Contact: Katie Vloet
University of Michigan Health System
Women double fruit, veggie intake with switch to Mediterranean diet plan
Consumption of 'good' fats also increases in study
ARBOR, Mich. — In a new study led by the University of Michigan Health
System, women more than doubled their fruit and vegetable intakes and
dramatically increased their consumption of "good" fats when they were
counseled by registered dietitians and provided with a list of
guidelines on the amount of certain foods they should eat each day.
six-month study of 69 women divided the participants into two groups.
In one group, registered dietitians used an "exchange list" of foods
that are common in a Mediterranean diet to make a plan for each
participant. The new plan maintained the caloric and total fat intakes
that the participants consumed at the beginning of the study.
list included suggested servings, or exchanges, of several categories
of foods—such as dark green vegetables, such as spinach, or
high-monounsaturated fats, such olive oil. The dietitians also provided
counseling on the telephone to help the participants to make the
dietary changes, as well as in-person sessions at the start of the
study and three months later.
Women in the comparison group
continued their usual diet and did not receive any dietary counseling,
though they were offered one free dietary counseling session after they
completed their part in the study. If their intake of any vitamin or
mineral was less than two-thirds of the recommended levels, they were
given a list of foods that are rich in that nutrient. They also were
given the National Cancer Institute's "Action Guide to Healthy Eating."
found that the group that followed the exchange-list plan reached the
goals of the Mediterranean diet within three months, and maintained the
change for the six-month duration of the study. But the comparison
group that did not use the exchange list or receive dietary counseling
made few dietary changes.
"That tells us that the exchange
list was helpful in assisting women to make major changes in their
diet, without changes in their caloric or total fat intake," says lead
author Zora Djuric, Ph.D., research professor of Family Medicine at the
U-M Medical School. The study appears in the December issue of the
Journal of the American Dietetic Association.
member of the U-M Comprehensive Cancer Center—is also leading a study
called Healthy Eating for Colon Cancer Prevention, in which she and
colleagues are examining whether a Mediterranean diet can have
preventive effects in the colon in persons at increased colon cancer
risk. The diet used in the newly published study also should be
applicable to prevention of many cancers, such as , breast cancer,
Djuric says. More information on the current study, and how to
participate in it, can be found at the University of Mcihigan Engage
Mediterranean diets have been associated with health
benefits such as lower risks for cardiovascular disease and cancer,
Djuric notes. Recent studies also have suggested that such a diet can
increase longevity, but this data is from observational studies of
Europeans who followed a traditional Mediterranean dietary pattern. The
new research is the first time a method has been devised to achieve the
major Mediterranean nutrient intakes using American foods, and American
women were able to follow this diet.
Eating patterns in Greece
and other Mediterranean countries traditionally have been high in
monounsaturated fats, compared with the saturated fats and
polyunsaturated fats that are more common in the United States. The
Mediterranean diet is also rich in fruits and vegetables.
In this new study, specific suggestions in the exchange list included:
8-10 servings (or exchanges) each day of high
monounsaturated fatty acid (MUFA), such as olive or hazelnut oil,
avocado and macadamia nuts
Limits on fats that are low in MUFA, such as corn oil, margarine, tahini, pine nuts and sesame seeds.
One or more servings a day of dark green vegetables, such as broccoli, peas and spinach
At least one exchange per day of garlic, onions and leeks
One tablespoon or more per day of green herbs, such as basil, cilantro, peppermint and sage
One or more servings a day of red vegetables, such as tomatoes, tomato sauce and salsa
One or more servings a day of yellow or orange vegetables, such as carrots, red bell peppers and pumpkin
One or more servings a day of other vegetables, such as artichokes, cucumber, green beans and sugar snap peas
One or more servings a day of vitamin C fruits, such as oranges, mangoes and strawberries
One or more servings a day of other fruits, such as apples, bananas and grapes
Authors: In addition to Djuric, authors of the paper
were: senior author Ananda Sen, Ph.D., associate professor at the U-M
Department of Family Medicine; Glee van Loon, R.D., who was a research
dietitian at U-M; and from the Karmanos Cancer Institute: Katherine
Radakovich, M.D., R.D., Nora M. DiLaura, M.S., R.D., and Lance K.
Funding: American Institute for Cancer
Research; National Institutes of Health Cancer Center Support Grants;
and the chemistry laboratory of the Michigan Diabetes Research and
Training Center and the General Clinical Research Center at U-M.
Journal of the American Dietetic Association, Dec. 2008, Vol. 108 Number 12, "Design of a Mediterranean Exchange List Diet Implemented by Telephone Counseling."