Design and implementation of a self-selected mediterranean diet

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Overall eating patterns appear to be more important for prevention of cancer than intakes of specific nutrients or food groups. Of the diets that can be achieved using Western foods, a Greek-Mediterranean dietary pattern has great potential for cancer prevention. We therefore developed an exchange list diet that would target key nutrient intakes of the Mediterranean eating pattern. The goals were to replace half of usual polyunsaturated fat (PUFA) intake with monounsaturated fats (MUFA) and to increase intakes of a wide variety of fruits and vegetables, including dark green vegetables, allium vegetables and herbs. A total of 70 women, ages 25-65, were enrolled in the study and randomized to the Mediterranean diet or not for 6 months. Subjects in the Mediterranean diet arm received individualized telephone counseling with a registered dietitian. Menus were provided as examples, but the diets were self-selected. Compliance to the dietary goals was assessed by food records and by levels of plasma fatty acids, lipids and carotenoids. The results of this trial indicated that women following a typical American eating pattern at baseline were able to change their dietary intakes to reflect a Greek-Mediterranean pattern. Intakes of PUFA decreased by 50% while intakes of MUFA increased by 50%. Fatty acids levels in plasma changed in the same direction, but were smaller in magnitude. The ratios of n-3 to n-6 and n-9 to n-6 fatty acids also changed favorably. Intakes of fruits, vegetables, beta-carotene and lutein doubled in the Mediterranean diet arm. These dietary changes were achieved with no significant changes in mean body weight. This modified Mediterranean diet will be tested for its effects on markers of cancer risk in future studies.

Supported by American Institute for Cancer Research grant #03B043.