Podcast Episode 254: The Truth About the Mediterranean Diet: Debunking Common Misconceptions – Pam Fullenweider

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[00:00:00] Speaker 1: Welcome to Sound Bites, hosted by registered dietitian nutritionist Melissa Joy Dobbins. Let’s delve into the science, the psychology, and the strategies behind good food and nutrition.

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[00:00:22] Melissa Joy Dobbins: Hello and welcome to the Sound Bites podcast. Today’s episode is about the Mediterranean diet, what you thought you knew, and what you need to know about this very popular diet and lifestyle. My guest today is Pam Fullenweider. Pam is a registered dietitian nutritionist, a culinary nutritionist, and the founder of Fully Mediterranean, where she and her team teach people how to incorporate the Mediterranean diet into their lifestyle. Welcome to the show, Pam.

[00:00:54] Pam Fullenweider: Thank you so much, Melissa. I’m so happy to be here and to visit with you and your listeners about the Mediterranean diet.

[00:01:00] Melissa: I’m so excited to dive right in. I want everybody listening to know that this episode is not sponsored. Pam, you have spent the better part of your career focusing on public health and cardiovascular health in particular.

[00:01:14] Pam: Right.

[00:01:15] Melissa: You have a very strong culinary background as well. I would love for you to share with our listeners more about your background, your education, perhaps, how you got interested in this work, and then the work that you do in particular, and also any disclosures to note.

[00:01:30] Pam: Sure. I do not have any disclosures as of right now. Yes, I love what I do, first of all, and it’s just a natural fit for me. I’ve always loved to cook. I have always enjoyed meals with my family and friends and it’s always been a part of my family. My grandmother was from New Orleans, so it just came very naturally. It’s what we did growing up. Then I’ve passed it on to my own children that I really got interested in becoming a dietitian. Twofold, because my mom was like the original of a lactation consultant with the Children’s Nutrition Research Center in Houston.

[00:02:03] Melissa: Wow.

[00:02:03] Pam: They were the first ones doing breast milk research. I got to meet Anita Owen, the president of the American Dietetic Association,-

[00:02:12] Melissa: Oh my gosh.

[00:02:12] Pam: -what we used to call it back there. Really great. I was working there in the summer. Then I have a really strong family history of heart disease. That was so impactful because I saw what was happening in my family and what the doctors were recommending. We have this amazing Texas Medical Center where some of the founding– really heart transplants and heart operation really all founded.

It’s been so great to be in Houston, but that’s all how it happened. I just have always loved food and really started becoming more and more interested in it. I’ve been a registered dietitian for over 30 years. I’ve done everything from clinical practice, which I love. I have a private practice still. I had a partners. I’ve had different partners. A corporate consultant. Then I released, started even in the clinical setting, started working with chefs. That’s really what was super fun for me. I got to compete in a national cooking competition and we actually won.

[00:03:10] Melissa: That’s awesome.

[00:03:11] Pam: Super fun. Then I’ve worked with restaurants and then really in culinary education is where I’ve ended up more recently. I’ve seen a lot of different diets, right? As a dietitian, practicing this long. We were low fat, no fat. Really, like you said, primarily, I’ve always dealt with heart health. Really, that’s really always been my focus. We were eating eggs and we’re not eating eggs or we’re eating them again.

I felt like my patients and clients really made progress, but it wasn’t sustainable. Then in 2016 I was so happy I had the opportunity to partner with UTHealth School of Public Health with their Nourish Program. They’re this amazing nutrition hub in the middle of the Texas Medical Center here in Houston. What they do is they’re food first and they’re a seed-to-plate teaching model. They’re part of the teaching collaborative kitchens. What they do is they teach culinary medicine to medical students, other health professionals.

I came in and so I ended up being the public portion to their program. What they do is they have this beautiful teaching garden demonstration kitchen, and then you get to teach while you’re cooking and eating and enjoying meals with others. That’s what we would have people come into the medical center to do. It’s really there that I witnessed firsthand the impact that the Mediterranean diet really had on people.

The Mediterranean diet was part of their curriculum, was what they were teaching. I saw that students, the food tasted great and was healthy. When I asked students what they love about the class, we always do a survey, and it was that the food tasted great. It really, really helped people understand that good food and good health go together and it’s possible.

[00:04:59] Melissa: Wonderful. Thank you so much. I’d like to start off by teasing some of the common misconceptions about the Mediterranean diet. As we go through our conversation, we can clear some of those up. What are the most common misconceptions that you’re hearing about the diet?

[00:05:16] Pam: Okay. What we hear all the time is it’s a vegetarian diet, right? That’s one of the biggest. Then we see, well, this is one of my favorites. I drink red wine, so I follow the Mediterranean diet. Or it could be I eat salmon, which is all great. You have to eat only Mediterranean foods. Another one is that it’s expensive. And I understand that. Then it’s really misconceptions about fat. That, is fat going to make me fat? Wait a second. I have heart disease. Aren’t I supposed to be on fat-free or low-fat diet? Those are really the big misconceptions that we have.

[00:05:50] Melissa: Okay, great. Let’s talk about what exactly is the Mediterranean diet and lifestyle, because I know that’s a big part of it.

[00:05:57] Pam: Yes.

[00:05:57] Melissa: What are the associated benefits?

[00:05:59] Pam: Sure. The Mediterranean diet is this wonderful eating pattern and lifestyle based on countries bordering the Mediterranean Sea. When you think about the Mediterranean, people assume it’s Greece, Spain, and Italy. Of course, it is, but there’s really more to the story. There’s 21 countries bordering the Mediterranean Sea. We like to talk about the pillars of the Mediterranean diet. Let’s go through those.

There’s three. The first one is nutrition, and that’s what you want to think about here. That it’s primarily plant-based foods, but not exclusively. You really have to help your clients understand what that means. Plants are at the center of your plate, but not exclusively. There’s still room for meat, just in smaller amounts. It’s really all about quality food components, whole unprocessed foods. The second pillar is exercise and movement.

We want you to include activities of daily living and exercise. Both of those are important. Exercise and physical activity should be a part of your lifestyle to maintain good health. Then finally, the third pillar is really what sets us apart from other eating patterns and lifestyles. We recommend enjoying meals with others. It’s all about that social connectivity. That offers so many health benefits. I think this one is so important and really often overlooked.

The Mediterranean has this wonderful perspective on eating. It’s the emphasis on pleasure of sharing meals with others. Meals are more than just about fuel. It’s really about enjoying your food and taking the time to enjoy your meals. It strengthens your social connectivity. We can talk later about all the different benefits that come along with that. What we do at Fully Mediterranean is we take this pattern of eating and apply it to any cuisine.

My job is that we have to meet people where they are. We help them interpret this pattern into their own kitchen and their lives. I always say, “We have to really think about it as dietitians because changing eating patterns is hard,” right? We try to make it as fun as possible. For me, that fun is in the kitchen. We have this culinary aspect to our programs because listen, it is stressful, it is painful. Food is personal. We really want, again, to meet them where they are and really help them see the pleasure in all of this.

When we talk about the associated benefits, this is where it’s really so amazing because we know that people who follow the Mediterranean diet have a 30% reduction in death from all disease. You got to take that in a second. It’s pretty amazing statistic. The diet was discovered based on observations that people living in these Mediterranean countries had significantly lower incidences of heart disease and stroke.

We know that following the Mediterranean diet helps prevent heart disease. We know it’s involved in the prevention and management of diabetes. It helps reduce your risk of certain cancers, colorectal, breast, stomach, and liver. It helps prevent Alzheimer’s, dementia, and depression. Really, it helps people live longer. It’s about longevity. How we eat today is so influenced by misinformation and gimmicks and fat diets, and we know they don’t work. I like people to think about the Mediterranean diet. Really think that it is all about sound science, and it’s not about the quick fix. It is all about long-term sustainability.

[00:09:39] Melissa: Excellent. Thank you. Several things that you mentioned I wanted to touch on. I love that it’s exercise and movement.

[00:09:48] Pam: Yes.

[00:09:49] Melissa: Because, like you said, those daily activities.

[00:09:53] Pam: Activities of daily living.

[00:09:55] Melissa: Yes. The ADL. Things like vacuuming and I don’t know, gardening.

[00:10:03] Pam: Yes, gardening, moving around. What you do is so important and I think sometimes we forget we’re not moving. It depends on where you live. Listen, I live in a very hot climate. Houston has been ridiculously hot this summer and you’re like, “How am I going to get outside? How am I going to move in my house, keep doing these things that we want to do?” Then, of course, you have the exercise. I would throw in there too, as we age, strength training. We have to talk about that too.

[00:10:30] Melissa: Yes, absolutely. I love that because people, we hear exercise all the time and I do think we forget about these activities of daily living that really does help increase your movement. Yes. Then the social aspect and the enjoyment, of course. I’ve heard this a lot with the family meals movement where there’s a ton of research on the social aspect of our meals translating to significant health and mental health benefits.

[00:10:58] Pam: My gosh.

[00:10:59] Melissa: I hadn’t really thought of it with the Mediterranean diet, so I love that aspect as well.

[00:11:03] Pam: Absolutely.

[00:11:04] Melissa: You also touched on one of the things I was going to talk with you about, and I think we can weave this through the rest of our conversation, is behavior change, diet, lifestyle is not easy. Putting that fun factor into it is genius. It’s key. It’s the game changer. Right? I want to talk more about the fun and the enjoyment. Like you said, food is personal and to help somebody get from what they’re currently doing towards the Mediterranean diet, that’s everything that you do with your work and your program that you’re going to tell us about, and that longevity. The longevity is one thing, but it’s the quality of life too.

[00:11:42] Pam: It is, absolutely.

[00:11:44] Melissa: Yes. Also the elephant in the room, is this Mediterranean diet– You probably know all the stats. It’s rated the number one diet for decades. I don’t know how long.

[00:11:53] Pam: US News & Report even rated top diet for the last six years. Right? Easiest to follow. Best diet for diabetes, tied with heart health, really. Best plant-based, plant-forward diet. Wow. What’s so incredible is that there’s this consensus from all different areas of our life for not only researchers, doctors, and then health professionals have rated it that high. Right? It’s from all different areas, which is very rare.

[00:12:23] Melissa: Right. Despite that consensus which is very compelling, it’s sort of like, I don’t want to say boring, but compared to these gimmicks and all these things that people are hearing, so it’s not lost on me. That’s part of what we’re going to talk about today, is how do we get people’s attention beyond the fact that it’s been rated the number one diet by US News & World Report for six years? How do we get people to really pay attention? I think a big part of that is this gradual changes to incorporate into their diet and lifestyle that you do.

[00:12:54] Pam: Yes. We can talk about– we have a big step by step guide that we put out that really is one of our most popular downloads. I think it’s really helping people understand that it’s these small changes that add up to large health benefits over time. If we can get you changing one thing, that’s what I do. I have a lot of clients that don’t eat vegetables. Right? We do that. In our world we’re like, “What?” You’re like, “Yes.” Most people are not doing it. When you see how satisfying and really how successful you can be when you introduce them to–

Part of this diet, and we can get into, is that we use that. We like using olive oil. Guess what? It has so many different purposes in our body, as we know, as you and I know. Guess what? It makes food taste great. That is part of the key here for us at the Mediterranean Diet.

[00:13:46] Melissa: Yes. I want to dive into some of those misconceptions, especially the fat.

[00:13:50] Pam: Sure.

[00:13:51] Melissa: I do want to mention too, you had talked about all of these other Mediterranean countries that we don’t hear much about. I do have a somewhat related episode, number 231, Carbohydrate Food Scores and Culturally Diverse Diets, where Dr. Judy Rodriguez talks about these other countries. I think it’s becoming more– We’re increasing awareness that it’s not just Italy and Greece.

[00:14:15] Pam: Exactly. That’s so important because when I say I like to meet people where they are, because listen, I live in one of the most diverse cities. It’s culturally diverse. You have to understand that this is this eating pattern. All of these guidelines are– I love that episode, Aspirational Instruments. Right?

[00:14:33] Melissa: Yes. That’s what we referred to.

[00:14:34] Pam: Really meet people where they are and what we’re working towards. Whatever country or whatever, you take that eating pattern and then you translate it into their lives where they are. It can really, really be done because when we get into the nitty-gritty, you have to look at what is the main goal that we’re trying to do here, and it’s really getting people to be primarily plant-based. How do we change that culturally for them and their diets? Yes, no, it’s wonderful. You don’t want to forget about those 21 countries. Right?

[00:15:06] Melissa: Right.

[00:15:06] Pam: Cultural diversity.

[00:15:07] Melissa: Yes. And a lot of times, some of their favorite cultural foods fit very well already and they don’t know that.

[00:15:14] Pam: Exactly.

[00:15:15] Melissa: So you’re assuring them you can keep these cultural foods in your diet. If they don’t fit as well, there are ways to maybe include other foods to increase variety and nutrient density, and so on.

[00:15:27] Pam: Absolutely. That’s exactly what we do.

[00:15:30] Melissa: Let’s talk about some of those misconceptions more in-depth. Maybe let’s start with the fat because that’s a big one.

[00:15:36] Pam: Let’s talk about fat because we get of a lot of questions. Is fat going to make me fat? Right? Am I going to gain weight? Clients are concerned about two things really when we see this, that A, wait a second, I have heart disease and you’re asking– aren’t I supposed to be on a low-fat or a fat-free diet? Then it’s also associated with people are concerned about gaining weight because they do know that fat has more calories. What you want to understand is the Mediterranean diet is a higher fat diet. It’s typically about 30% to 35% of our total calories.

Most recommendations are lower than that, maybe in the 20% to 25%. What we focus on is using the right type of fat. We all need those healthy fats in our diet, but we want you to use those unsaturated fats versus the saturated fats. Think olive oil instead of butter. Then we’re also going to include those fatty fish, nuts, avocados. On the Mediterranean diet, we primarily use monounsaturated fats. Olive oil is king to us. We love olive oil, avocado oil. It’s reducing our cholesterol, reducing that LDL.

When people are concerned about gaining weight, the research has actually found that adding a little more fat in our diets helps with satiety. It helps keep you fuller longer, so you’re eating less. Then when we think about the role of fat in our diet, it takes longer to digest. It helps with that satiety and that feeling of fullness. This is where I think the culinary part comes in our diet. It makes food taste great. This is really important because people want to eat food that tastes great. I think there’s nothing better than teaching somebody or helping someone put a little olive oil in the pan. You’re using some zucchini or fresh squash and you’re sautéing it till it gets this beautiful crispy brown on one side.

Then we’re going to maybe throw a little parmesan in there. Then we’re going to add some basil. Voila, you have this tasty side dish that’s super simple and it’s helping them understand the use of fat and then the use of vegetables. Then when we talk about why are we so much higher in fat, because people are confused by that, when we look at the PREDIMED heart study, it’s a primary prevention trial and it included thousands of people with diabetes and other risk factors for heart disease, and they found that a Mediterranean diet that had the olive oil or nuts really reduced the rates of death from stroke by roughly 30%.

We were having this higher fat diet and it’s still reducing your rate of heart disease. Again, it is hard for people to understand that. More and more, the research is showing that it is possible, and it does help prevent heart disease. We knew that early on, but the research is continuing, so we have multiple studies for that factor.

[00:18:28] Melissa: As you’re talking, so the Mediterranean diet is higher in fat than a lot of other diets. It’s probably not higher in fat than the average American is eating. I’m guessing it’s shifting from those saturated fats to the mono and the polyunsaturated fats.

[00:18:46] Pam: Right. It’s all about the type of fat, right? It’s using those unsaturated fats. That’s exactly it. We really focus there for people, and that’s a big shift. That is really a big shift. That can also reassure people, not telling you to eat more fat than you currently are, necessarily. They’re a different type.

[00:19:03] Melissa: Absolutely. Okay, great. I also hear a lot that people think that beef cannot be part of the Mediterranean diet, so I would love for you to address that.

[00:19:12] Pam: Yes. That is a biggie. We hear a lot about that. That’s usually one of the first questions that people ask and, really, people will say really more in the context of it’s vegetarian and no. What’s so wonderful about the Mediterranean diet, that all foods are included and it’s primarily plant-based, remember, but not exclusively. Meats are still consumed, but in leaner and smaller portions. We really want you to change the way you think about meat. Beef falls into this category, right? We want you to use smaller amounts of beef, eat less often, save for special occasions.

This is the biggest difference between the American diet and the Mediterranean diet, that plants are at the center of our plate, right? Again, I grew up in Texas. Here I am, I love red meat. I was a family. We bought it by the half cow. We bought our beef. There is still room for beef in your diet. Just using it and just changing the way you think about it and using it in smaller amounts.

[00:20:12] Melissa: What other misconceptions should we dig into?

[00:20:16] Pam: I think one that’s really important right now is that it’s expensive. I understand that. We’re all very concerned about our grocery bills. Lunchflation is real. We did a whole topic on this. It is hard for people if you want to eat healthy, it can feel expensive. Especially when we’re asking you to maybe have fatty fish and seafood. Those things appear to be expensive. What we typically recommend doing is we always, so we are all about seasonal foods. Purchasing fresh fruits and vegetables in season, it’s always the best, most economical way to go. What that means is you have to know what’s in season. What are the seasonal fruits and vegetables?

We post that all the time on all of our social channels. Then we always recommend keeping frozen or canned fruits and vegetables. Because now we know they’re picked right out of the fields at the peak of rightness, they’re flash frozen or canned. Also, we recommend using frozen or canned fish and seafood. Those are great choices. I always have frozen fish or canned tuna or canned salmon in my pantry.

Then going back to canned foods, we know one of our favorite canned foods are canned beans. Yes. We love them. They’re so economical. You can buy low-sodium varieties, and it’s a great way to add that plant-based protein and fiber and use less meat. We have a whole blog post on this on our website that you can check out for additional tips.

[00:21:48] Melissa: Okay, great.

[00:21:49] Pam: I think there’s one other misconception though that I want to clear up. I think it’s such an important one because I think people don’t realize and it’s really, the whole idea of I drink red wine, so I follow the Mediterranean diet. I think that is so important because what we know from the research is you have to incorporate all the components of this eating pattern to reap the health benefits. You can’t just cherry-pick what you’d like to do. You can’t just drink the red wine or eat the salmon.

You have to exercise. You have the physical activity and the mindfulness. It’s all of those pillars working together. I think just like we were talking about it, so many people want the magic bullet or one thing that they know that’s going to work. Really, once again, it’s all these wonderful components working together that help prevent disease. I think that is a big point.

[00:22:40] Melissa: Yes. If somebody is eating salmon and drinking red wine, hey, they can check those two off. They’re currently doing that. We’re meeting them where they are.

[00:22:47] Pam: Yes.

[00:22:48] Melissa: What’s the next thing to add and so on?

[00:22:51] Pam: Exactly. What’s the next small thing? Then I think the other misconception that really comes up a lot is, I don’t like Mediterranean food, I really don’t think I’m going to try this. I think people don’t realize is that you do not have to eat just Mediterranean foods, Greek food, or other foods. All cuisines can fit into this pattern of just not the Greek foods. Remember, there’s over 20 countries, and again, we meet you where you are. We want to help you with this eating pattern. What we like to do at Fully Mediterranean is we have a little technique.

We say we like to make it Mediterranean, so we’re taking traditional recipes and giving them this wonderful Mediterranean twist to amp up their health benefits, make them more nutrient-rich. We always try and focus with our clients. What do I need to add to my diet? I think that’s incredibly important. It can be as simple as adding fruits or vegetables to each meal. Veggies to your greens, greens to your pasta. We love to show a graphic where you have a cheeseburger so we know it’s high in saturated fats, low in fiber, and low in veggies. Then we’re going to put a little arrow and we’re going to say, let’s make a nourish-blended burger.

Then we’ve taken some lean red meat, but we’re going to add some legumes, maybe some black beans to it, some veggies, and then we’re going to serve it with a side salad so that really, you’re getting more of that fiber and those antioxidants and all those good things that we need. Another thing that we really work on with clients, and part of this is making more of your meals meatless.

I think this is hard for people to do as well, especially if you’re used to eating a lot of protein in your diet, meat and stuff. We like to make your favorite meals meatless. Being from Houston and Texas, we eat a lot of Mexican food. Maybe it’s just changing up the beef for black beans or maybe in your enchilada is trying spinach, things like that. Or even just other simple ideas include whether you’re for stir fry using tofu or at Umami, you know, really getting people used to trying some different things so you don’t have to just have Mediterranean foods.

[00:25:06] Melissa: Obviously, you don’t want to necessarily decrease your protein intake overall. It’s sort of like the fat conversation we had. You want to swap out for some other sources of protein because you definitely don’t want to be too low in protein.

[00:25:21] Pam: No, and we want to use this plant-based protein. That’s what we love to do.

[00:25:26] Melissa: Great. I want to get more into some of the culinary aspects and how you work with people. You’ve touched on that a little bit and the fun enjoyment aspect. Before we do that, I would love to hear more about research on the Mediterranean diet, about why it’s so effective in disease prevention and risk reduction, and what you would like people to know. Also addressing some recent news about the MIND diet not being as effective as we thought it might be, and explaining what that MIND diet is and the recent news about the randomized control trial study.

[00:26:00] Pam: Right. Now, that sounds great because there’s a lot of research, obviously, on this topic, and I think it goes back to when we were talking about a little bit of a deeper dive into the Mediterranean diet and talk about those foods. When we talk about that it’s primarily plant-based, so it incorporates the basics of healthy. Fruits, vegetables, all those wonderful protective foods. Whole grains, legumes. These are protecting us from inflammation with the vitamins, minerals, and antioxidants. Again, it’s all about quality food components. We talked already about that it’s the biggest difference between the American diet and the Mediterranean diet.

That these plant foods are at the core of your plate, the center of your plate. I like to say it’s the original, it’s the OG of anti-inflammatory diets, and all foods are included. It’s not restricted. We want to pay attention to what you’re choosing and the amount. When we think about it being an anti-inflammatory diet, it’s this eating pattern that promotes fighting inflammation in our bodies. We know that it’s the chronic inflammation that occurs slowly over time in response to this long-term exposure to stress. That’s poor diet, which is the refined processed foods, too much sugar and excess of refined carbohydrates, excessive alcohol, unhealthy fats, all those things.

When we see this chronic inflammation within the body, it can cause chronic diseases such as cancer and diabetes, heart disease, and then cognitive decline. We really think, from the research, the Mediterranean diet, it fights inflammation because it emphasizes these plant-based foods. It’s that fiber, that wonderful fiber that we’re getting the antioxidants, all those healthy fats, the monounsaturated fats, and then we get into with our fatty fish and salmon, the omega-3s, they help fight inflammation. Then, of course, you’re eating less processed food if you’re following this trend. Again, it’s this synergistic effect that we see, that the research shows us that is really what is reducing inflammation in our body.

It’s the sum of all those parts. All these components that we just talked about are associated with helping improve risk factors for all these different diseases. We have specific research that shows for each state that high-fiber plants are helping improve our blood sugar control, the healthy fats are helping prevent heart disease. I mentioned earlier the original studies that this whole diet was founded on was by Ancel Keys, the Seven Country Studies. It was really groundbreaking because it showed there was this diet-heart health relationship, and then it was that this way of eating really reduced your risk factors for heart disease. That was hypertension, obesity, an increased LDL.

When we talk about diabetes, and I know you’re a certified diabetic educator, we have the cardiovascular disease and type 2 diabetes show some of the same risk factors, so obesity, high triglycerides, that low HDL. We know studies on the Mediterranean, it’s beneficial for preventing and the management of type 2 diabetes. One of the studies showed it’s improving your risk factors for those triglycerides, the body weight, your A1C. Then other studies have shown that it helps with insulin resistance, losing that weight.

For heart disease, we know it helps. We have the research for diabetes. Then, really cancer is their next thing that we really see a lot of, a significant amount of research on them because it’s that protective effect, it’s the high intake of those fruits and vegetables, whole grains. Again, I like to call them their protective foods that’s reducing inflammation, and we know that reduces your risk of overall cancer deaths. When we see in studies, if you have a higher adherence to the Mediterranean diet, that’s when we get into the really preventing colorectal cancer, breast cancer, liver, pancreatic, and prostate cancers.

There was a big review in 2021 that showed that it lowered the risk for all cancer deaths. There’s always amazing research out there. I think it’s constantly changing. Sometimes you’re like, oh my gosh, there’s another one and another one.

In response to this new MIND diet study that just came out this summer, really all the studies in the past about the MIND diet, which stands for, it’s a combination of the Mediterranean and the DASH diets. Mediterranean-DASH diet Intervention for Neurodegenerative Delay, and that’s what they call the MIND diet. It’s a diet designed specifically to boost the brain. In the past, it’s really been all observational studies. Now, we finally have this randomized clinical trial that happened over the last three years. Their expectations were very high that they would see that the group following the MIND diet would show significant improvements in their brain function through their MRI scans.

Actually, that didn’t happen. Really, the control group and the MIND diet group were really actually showed the same results. People were really surprised by this, I think. To me, I think you have to look at a couple of things, I think, when we’re looking at this. First of all, what was the length of the study? I think this is where people are thinking, okay, most of our studies have been over multiple years, really longer durations. It’s too short of a time to impact a disease that take decades to develop. That’s first thing about this study.

Secondly, I think researchers know it can be difficult to do a clinical trial on nutrition because people may realize what arm of the study that they’re in. We know the control group also lost weight. They had some slight improvements also in their MRI scans and in their brain function. They may have improved their own diet. A lot of people feel clearly they were changing their diets. I think the good news that’s happening here is that the bottom line is that I think we found out that a healthy diet, not just the MIND diet, really does improve cognitive function. It’s not just one, you have to do this, and I think that’s encouraging for people.

Then also, you have to remember, I think part of our world that solid science is not based on one single study. We have to take it all into comparison. Again, I think it’s super interesting, but I don’t think it’s like, oh, we’re going to throw out the MIND diet. I think we just, A, it calls for further research, but wow, that is good news though. Both groups improved their cognitive function, and they did lose weight over those three years. All good things.

[00:33:17] Melissa: Thank you for that. I appreciate your recap on that. I had said earlier I would love to hear more about how you bring the culinary aspect into your education and your programs and why that’s so important. The fun factor, I’m guessing, and maybe even sharing some client success stories.

[00:33:32] Pam: Yay, this is the fun part for me I love. I’m definitely a practitioner. This is what I do day in and day out. You may not think cooking and fun go together, but by the time we’re through with you, we’re going to make it a pleasurable experience in the kitchen.

[00:33:48] Melissa: Excellent.

[00:33:49] Pam: Our whole goal is to get people back to eating at the table and remembering that this is difficult for people, that this is a hard journey. Food is personal. You’ve had these habits for a long time. We’re going to help you change them, but by goodness, we’re going to have fun doing it. Health starts in the kitchen. There are so many wonderful benefits to teaching people to cook. We know from the research, when you cook at home, you eat healthier. It helps with when you’re cooking, you get to choose your own ingredients.

You can choose more variety. This helps ultimately in that disease prevention that we’re talking about. Then also, one of our goals is to get people back to eating at the table.

There are so many benefits surrounding eating at the table. When we talk about it, we know from the research, sharing meals together, it encourages better relationships. There’s less stress. We know we just talked about, you make healthier choices when you’re eating at the table together. You live longer. If you have children at home, family meals are even more important because research shows that family meals can reduce depression, promote healthy eating, and improve self-esteem. Super important.

We incorporate this into our curriculum in all different ways. I do private cooking with people, I do reels, we do recipe demos and videos. The whole goal is to make people feel comfortable in the kitchen so that they can accomplish their goals of eating healthier. I think one of the most important things we show them is that it doesn’t have to be complicated to taste good or to be healthy.

[00:35:24] Melissa: Amen.

[00:35:25] Pam: Listen, I get people don’t have time to cook, and they don’t necessarily always like to cook. That’s super important to help them with it. One of my favorite when we talk about success stories, I have two, and they’re totally opposite. One of them is about, we call him the West Texas carnivore because he was a guy from West Texas that had a very strong history of heart disease. His lipids were way out of balance. As he likes to say, he was staring down the path of becoming a vegan from his doctor. Like he always says, “That is totally out of question for someone like me, a West Texas carnivore who loved his red meat.” That was what he was about.

I worked with him for nine months, and he did not need to lose weight, but he showed incredible sleep improvements, dramatically enhanced all of his scores and his doctor said it was the single fastest improvement he has ever seen. He was the perfect student. He really was so conscientious about it because he had such a significant history in his family. I think the other thing that really struck me was his own words was he really is enjoying his new relationship with fish, which he really didn’t enjoy, fruits, and vegetables, along with less red meat. He really did.

It took nine months. It takes a while to get there. That is such a great story because I think it really shows you that even though you’ve enjoyed meat your whole life and you still can enjoy it, step by step, we can help you translate this pattern into your own eating, and into your own kitchen and your own lives.

[00:37:08] Melissa: That’s excellent.

[00:37:09] Pam: The other example may not seem as dramatic as this, but it really is in just a more subtle way because I have this client that really needed to make some behavior change and really make some changes in their diets and full-time work, kids, the whole kid caboodle, really difficult and she didn’t like to cook. I think it was so rewarding for me to see at the end of the day– she really dreaded it. Coming home and answering that question, it was really hard.

I think at the end of our program, she was like, “I look forward to it now. I come home, I turn on my music, I relax, and then I cook. I know what I’m doing, and I can nurture my family.” That’s what it’s about. Then, she would always send me pictures of what she was cooking. That’s the ultimate compliment to me, is when my clients and people that know and love me send me pictures of their food and I’m thinking about you!

[00:38:10] Melissa: That’s cute.

[00:38:11] Pam: I love that. That’s what it was for her. It was really so amazing to see that change and her feel so good about it.

[00:38:19] Melissa: Quality of life. I love that.

[00:38:22] Pam: Totally.

[00:38:22] Melissa: I’ve shared this a little bit on the podcast before, but I’ve evolved my own kitchen confidence over the past eight years or so that I’ve been doing the podcast, and in particular, my do more with dinner initiative. I didn’t dread cooking, but I was busy. I just wanted something quick and easy. Now, I am at that point where I look forward to it. and it’s almost like I’m done working, I’m going to the kitchen, and I’m having fun. I think that’s really, really great.

[00:38:55] Pam: Yes. I love that.

[00:38:56] Melissa: I’ve enjoyed that, and so has my family. They’ve benefited from it. That is, yes, we love that. I know that you have this program that is step by step, but if you could just share a few simple steps that people could take to kind of get started right on this Mediterranean diet/lifestyle journey and what that might look like.

[00:39:18] Pam: We have the guide. Please go download it. It’s free on our website. I think there’s three things that you can really do. I think the first thing you should do is choose olive oil. Just start cooking with olive oil. Really changing that. Looking at what type of fats you’re using at home. If you’re buying salad dressing, what oil are they using? Looking at your labels and seeing what type of fat is in those products. I think that’s key. Choose olive oil.

Secondly, I’d say check your plate. You can do it at any time, wherever you are, or whatever you’re doing. What does your plate look like? If we want those plant-based foods to be at the center of your plate, are they? That’s fruits, that’s really those vegetables, those whole grains and beans. What is crowding your plate? That’s what we want.

Listen, I want half of it to be vegetables. Really and truly, those dark green leafies, eat the rainbow. I think this is something that’s so important, so check your plate. Again, I love that because whether it’s a bowl in the morning, whether it’s lunch or dinner, anyone anywhere can do that. Then thirdly, change the way you think about meat. Really start looking at how much meat am I really eating? Chicken, turkey, red meat, what does that look like?

Obviously, we’d like you to incorporate more seafood in your diet at least twice a week, and I say at least. Again, maybe using meat as a garnish, using it just in those stir-fries, using it for flavoring, that’s such a wonderful way to start. Changing the way you think about meat and incorporating those meatless meals, that’s really thinking about can I make my favorite foods meatless? Can I do that? Of course, you can. Tacos are the simple way to start, lasagna, so some of those things.

[00:41:11] Melissa: Thank you. As we’re wrapping up, I know we’ve got a lot of resources that we’re going to touch on. We’ve got these simple steps to get started, but what would you say the bottom-line takeaway is for our listeners?

[00:41:23] Pam: The first thing would be that the Mediterranean diet is a lifestyle. It includes nutrition, movement, and enjoying meals with others. Focus on the foods that you need to incorporate into your diet. Remember, there’s primarily that plant-based foods but not exclusively. I think for healthcare practitioners, and I really think for dietitians, this is what most clients need help on. Really identifying, well, what does that really mean? What does that look like for me on my plate at home? I think that’s one of the most important things that you can work on.

Secondly, remember to reap the health benefits of the Mediterranean diet lifestyle. You have to incorporate all the components. You can’t just cherry-pick what you like. Yes, it’s wonderful. You might be eating salmon and some of those things, but keep going, keep checking off your list. Keep working on it because it’s that synergistic effect that really prevents disease in our body. Then finally, I think it’s so important to understand is that with the Mediterranean diet, you can enjoy food and prevent disease. Good food and good health go together.

[00:42:37] Melissa: All right. Thank you. Where can people find more about this topic and connect with you? Websites, social media handles, anything specific in the way of resources that you’d like to share?

[00:42:48] Pam: Sure. You can find us all over the place. You can find us at Instagram, @fullymediterranean, on Facebook, @fullymediterranean, our website. We have, like I was saying on the website, it’s a pop-up. Our step-by-step guide is always available. Then we’ve just introduced this wonderful– well, not introduced, it’s been going for two years. We have a Mediterranean diet course, so just think just like Netflix so that people can join. We also offer it not overly privately to people but we work with physicians and corporate clients to offer it as well.

[00:43:24] Melissa: Okay, great. I’ll have all those links of course in my show notes at soundbitesrd.com. I also wanted to give a shout-out to our colleagues who have some Mediterranean cookbooks out there, Serena Ball and Deanna Segrave-Daly, two friends of mine. They authored the 30-Minute Mediterranean Diet Cookbook and also the Sustainable Mediterranean Diet Cookbook. They have a new one coming out called the Smart Mediterranean Diet Cookbook, which is really focused on what’s good for the heart is good for the brain, so it’s really focused on brain health and the research there. Stay tuned for more information on that on the podcast, but I will put links to those books in the show notes as well. I’m sure you can find those on Amazon as well.

[00:44:11] Pam: Wonderful. They are great. They have great cookbooks.

[00:44:14] Melissa: Make it tasty. You got to make it tasty.

[00:44:17] Pam: They do. That’s the key.

[00:44:18] Melissa: That’s right. It’s delicious. Are you working on anything else right now that you’d like to share with us?

[00:44:23] Pam: Really just our course. It’s our course that we’re really working on, that we’ve been doing, like I said, for the past two years. I think it’s really exciting because people are busy and so it’s really based on my private practice. You just sign up and it’s like I said, Netflix, you just download it and you start watching and then we have office hours that you can hop into with me and one of our team of dietitians and then we have group cooking classes. It’s really fun and it’s a great way for people that are super busy to really learn all about the Mediterranean diet.

[00:44:58] Melissa: Excellent. Thank you so much for coming on the show and talking all things Mediterranean diet lifestyle.

[00:45:04] Pam: Well, thank you for having me. It’s always a pleasure. I could always keep going and going. There’s just so much you could talk about, so thank you for having me.

[00:45:12] Melissa: Well, thank you for the work that you do. For everybody listening, as always, enjoy your food with health in mind. Till next time.

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[00:45:21] Speaker 1: For more information, visit soundbitesrd.com. This podcast does not provide medical advice. It is for informational purposes only. Please see a registered dietitian for individualized advice. Music by Dave Burke, produced by JAG in Detroit Podcasts, copyright Sound Bites, Inc. All rights reserved.

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