The Indo- Mediterranean Diet

Mediterranean diet is the diet known to be consumed by the countries in the Mediterranean region (Spain, Crete, Greece) since the 1960's. There has been no single accepted definition of Mediterranean diet yet, though it includes high amounts of fruits and vegetables, unrefined cereals and olive oil. It also caters to inclusion of red wine in the diet, fish and dairy though the amount of non-fish meat intake is low. This diet has proven to be one of the most effective in preventing cardiovascular diseases and has been reported to be the best dietary choice. This leads to the need for Indianising the Mediterranean diet. .lndianised Mediterranean dietUnlike the Mediterranean region, India has a huge geographical variability, along with which comes a huge variety in food availability, choices and cooking styles.Nevertheless, due to increasing accessibility, all foods are now available globally. A traditional Indian diet varies from region to region and to generalise this is not feasible.What is feasible though is replacing raw ingredients of Indian diet with those used a Mediterranean diet and using Mediterranean diet oils.The upside of the Indian diet is that it comprises a wide range of fruits, vegetables, cereals, millets, pulses, legumes, milk and milk products, nuts, oil seeds, meats as well as oils and fats like the Mediterranean diet. In the Mediterranean diet, the individual is encouraged to have fruits, vegetables, whole grains and beans liberally. This makes it possible to blend the Mediterranean diet with the Indian dietary customs to a great extent. One can easily follow the Mediterranean diet by using locally available food in India.OilsMediterranean diet emphasises the use of olive oil in the diet which has proven cardiovascular (heart) benefits. On the other hand, Indians use a variety of oils across the country among which groundnut oil, mustard oil and rice bran oil have similar nutritional composition of fatty acids, though they have not been known to show similar potent benefits. Groundnut oil, in some studies, ischemic heart disease (heart problems caused by narrowed heart arteries) and rice bran has shown hypolipidemic (reducing the level of lipids and lipid-protein complexes in the blood) activity, and thus they may be strong contenders for Indian choices of oils. Rice bran oil especially has extensive use since it is stable at high temperatures and can be consumed in varied cuisines across India. Olive oil, due its high cost, low burning point and limited availability, is a difficult purchase option for Indians.Hydrogenated, saturated fats and oils, like butter, margarine, dalda products must be replaced with olive oil, nuts, safflower oil, sunflower oil, oilseeds.Fruits and vegetablesMediterranean diet lays stress on the consumption of plant-based foods, especially in raw form. Ironically, India is the second largest producer of fruits and vegetables but the consumption is not even among the top 10 countries. Major reasons for low consumption of fruits a vegetables in India have been affordability and a lack of awareness.Indians primarily have a cereal based diet pattern and including fruits and vegetables in such a diet pattern involves innovative recipes like vegetable poha/upma, vegetable stuffed parathas, fruit salads, vegetable soups, vegetable idlis, vegetable pizzas and burgers and vegetable rolls.Indian cooking involves a lot of chutneys and sauces, which can be made with various vegetables (e.g. bottle guard, onion, tomato, pumpkin, coriander, mint, etc) and consumed on a regular basis. Another easy way is to make the dough using ground green leafy vegetables like spinach paratha or coriander paratha or fenugreek paratha.LegumesLegumes are an important part of the Mediterranean diet as they are rich in fibre, minerals, proteins etc. Indian cuisine involves legumes in cooking, though this consumption only has to be increased toreach optimal levels. They are also a good option for a low-fat protein source in a vegetarian diet.Legumes are a versatile food item and can be eaten in salads, as an independent dish, mixed with other vegetables and made into chutneys. Indian snacks, which are usually high in carbohydrates and fats, can be replaced by healthier leguminous options. The cost of legumes also plays a role in the low consumption among Indians and increased production at lower costs should be prioritised.Whole grainsWith increasing globalization, the Indian diet has been invaded by refined flour, often replacing the use of whole grains from traditional cooking. The influx of breads, ready-to-eat foods, biscuits, bakery products, pre-packaged flour options has increased the carbohydrate and saturated fat intake extensively across all strata of the population. Far reaching marketing strategies have promoted these foods as quick and easy snacks and often targeted the younger adults and kids.This invasion of Indian cuisine has resulted in biscuits becoming tea-time snacks for adults and breakfast for children. This trend can be reversed by promoting use of preparing homemade biscuits and cakes using home-ground whole grain flour, adding of grain fibre (bran) to ensure use of whole grains etc. A conscious decision has to be taken, in this regard, to encourage whole grains instead of refined flours.Increasing the use of millets regularly in the diet has been seen as a reassuring step as well.FishThe countries consuming the Mediterranean diet are largely coastal regions and hence their fish consumption is high. In India, on the other hand, there is a huge variability in fish consumption across the different regions. Fish contains long chain omega-3 fatty acids which have been proven to be healthy and beneficial for the heart. In Indian cuisine, eating of healthier fish should be encouraged in the fish consuming populations. For others, incorporation of a variety of nuts, flax seeds or mustard oils can be considered beneficial, even though these foods contain shorter chains of omega-3 fatty acids.These foods can be taken early morning (soaked nuts), after meals like a mouth freshener (roasted flax seeds), as toppings for salads and vegetables or as quick and easy to carry and store snacks.MeatsOver the past decade, it has been suggested that red meat intake is harmful for the heart and lean meat is advantageous. Even though the meat intake in Indians has risen, there still are huge religious preferences to it, thus the meat consumption is not consistent throughout the year. For this reason, it is essential that vegetarian options like milk, home-made cottage cheese, tofu, mixed sprouts, soy be included as a part of the daily diet to ensure intake of good quality proteins. Wherever possible, lean meats should be recommended and red meats avoided.DrinksMediterranean diet often includes red wine with meals which due its phytochemical content has shown cardiovascular benefits. Indians, on the other hand, consume beer and whiskey more than red wine. Moreover, the consumption patterns in India are different compared to Mediterraneancountries, in India, the alcohol is consumed before meals on most occasions unlike the latter where they are consumed as an accompaniment of the main meal. Instead of red wine, Indians can consume various juices like pomegranate or cranberry juices or mixed juices (Indian gooseberry + beetroot + orange + grapes) which may not offer the same benefits but are still good options.SaltA Mediterranean diet does not involve the use of salt to a great extent, whereas an Indian diet has used salt as a major taste enhancer for most dishes. Natural taste enhancers can be suggested in the Indian diet which will limit the use of sodium while cooking, like tamarind, lemon, garlic flakes, chilli flakes, herbs and spices or infused oils etc.Another source of sodium in the diet is the processed and pre-packaged foods which are a major source of sodium in the diet.Use of different salts like the Himalayansalt, pink salt, Celtic should be encouraged, though the use of iodised salt should not be eliminated completely (to avoid iodine deficiency disorders).Cooking methodsMediterranean diet encourages oil cooking at lower temperatures and prefers steaming, air frying, baking and shallow frying as cooking techniques. These can be easily incorporated into the Indian diet to limit the use of oils and fats. Non-stick utensils can also be suggested to reduce the oil consumption. India, being a country of diverse cultures, hosts a very vast cuisine with dishes that can be cooked with minimal oil, like idlis from south India, dhoklas from western India, pataud from northern India and momos from eastern India. It is always a good idea to include fresh vegetables and recipes from different parts of the country to make the menu full of variety, nutritious and achieve a Mediterranean effect (For example - vegetable stuffed and steamed idlis, vegetable steamed momos).Mediterranean diet also encourages that the food should not be over-cooked, thus only sauteing vegetables is good way to retain their taste, texture and prevent the loss of nutrients.What happens to the flavours?In an Indian diet, flavour is derived essentially from the use of herbs and spices. Adequate use of the same ensures tasty and palatable meals. Reduction in the use of salt will not necessarily make the food tasteless or unpalatable, if spices, herbs, natural taste enhancers are used.These foods then become rich in micro-nutrients too and are always healthier alternatives.The use of oil can also impact taste, though roasting or boiling foods before tempering can be a good choice of cooking style. Indian cuisine has numerous naturally used taste enhancers like lemon, tamarind, chilli flakes, spices, nuts, dried tomatoes.These can make up the flavour to compensate for using less oil and salt. Thus, Mediterranean diet in the Indian context can be loaded with a lot of flavours making it highly palatable.Benefits of lndo-Mediterranean dietA Mediterranean diet is all about eating fresh, wholesome and a balanced diet accompanied by regular physical activity too. It fosters healthy eating habits, mindfulness and promotes mental and physical well-being. TheInda-Mediterranean diet continues to remain as a lifestyle that promotes liberal intake of plant based foods, white meat (chicken, fish, eggs), restricted intake of salt, and moderate physical activity, while demoting consumption of red meat, processed foods at the same time.A study by Robinson Ramirez-Velez, Jorge Enrique Correa-Bautista confers that, combination of optimal adherence to Mediterranean diet and higher muscular fitness is associated with healthier cardio-metabolic profile.Limited intake of bakery products, salt, processed foods, red meat and saturated fats, accompanied with a moderate intake of red wine or drinks rich in phytonutrients, spices, herbs, fresh fruits and vegetables promotes vascular health. The cardiovascular benefits of the Inda-Mediterranean diet are unaltered and may be enhanced with the use of herbs and spices. The Indian diet lacks protein quality as compared to the Mediterranean diet and thus it is important to include a variety of proteins in the Inda-Mediterranean diet to achieve similar benefits.The Mediterranean diet improves the glycaemic variability, controls blood sugar levels, reduces blood cholesterol levels and improves the vascular health and in turn reduces the risk of Alzheimer's and dementia.The Mediterranean diet is rich in antioxidants and it prevents and delays our cells from getting damaged due to oxidative stress. It is thus a great diet for reducing the risk of Parkinson's, cancers, heart disease and also delays ageing.The Mediterranean diet encourages the consumption of fresh fruits and vegetables, limits saturated fats and refined flour and is rich in fibres and micro nutrients which are all crucial for managing Diabetes and its complications.The Inda-Mediterranean diet is loaded with antioxidants, vitamins and minerals, unsaturated fats and fibre. As mentioned earlier, a Mediterranean diet includes physical activity, eating etiquettes, and a balanced-nutritionally adequate diet. It has been noted that consumption of such a diet improves muscle strength and reduces frailty by 70 per cent.Switching to a Mediterranean dietChanging lifestyle and diet is always tough and takes a lot of time and energy. It is best to start by including small changes to everyday life. The best advice ever given for this is- If you want to start, then today is the best day!• Begin with reducing the amount of oil used and sauteing food instead of fiying. Changing the type of oil and limiting the use of ghee or saturated fats should be the next step.• Identifying triggers to cravings for junkfood and avoiding or controlling them will play a major role towards consistency in following the Mediterranean diet. It is best to keep fruits and salads as a snack at easy to reach places like tables and kitchen counters.• Replacing refined flours, packagedfoods and bread may take a little longer. An alteration to your shopping list is the way to begin. When going to themarket, it is important to read food labels, be aware of food ingredients and choose whole grain options over processed foods.• Red meat intake should be minimised. Instead fish, nuts and seeds should be consumed.• Milk consumption has gone down drastically in Indian household, nevertheless, opting for low-fat or skim milk over full cream, whole milk and full-fat options is a good start.• An important aspect of the Mediterranean diet is also that it involves eating patterns and behaviours. Eating food on time and not missing meals, especially breakfast is imperative.• An advantage of the Mediterranean diet is that it promotes fresh and dry fruits as dessert.Busting the mythsMyth 1: A Mediterranean diet is an expensive dietFact: Cost is a comparative term! If we compare the cost of packaged, ordered foods to the home-cooked wholesome meals the cost is in favour of the latter. It is also important to note that the expenses incurred towards health issues due to unhealthy diets outweigh the advantages of saving time and ease of cooking.Myth 2: Alcohol is good for healthFact: Not all alcohols are good for health! Only red wine, in recommended quantities, is considered heart-friendly due to thepresence of phytochemicals and antioxidants. Moreover, if a person does not consume any form of alcohol, inclusion of red wine will not offer additional benefits.Consumption of red wine in excess or beyond the recommendations will have deleterious effects.Myth 3: Mediterranean diet is all about pastas and breadsFact: Typically, a Mediterranean diet includes small servings of home cookedpastas and bread as a side dish (% to 1 cup serving) and the rest of the plate is full of fresh fruits and vegetables and fish.Mediterranean people do not load up their plates with carbohydrate-rich foods.Myth 4: Mediterranean diet talks only about dietFact: Mediterranean diet is a holistic approach to lifestyle and eating. It includes physical activity and talks about portion sizes as well. Mediterranean people make it a point to have leisurely meals with family, without the television, do not eat in a hurry and make meals a social activity.The Inda-Mediterranean diet is only a modification of the Mediterranean diet without altering the nutritional composition of the same. The components of the Mediterranean diet and the resulting benefits remain the same in the Indian context as well.Please Note: It is important to consult your doctor and dietician before starting any diet or before modifying your dietary intake. Remember to seek medical advice before considering the Mediterranean diet. Diabetes Health does not seek to endorse the Mediterranean Diet. Dr. Mansi Patil, PhD, is the Committee Member of Women in Hypertension, /SH, London. She is also the Joint Secretary, Indian Association of Parenteral and Enteral Nutrition and Research Fellow- International Society of Hypertension.She is the Co-Founder of www.livhealthylife.comMs Bhargavi Patel has helped in compiling information and resources for this article

The Indo- Mediterranean Diet

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