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The original Mediterranean diet was that eaten by rural villagers on the Greek island of Crete. The Mediterranean diet was nearly vegetarian, with fish and very little meat, and was rich in green vegetables and fruits. People living on Crete got more than one-third of their calories from fat, most of it from olive oil, which is rich in monounsaturated fatty acids. They also consumed wine every day.

Unfortunately, something got lost in the translation when these traditional diets were brought to America. What happens here is we add a great deal of meat, also sugar, and a lot of cream sauces.

Jayne Hurley, RD, the senior nutritionist who helped conduct the survey of Italian restaurants for CSPI, agrees. "We're not saying Italian food is unhealthy," says Hurley. "But the food we saw had been Americanized." While the traditional diets used cheese and meat sparingly as a condiment, for instance, our versions are typically loaded with them. Spaghetti, as served in the United States, often includes a generous helping of grated cheese and up to a pound of ground meat, says Nancy Harmon Jenkins, a food writer and author of The Mediterranean Diet Cookbook.

"Traditional food can easily become corrupted from simple ignorance of the cook," says Paula Wolfert, a San Francisco-based author of several Mediterranean-style cookbooks. At one restaurant she visited, Moroccan kebabs were made with pork. "The population of Morocco is predominantly Muslim, and they don't eat pork products," she says. Kebabs are traditionally made from lamb, chicken, or fish.

What's more, many breads and pastas are no longer prepared the traditional way. Refined flours were never part of the original Mediterranean diet, says K. Dun Gifford, president of the Oldways Preservation and Exchange Trust, a food education and policy group based in Massachusetts. The diet that Keys studied was one eaten by poor farmers and laborers, who ate whole grain breads and pastas. "White flour was more expensive than whole grain flour," says Gifford, who has earned a reputation as a crusader for back-to-the-basics cooking. "We call it peasant bread, or rough country bread."


The Traditional Mediterranean Diet

Although there are many countries that border the Mediterranean Sea, offering different cultures, food availability, and lifestyles, there are broad characteristics that make up the foundation of this healthy diet:

-An abundance of plant foods (fruits, vegetables, whole grains, nuts and legumes) which are minimally processed, seasonally fresh and grown locally
-Olive oil as the principle source of fat
-Cheese and yogurt consumed daily in low to moderate amounts
-Fish and poultry consumed in low to moderate amounts
-Red meat is consumed in small amounts and used more as a sauce and to season food than as the main ingredient in meals
-Fresh fruit as a typical daily dessert, with sweets containing sugars and honey eaten only a few times each week
-Wine consumed in low to moderate amounts, usually with meals

The traditional Mediterranean diet is low in saturated fat (less than 8 percent of total calories) with total fat ranging from 28 percent to more than 40 percent of total calories. In addition, the diet includes modest of foods from animal sources. In fact, as in many traditional diets, plant foods make up the core of the daily intake. This balance increases the amount of vitamin B12 and iron available in the diet, and at the same time, keeps the amount of saturated fat low.


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