kind of fat. Olive oil is the main source of fat in the diet and it is used liberally for cooking, as a dip for bread, and as a salad dressing. In fact, the recommendation to use olive oil for health reasons originally stemmed from research on Mediterranean populations. Detailed research since then has revealed links between the use of olive oil and decreased risks of breast, ovarian, and stomach cancers, reduced risk of heart disease, and lower rates of inflammation. On the Mediterranean Diet Pyramid, olive oil is its own food group and is the principal source of fat, replacing butter, margarine, lard, partially hydrogenated oils, fatty meats and deep-fried foods. Most other fat in the diet comes from daily consumption of nuts and cheese and weekly consumption of fatty fish. Total fat in the diet can provide anywhere from 25-40% of total calories, which means you can adjust it to suit your personal preferences for fat. The important thing to remember is that the monounsaturated fat from olive oil should replace most of the saturated and trans fats in your diet, which means you'll have to minimize processed foods and meat-centered meals. This eating plan recommends that you eat olive oil daily and liberally.

Produce

The Mediterranean diet is not a vegetarian diet, but it does emphasize eating most of your food from plant sources. Fresh, minimally processed produce is highlighted. Fruits and vegetables are low in calories and high in vitamins, minerals, phytonutrients, and fiber, which all work together to control weight, blood sugar, blood pressure, cholesterol, and inflammation. No fruits or vegetables are restricted, but an emphasis is placed on seasonal, locally grown produce. The benefit of this open-ended approach is that you can get creative with your cooking and add various ethnic flairs to your dishes, ranging from Mexican to Japanese, to keep the diet interesting and exciting. Vegetables are often eaten in salads and are incorporated into cooked mixed dishes. Leafy greens, particularly purslane, spinach, and fresh herbs (think parsley, oregano, rosemary, mint, and dill); root vegetables, including garlic and onions; and tomatoes are especially prominent healthful items in the diet. Fruit is also a large part of the native diet and is often eaten at the end of the meal for dessert. Figs, grapes, and lemons seem to have an especially important role (walnut-stuffed figs is a favorite Mediterranean snack), but all fresh fruits are considered a healthy part of the diet. Fresh fruits and vegetables, both raw and cooked, are to be eaten daily in abundance to maximize antioxidant intake.

Grains and Cereals

Since Mediterranean cuisine varies by country and region, it is only to be expected that the native grains and cereals reflect that diversity. Therefore, unrefined rice, pasta, cous cous, polenta, bulgur, barley, and various types of flat and crusty breads are included in the diet. Potatoes, a starchy root vegetable, is considered part of this group rather than the vegetable group, so keep in mind that you don't need bread or any other grain if you're serving potatoes with a meal. All of these varieties of grains are readily available to us here in Southern California, but it's important to make a little extra effort to make sure that the grains we choose are minimally processed. Whole grains are to be eaten daily, but limited to one to two servings per meal.

Beans, Other Legumes, Nuts, and Seeds

Beans and other legumes, especially lentils, are heavily relied upon plant proteins in the Mediterranean Diet. Beans are extremely rich in antioxidants (red and kidney beans have more than blueberries!) and they are high in both fiber and protein, for ultimate blood sugar control. Recently, scientists found beans and legumes to be the single common factor in all healthy traditional cuisines, and Americans eat virtually none. Add beans to salads, soups, stews, sautéed vegetable dishes, and snack on edamame, hummus, walnuts, almonds, and cashews. It will probably take some effort to make beans a regular part of your daily diet, but it is crucial to replace servings of red meat and poultry with this food group.

Yogurt and Cheese

Rejoice! Cheese is eaten daily on the Mediterranean Diet, usually in the form of Feta, Mozzarella, and Reggiano Parmesan, which are lower in total fat and saturated fat than most other cheeses. Dairy is eaten each day but in small amounts as cultured and fermented products, like yogurt and cheese, but rarely as fresh milk. Cheese does contain saturated fat, but the quantity that cheese is eaten in is small enough to keep saturated fat to 7-8% of total calories. The high antioxidant content of the overall diet may help to offset the deleterious effects of the saturated fat in cheese as well.

Wine

Wine, especially red wine, contributes significant amounts of antioxidants to the diet and has been shown to protect the heart. Wine is typically consumed daily with a meal, but in moderation; five ounces for women and ten ounces for men.

The Weekly Diet
Fish

Fish is considered the healthiest of animal proteins and is therefore eaten once or twice a week. Wild fatty fish are rich in cardio-protective omega 3 fats and selenium, an antioxidant. Salmon, black cod, tuna, herring, and mackerel are highest in omega 3 fats, but no fish or seafood is restricted. In fact, octopus is the Greek National Appetizer! Try to eat 7-11 ounces of a variety of fish and seafood each week.

Poultry

Free-range or organic poultry is a small part of the Mediterranean diet. Fish is favored over poultry since it contributes important but scarce healthful nutrients, while poultry's nutrients, such as protein, iron, zinc and B vitamins, are easily obtained from other foods. Chicken, turkey, and other poultry are eaten weekly, and in slightly smaller amounts than fish.

Eggs

Free-range or organic eggs are eaten weekly on their own as omelets, for example, or in pasta, breads, and cakes. Enjoy a Mediterranean-style omelet or frittata once or twice a week by first sautéing vegetables like onion, garlic, tomatoes and spinach in olive oil and then adding in the eggs. Try to eat 0-4 eggs per week.

Sweets

Mediterranean dieters love their sweets and they indulge in sugary treats weekly. The sweets, however, are usually sweetened with honey instead of high-fructose corn syrup or sugar. Though sweets are eaten in moderation, adherents to the diet do not seem to vilify sugar as a more western diet tends to do. Small treats are eaten just a few times a week.

The Monthly Diet
Red Meat

This is another point where the Mediterranean diet may be particularly challenging: red meat is only eaten a few times a month. The average American eats a third of a pound of red meat per day! Choose leaner cuts of meat such as filet mignon, New York strip, top round, flank, and the small end of the rib eye. Try to limit your red meat consumption, including lamb, pork, veal, venison, and buffalo to 12-16 ounces a month.

Other Lifestyle Factors
Physical Activity

Daily physical activity plays an important role in the healthfulness of the Mediterranean lifestyle. Exercise helps to balance out calorie intake to promote a healthy weight. It also contributes to fitness, cardiovascular health, and overall well-being. Try to incorporate activity into your daily routine by taking the stairs and parking the car a little further from your destination, as well as set aside time for exercise, such as walking or yoga.

Social Support

One unwritten aspect of the Mediterranean Diet is the strong social bonds that are inherent in these cultures. Food is very important and is meant to be enjoyed, preferably at a leisurely pace around a table shared with family and/or friends. Shared meals reinforce strong social and familial bonds that are important for emotional and physical well-being.

Anti-Smoking

At the time of these extensive Mediterranean population studies, very few Mediterraneans smoked. These low rates of smoking are believed to have contributed somewhat to the lower incidence of chronic diseases. Smoking and health are not compatible.

If you do decide to visit the Mediterranean, and I hope you will, you'll need to commit to taking your whole self there-you can't have one foot in the US and one foot in Greece (unless your legs are very, very long). As I said before, there is not one aspect of this diet that makes you healthier than other parts. All parts work together to have a huge positive impact on health. This Valentine's Day, take a trip to the Mediterranean and give yourself a gift that will last a lifetime.