The "How do I eat?" thing has become increasingly combative and confusing. Do you give up carbs, or fat, or both? Do you go vegan or paleo?
No. You eat like a Greek, or like a Greek used to eat: a piece of fish with a lentil salad, some greens with olive oil and a glass of wine. It's not onerous. In fact, it's delicious.
The value of this kind of diet ("diet" in the original, Latin sense of the word "diaeta," a way of living) has once again been confirmed in a study from Spain involving thousands of participants and published in this week's New England Journal of Medicine. So compelling were the results that the research was halted early because it was believed that the control group was being unfairly deprived of its benefits.
Let's cut to the chase: The diet that seems so valuable is our old friend the "Mediterranean" diet (not that many Mediterraneans actually eat this way). It's as straightforward as it is un-American: low in red meat, low in sugar and hyperprocessed carbs, low in junk. High in just about everything else - healthful fat (especially olive oil), vegetables, fruits, legumes and what the people who designed the diet determined to be beneficial, or at least less-harmful, animal products, in this case fish, eggs and low-fat dairy.
This is real food, delicious food, mostly easy-to-make food. You can eat this way without guilt. Unless you're committed to a diet big on junk and red meat, or you don't like to cook, there is little downside.
On Monday I spoke by phone with Dr. Walter Willett, chairman of the nutrition department at the Harvard School of Public Health, who's been studying the Mediterranean diet for as long as I've been writing about food. His take was simple: "We have so many types of evidence that this kind of eating works, but the weight of evidence is important, and this adds a big stone to that weight."
As encouraging as the study is, it's far from perfect, and it would be hyperbolic - ridiculous - to say that it represents The Answer.
For one thing, the control group was supposedly on a low-fat diet, but didn't necessarily stick to it; in the end, it wasn't a low-fat diet at all. And the study did not show reversal of heart disease, as was widely reported; as far as I can tell, it basically showed a decrease in the rate of some cardiovascular diseases in people at risk, when compared with those at risk who ate typically lousy diets.
In short, as Dr. Dean Ornish said to me, "It's clearly better than a horrible diet, which is what most people eat." Ornish, who has devised a low-fat diet that has been demonstrated to reverse heart disease, said that "the most responsible conclusion from this study would be, 'We found a significant reduction in stroke in those consuming a Mediterranean diet high in omega-3 fatty acids, when compared to those who were not making significant changes in their diet."'
Exactly. And that's good news, because it might encourage some of the majority of people who are not making significant changes in their diet. Most Americans eat so badly that even a modest change in the direction of this diet is likely to be of benefit. That was the revelation of the Mediterranean style of eating when it came to public notice a generation ago. (Next year is the 20th anniversary of the publication of Nancy Harmon Jenkins' "Mediterranean Diet Cookbook.")
Since we're being all Med, I could say nihil novi sub sole - there's nothing new under the sun - but it's not exactly true. What's new is all the junk that been injected into our foods and our diet since the end of World War II. What's not new is that eating real food is good for you. You could say that the Mediterranean diet prohibits nothing that was recognized as food by your great-grandmother. Whole, minimally processed foods of almost any type can be included in a sound diet. Period.
Current research doesn't give us the kind of detail many of us crave. It may well be that the reason red meat appears to be "bad" for us lies in the way cattle are raised. It may well be that the reason wine appears to be "good" for us is that it's usually consumed as part of a leisurely meal with family or friends. My guess is that wild fish - which is in general endangered and cannot in good conscience be eaten as often as I, for one, would like to - is far more beneficial than farm-raised fish, which has mostly understated environmental issues. But we don't need to resolve these issues to understand that eating real food - most often cooked by yourself, because getting real food in all but the best restaurants is a great challenge - is going to help you avoid chronic disease.
This probably means you should think about salads or rice and beans for lunch, because unless you're at home or your workplace has a super-duper cafeteria or you have loads of money and work next door to, I don't know, the Four Seasons in New York City, you're not going to have many better options. It probably means that breakfast should be oatmeal or fruit salad - or eggs, which were unrestricted in this study - because you're probably not going to whip up a Japanese breakfast. Snacks should be nuts or fruit or more vegetables or beans. And it probably means you should take control over dinner. So you're looking at a vegetable dish or two, some legumes and a piece of fish, all cooked in or dressed with olive oil, and maybe a little bit of bread (preferably whole grain).
For dessert, fruit, or at least a dessert based on fruit or nuts or both. (The researchers had their subjects steer clear of what they called "industrial desserts," and one might just as well take that a step further and say "steer clear of industrial food.") Good chocolate, by the way, appears to be just fine.
As does wine: The study's participants were allowed seven glasses a week. Though red wine has a substance called resveratrol that seems to protect against cardiovascular disease, I have a hard time believing you must drink wine to be healthy. (I have an equally hard time limiting myself to a glass a day.)I started a similar regimen to the one just described a few years ago, and by every measure my health improved.
But, you could justifiably ask, "How many times do we need to hear what has long been intuitively obvious: eat more fruit and vegetables and less junk and red meat?" The point is that most people don't, which - unless we begin to mandate dietary regulation - makes this Spanish study all the more powerful.
Consider this the bottom line: Eating well is not deprivational, but delicious. It's difficult to make generalizations about the U.S. diet of a century ago, but we do know that it didn't include junk food because junk food didn't exist, and it didn't include a lot of sugar because there wasn't that much around.
So start with what we imagine that diet to have been, and adjust it so that it includes more legumes, less red meat and dairy and more olive oil and more fish.
This is hardly a sacrifice: think about a frittata, a pasta dish with more vegetables, simply prepared fish (the salmon dish included here was among the first Minimalist columns I did, and it's become a staple for me) and a reliance on legumes. The reasonable diet can include rib-eye, too, and even bad cheeseburgers, but the message is that those are not staples but treats, like ice cream and cheesecake and Reuben sandwiches. It's kind of as simple as that. Should you eat beans two times a week or two times a day? Should you drink wine even if you don't like it? Feh. I would just envision a typical mezze plate and you'll probably see what foods should dominate the assortment that makes up your daily diet: very little meat and dairy; a great deal of legumes and vegetables; perhaps a bit of fish; bread, and not much else. Certainly no cheeseburgers or Lean Cuisine.
Healthful food is delicious food, traditional food, real food. There is nothing new here. Eat real food, watch it on the animal products and - even if you're a few pounds overweight - you'll improve the chances of your living a healthy life into what might actually be your golden years. And they'll be delicious. More-vegetable-than-egg frittata
Time: 30 minutes Yield: 2 or 4 servings
2 tablespoons olive oil
1/2 onion, sliced (optional)
Salt and black pepper
4 to 6 cups of any chopped or sliced raw or barely cooked vegetables
1/4 cup fresh basil or parsley leaves, or 1 teaspoon chopped fresh tarragon or mint leaves, or any other herb
2 or 3 eggs
1/2 cup freshly grated Parmesan cheese (optional).
1. Put olive oil in a skillet (preferably nonstick or well-seasoned cast iron) and turn heat to medium. When fat is hot, add onion, if using, and cook, sprinkling with salt and pepper, until it is soft, 3 to 5 minutes. Add vegetables, raise heat and cook, stirring occasionally until they soften, from a couple of minutes for greens to 15 minutes for sliced potatoes. Adjust heat so vegetables brown a little without scorching. (With precooked vegetables, just add them to onions and stir before proceeding.)
2. When vegetables are nearly done, turn heat to low and add herb. Cook, stirring occasionally, until vegetables are tender.
3. Meanwhile, beat eggs with some salt and pepper, along with cheese if you are using it. Pour over vegetables, distributing them evenly. Cook, undisturbed, until eggs are barely set, 10 minutes or so; run pan under broiler for a minute or two if top does not set. Cut frittata into wedges and serve hot, warm or at room temperature.
Pasta with cauliflower
Time: About 40 minutes Yield: 3 or 4 servings
1 head cauliflower, about 1 pound
Salt and black pepper
1 tablespoon minced garlic
1/4 cup olive oil
1 pound penne, fusilli or other cut pasta
1 cup coarse breadcrumbs
1. Bring a large pot of water to a boil. Trim the cauliflower and divide it into florets. Add about a tablespoon of salt to the water and boil cauliflower until it is tender but not mushy. Using a slotted spoon or strainer, remove the cauliflower and set it aside. When it is cool enough to handle, chop it roughly into small pieces.
2. Meanwhile, in a large deep skillet over medium-low heat, saute garlic in olive oil, stirring occasionally, until garlic is golden. Start cooking pasta in same pot and same water as was used for the cauliflower.
3. When the garlic is ready, add the cauliflower to skillet and turn heat to medium. Cook, stirring occasionally. When pasta is just about done - it should be 2 or 3 minutes short of the way you like it - drain it, reserving about a cup of cooking liquid.
4. Add pasta to skillet containing the cauliflower, and toss with a large spoon until they are well combined. Add salt and pepper to taste, along with just enough pasta water to keep the mixture moist but not soupy. When the mixture is hot and the pasta is tender and nicely glazed, mix in the breadcrumbs.
Four spice salmon
Time: 20 minutes Yield: 4 servings
4 6-ounce skinned salmon fillets
Salt and black pepper
1 tablespoon coriander seeds or ground coriander
1/4 teaspoon whole or ground cloves
1 1/2 teaspoons cumin seed or ground cumin
1 teaspoon freshly grated nutmeg
2 tablespoons peanut oil, grape seed or other neutral oil, or clarified butter
1. Season fillets on both sides with salt and pepper. If necessary, combine spices and grind them to a coarse powder in a coffee or spice grinder. Press some of the mixture onto the top of each fillet.
2. Heat a large nonstick skillet over medium-high heat for 2 or 3 minutes. Add the oil or butter and, when it shimmers, place the fillets, coated side down, in the pan. Cook about 2 to 3 minutes, or until the spice mixture forms a nicely browned crust.
3. Turn the fillets and cook for another 2 to 3 minutes, or until the salmon just slightly resists when pierced with a thin-bladed knife.