What is Mediterranean Keto?
As I’ve written before, although most people’s lipid numbers improve across the board, some people get interesting cholesterol responses to Primal ketogenic diets. LDL skyrockets, even LDL particle number. The jury’s out on whether or not they indicate negative health concerns or if keto dieters are a special breed that hasn’t received enough study. (There may be a few genetic profiles, such as APOE4 carriers, that react differently to certain dietary inputs.) Either way some people just want their cholesterol numbers to look good in a conventional way. These days, whenever I run into someone in the real world with these or similar concerns, I tell them to try “Mediterranean keto.”
What is that, anyway?
The Mediterranean diet can mean a lot of different things depending on who you ask. On one side, you have the folks who make the ridiculous claim that the Mediterranean diet consisted of pasta, low-fat dairy, beans, green veggies, seed oils with a “drizzle or two” of extra virgin olive oil for good measure, a handfuls of nuts, and a single filet of sardine once every three days. They avoided salt and red meat and full-fat cheese, somehow ignoring the vast body of salt water on their shores and the large population of sheep and goats roaming the land. I guess that livestock is only there to keep the weeds down.
On the other side, you have the people claiming that the true Mediterranean diet consisted of fatty lamb, hard cheeses, fish filets dripping with oil, skins of homemade red wine, cured meats, endless olives, vegetables at will, and the occasional legume bathing in mutton juices and a tiny piece of bread crust submerged in extra virgin olive oil.
This is probably closer to the truth, but both are a bit hyperbolic.
It also depends on where you’re looking. The Mediterranean is a big sea. Spain, Italy, Portugal, Greece, Crete, Turkey, Morocco, Algeria, Israel, Lebanon, Egypt, and even France are all technically Mediterranean countries. Are their diets identical? No. Are there common threads running through their respective cuisines? Yes.
- Olive oil
- Fish
- Wine (excepting Muslim dietary practices)
- Cheese
- Meat
- Vegetables
- Grains and legumes (Yes, they do eat beans and pasta and bread, although perhaps not in the quantities the grain-addicted would prefer)
And that’s not even mentioning all the various social, spiritual, and lifestyle components of the Mediterranean way of life. The sun, the walking, the hills, the family connections, the religious leanings. Today’s label is all about the diet.
The Mediterranean keto diet emphasizes olive oil, fish, cheese, meat, low-carb vegetables, and red wine. In other words, it takes all the keto-compliant foods readily available to denizens of the Mediterranean and constructs a nutrient-dense diet out of them.
And you know what? It seems to work really well.
In one of the most impressive studies, people with severe obesity and metabolic syndrome tried a Mediterranean keto diet for 12 weeks. That’s three months.
Here’s what the diet consisted of:
- No calorie counting
- Unlimited protein
- Lots of fish. At least (and often more than) four days a week, subjects ate over a kilogram of fish each day, mostly sardines, trout, mackerel, and salmon. On the other days, they got their protein from shellfish, meat, fowl, eggs, and cheese.
- Lots of omega-3s. Subjects were getting over 15 grams of omega-3s on their fish days and supplementing with 9 grams of salmon oil on their non-fish days.
- At least 200-400 mL of red wine a day, 100-200 mL at lunch and dinner. That’s up to over half a bottle.
- At least 30 mL (2 tablespoons) of olive oil a day, 10 mL per meal.
- Maximum two portions of salad and one portion of low-carb vegetables (cauliflower, broccoli, eggplant, etc) per day.
- A comprehensive vitamin and mineral supplement covering all the basics.
What happened to these subjects after 12 weeks on this Mediterranean keto diet regimen?
On average:
- They lost 30+ pounds.
- Their BMIs dropped from almost 37 to 31.5, from the middle of class 2 obesity to the bottom of class 1 obesity.
- They lost 16 centimeters, or 6 inches, from their waist.
- Fasting blood sugar dropped from 118 (pre-diabetic) to 91 (ideal).
- Triglycerides dropped from 224 to 109.
- HDL increased from 44 to 58.
- They went from prehypertensive to normotensive.
- Their liver enzymes and liver fat reduced and in some cases completely resolved.
- All 22 subjects started the study with metabolic syndrome and ended it without metabolic syndrome.
That last bit is pretty interesting. Note that the majority of the participants were still obese (BMI over 30) by the end of the study, yet every single one had cured their metabolic syndrome. Sure, they lost weight, and the trend was fantastic and heading down, but they weren’t there yet. Something about the diet itself was incredibly powerful.
The only limitation? It was a pilot study, not a randomized controlled trial pitting the Mediterranean keto diet against a control diet in real time. But considering that these people were coming off control diets—which clearly weren’t working for them—and onto the Mediterranean keto diet, it has more real-world power than you might think. You can bet the participants weren’t complaining about a lack of placebo control.
I’m not saying this is the best incarnation of all the potential Mediterranean keto diets out there. But if you’re having mixed metabolic results from the keto diet and looking for a ketogenic option with more monounsaturated fat and omega-3s, it’s the one that has some clinical research behind it. It’s one that doesn’t possess any glaring red flags.
This is also a form of ketogenic dieting that most people will view as “healthy.” It can be hard to get people to accept that putting real cream in their coffee and steak on their plates is good for them, even if they’re approaching death’s door eating what they’ve always eaten. It’s not so hard to get people on board with a diet of olive oil, fish, red wine, and salad. That’s no small feature.
In the end, the ketogenic Mediterranean diet appears to be an effective way to treat metabolic syndrome without scaring people away. For that reason, it might be a good option to try if you’re having issues with cardiovascular markers, blood sugar, hypertension, body fat, or any of the components that make up the metabolic syndrome.
What do you think of the Mediterranean keto diet? Think you could stick to it?
References:
Pérez-guisado J, Muñoz-serrano A. A pilot study of the Spanish Ketogenic Mediterranean Diet: an effective therapy for the metabolic syndrome. J Med Food. 2011;14(7-8):681-7.
Pérez-guisado J, Muñoz-serrano A. The effect of the Spanish Ketogenic Mediterranean Diet on nonalcoholic fatty liver disease: a pilot study. J Med Food. 2011;14(7-8):677-80.
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Ways the Long-Lived Live Longer
We read about them with astonishment and awe. In 2017 and 2018 there were many news reports of people who lived well past 100. Emma Morano died in April 2017 at age 117, 137 days. Violet Brown died in September 2017 at 117 years, 189 days. And Yisrael Kristal who died that same month at 113 years, 330 days almost made it to 114! Chiyo Miyako died in July 2018 cage 117, 81 days.
How did they do it? Surely they had something in common. Turns out they did.
Ways the long-lived live longest:
- Choose the right parents. Well, maybe it’s not a choice. But genetics have a lot to do with it. Simply put: If your parents and grandparents didn’t have diseases that have an inheritability and they lived past 90, chances are you will too. The big “if” is whether or not you do a decent job of tending to the body you inherited.
- Make a close knit family. You may not have been born to a healthy family, but you can make one. People who live the longest tend to be happily married and enjoy spending time with their children. They live near relatives who provide emotional support and practical help when they can. The culture of these families is to nurture the young and care for the old. You aren’t married? Then make a “chosen family” of close friends who are really there for each other and you can have the same benefits.
- Live in a “Blue Zone.” National Geographic Fellow Dan Buettner identified places in the world with the most people who lived beyond 100. He named these areas “Blue Zones.” Among them are Sardinia, an Italian island in the Mediterranean Sea; Nicoya Peninsula, Costa Rica; Ikaria, Greece; a community of Seventh Day Adventists in Loma Linda, California; and Okinawa, Japan. But before you pack your bags, do understand that it’s not the geography so much as lifestyle in those places that contributes to long life. People in these areas encourage close ties with family and friends. They eat well, exercise regularly, keep stress levels down, have a sense of personal purpose and a strong spiritual belief.
- Eat well: This isn’t news. A healthy diet leads to a body that resists illness and to a generally healthier life. 80% or more of Americans are overweight to obese. Excess weight contributes to heart disease, diabetes, and some cancers. It puts stress on bones and limits your ability to move. There is plenty of information about a healthy nutritious diet so I won’t repeat it here. But do read and heed. People in the Blue Zones don’t go on fad diets. They eat less meat and more vegetables than Americans do.
- Exercise: People in the Blue Zones move throughout their day, doing tasks that many Americans have given up to appliances and vehicles. They do their dishes and laundry by hand, sweep their floors, and shovel their walks. They garden, both out of necessity and for the joy of it. They walk. They walk a lot. If you can’t manage 10,000 steps a day and generally add in more physical tasks, consider signing up with a gym or for exercise classes.
- De-stress: Chronic stress can lead to high blood pressure and heart disease. People in the Blue Zones don’t equate being too busy and feeling over-stressed with success. They take care of themselves so they have the emotional energy and physical ability to manage the usual stresses of life. The culture in many such countries encourages a break in the middle of the day for a real lunch “hour” and napping. Do as they do: Don’t eat lunch at your desk. Don’t skip breaks. Home with children? Nap when they do or institute a family rest time. Your rest is more important than folding the laundry.
- Find something that gives your life meaning. Looking back on their lives, those long-lived people from the Blue Zones say they did things they found personally fulfilling. Current research in Positive Psychology confirms its importance. What makes life worth living is as individual as you are. Meaning can come from raising children well, doing a job you believe is significant at least some of the time, or from being the kind of friend you want to be. If that doesn’t feel like enough, there are organizations that need your support and your involvement. Volunteering has been shown to help people stay physically healthy, more connected to others, and happier. It helps combat depression and anxiety. A study at Carnegie Mellon found that only 200 hours of volunteering a year can be correlated to lower blood pressure. Other studies found that volunteering as little as 100 hours a year helps people be healthier.
- Embrace spirituality. Communities is Blue Zones have strong connection to their religion. Whether affiliated with an organized religion or a spiritual group, people who live long find comfort and relief from stress through their belief in a caring god or universe. Spiritual groups also provide community, promote mutual help, and lend meaning to life. A 2018 nationwide study by researchers at Ohio State University found that Americans with religious affiliations lived nearly four years longer than those with no ties to religion.
In 2014, more than 70,000 Americans lived to be at least 100 years old. I suspect that most of them created a “Blue Zone” in which to live, regardless of geography. That’s a goal in reach of every one of us.
New Research on the Benefits of Informal Meditation Practice: Taking Meditation Off the Cushion and Into Our Lives
Finding Moments of Presence
I came across a rather unusual sight as I pulled into the parking lot of my gym the other day — something that stopped me in my tracks. I am used to seeing people scurrying to and from their cars, heading into the gym or heading back to their cars to carry on with their day. But instead, there was a man standing by the edge of the parking lot — just standing… for a long time… in stillness. He was looking out toward the trees and tall grasses and a small bog at the edge of the parking lot that I had honestly never noticed before. He was just taking in the moment, taking in the natural world beyond the concrete pavement, and despite whatever things he had to do in his day.
It struck me how rare it is to see someone pause in the midst of the busyness of their day and savor the moment in this way. It also surprised me that in all of my times back and forth to the gym I had never once noticed this little patch of nature.
Consider these questions:
- Do you have informal moments, as you go through your day, when you pause to be fully present to what is within you or around you?
- Do you ever set aside a few minutes in your day to intentionally engage your senses fully and completely in something you are doing, such as eating a meal (without mental or other distractions pulling you away), or even something quite ordinary such as taking a shower or walking to your car?
- What is it that you miss in the course of your rushing and busyness?
Informal Practice of Presence
Much has been written about the benefits of formal meditation practice, but many people are less familiar with the idea of informal practice. With informal meditation practice we look for opportunities throughout the course of our ordinary day to be fully present, mindful and awake. Rather than setting aside a formal time to practice meditating, one can make activities such as walking, taking a shower, washing dishes, or talking to others as an opportunity for full on presence.
Neuropsychologist Rick Hanson has written extensively about the benefits of “taking in the good” by looking for positive moments in our day that we can enrich and absorb by pausing to experience these good moments as feelings in our bodies. These can be ordinary moments that we might otherwise overlook, like sipping a cup of tea, exchanging a friendly glance with someone, or enjoying the feeling of satisfaction that comes from completing a difficult project. They can also be imagined moments such as calling up a time in our mind when we felt safe or peaceful or supported, and experiencing those feelings in this moment. As we allow ourselves to experience these positive moments as a “felt sense” throughout the course of our day, Dr. Hanson explains that this hard-wires these experiences into our brains so that we build inner resources we can later draw on.
A Study Exploring the Benefits of Informal Meditation Practice
A recent preliminary study by Dr. Barbara Fredrickson and colleagues explored the benefits of informal meditation practice on participants new to meditation, to see if informal practice improves well-being independent of formal meditation practice. Adults new to meditation took part in a six-week group, either learning mindfulness meditation or loving-kindness meditation. They were encouraged to engage in informal meditation practices during the course of their day over a period of 9 weeks and to record the time spent doing so each day. Examples of informal meditation in the former group included paying attention to the physical feeling of breathing, paying attention in the body to a routine activity such as brushing one’s teeth, or eating a meal mindfully. Examples of informal meditation in the second group included sending kind wishes (in one’s mind) to oneself or others during the course of their day.
What the researchers found was that the more one reported practicing informal meditation on a given day, the more that individual reported experiencing both positive emotions and feelings of social integration (feeling socially connected or “on the same page” as others) on that day. In addition, those people who spent more time engaged in informal meditation practices overall experienced higher levels of positive emotions and more feelings of social integration than people who spent less time engaged in informal practice. These findings were independent of the effects of formal meditation practice, though it should be noted that they were correlational in nature and this study could not prove causality. Importantly, previous studies have linked both positive emotions and social integration to greater mental and physical health, so there are implications in this study that informal meditation practice could be beneficial for one’s overall well-being.
Bringing Informal Practice into Your Day
While more research needs to be done on the effects of informal meditation practice, I am a big believer in its impact. After I saw that man at my gym pausing to take in the little patch of nature, it was a great reminder for me to practice what I teach. So after I left the gym, instead of rushing to my car, I made sure to walk over to that spot and take in the peace of the sun and grass and bog and wildlife that could have so easily gone unnoticed for yet another day. After those few minutes, I drove home with a more peaceful and grateful heart.
I invite you to find just a few minutes within the course of your day or evening today to absorb yourself wholeheartedly in a moment of presence. Use as many senses as possible to step out of your thinking-only mind and into your body, to fully experience whatever you are doing — whether an activity or a moment of pausing. Then notice how you show up for the next moments of your day.
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