INTRODUCING THE MEDITERRANEAN DIET

Conner Middelmann, Nutritionist www.modernmediterranean.com Conner Middelmann 2 To obtain…

• Calories • Nutrients • Vitamin P

Conner Middelmann 3 1. Calories provide fuel

Calories provide the energy that fuels all our bodily functions: Heartbeat, thinking, breathing, moving, digesting, fighting infection, etc. Everyone expends different amounts of calories, depending on their age, sex, height, weight and activity level. Calorie expenditure varies from one day to the next and from one person to the next.

Click here for a primer on metabolism & calories

Conner Middelmann 4 2. Nutrients provide information

Nutrients (vitamins, minerals, protein, fat, etc.) tell your cells what to do. When we give our cells the right information, we feel more energetic, our minds are clearer and we are better able to resist or fight disease. When we eat foods with poor-quality information (e.g., processed foods) our bodies don’t know how to utilize that information. This can lead to health problems: Blood sugar imbalance, mood swings, weight gain, sleep problems, cardiovascular disease, a fragile immune system, etc.

Conner Middelmann 5 3. “Vitamin P” is for Pleasure

Meals can be a time to relax and enjoy life. Mindful eating can ease stress, digestive problems, metabolic imbalances and help with weight loss. And when share a meal with others, our bodies make a hormone called oxytocin (a.k.a. the “bonding hormone” or “love hormone”) which is associated with greater metabolic and emotional health.

Conner Middelmann 6 CALORIES + NUTRIENTS + PLEASURE = THE MEDITERRANEAN DIET

Conner Middelmann 7 Conner Middelmann 8 What the Mediterranean diet is NOT

• A weight-loss diet* (though you can lose weight/waist eating this way) • A veg(etari)an diet • A low-fat diet • An exclusion diet (e.g., paleo, keto or gluten-free) • A diet involving supplements or meal replacements • Only eating dishes from the Mediterranean region (North American, Latin American or Asian meals also can be “Mediterranean”)

*Diaita [δίαιτα] is the classical Greek word for “healthy way of living,” not “diet”

Conner Middelmann 9 What the Mediterranean diet IS

• Time-honored (it has evolved organically for over 5,000 years) • Delicious (if you like vegetables, fruits, fish, olive oil, cheese, eggs, nuts, beans, meat, herbs & spices) • Simple (most Mediterranean food is peasant food – “cucina povera”) • Versatile (suits omnivores, vegetarians, low-carbers, keto dieters, etc.) • Inexpensive • Environmentally friendly • Science-based (see next slide)

Conner Middelmann 10 Scientific pedigree

In over 7,000 studies published in peer-reviewed medical journals the Mediterranean diet is associated with a reduced risk of: • Heart attack & stroke • Type-2 diabetes • Non-alcoholic fatty liver disease (NAFLD) • Hypertension • Obesity (esp. around the abdomen) • Depression • Dementia Write-ups of recent Mediterranean-diet research here.

Conner Middelmann 11 So, what is the Mediterranean diet?

Conner Middelmann 12 Mediterranean Diet*: A Timeless Classic

• Minimally processed foods • Moderate oily fish, egg intake • Lots of vegetables & fruits • Moderate dairy intake (mostly cheese, yogurt & kefir) • Dietary variety • Moderate meat intake • Healthy fats • Moderate alcohol (with meals) • High in legumes, nuts, seeds • Conviviality, joy of eating, • Aromatic herbs & spices absence of guilt • Plus: Walking & siestas

13 6 Ways to Mediterraneanize your Diet

1. Eat Real Food (channel your great-grandmother) 2. Rule of Thirds 3. Variety 4. Pro- and prebiotic foods 5. Make your own meals 6. Enjoy, don’t endure (80:20 Rule)

Conner Middelmann 14 1. EAT REAL FOOD…

Conner Middelmann 15 … and minimize processed food (occasional treats)

Conner Middelmann 16 Graphic from Nutritional Doublethink article on food processing.

With every step of processing there is a loss of nutrients and a gain in food additives.

Conner Middelmann 17 There are 40+ essential nutrients

Four examples: • Magnesium is needed for nerve & muscle function, immune system, regulates heart beat, bone-building, blood glucose balance, energy production, protein synthesis, etc. • Vitamin D is needed for strong bones, can help prevent cancer, regulates cell growth, reduces inflammation, supports healthy immune system, etc. • Protein is needed to make muscles, tendons, organs and skin, enzymes, hormones, neurotransmitters and antibodies and for satiety and blood glucose control, etc. • Fats are needed for nerve & brain function, healthy skin, to regulate inflammation, to form hormones & to help us absorb fat-soluble vitamins from food (A, D, E, K and K2). Many Americans are deficient in one or several essential nutrients; see this article.

Conner Middelmann 18 Less (processing) = more (nutrients)

Less-processed, whole foods contain … • more vitamins • more minerals • more fiber • more healthy fats • more protein • healthy microbes … than processed foods.

Conner Middelmann 19 2. “Rule of Thirds” At every meal or snack, eat some healthy fat, carbohydrate and protein (defined below)

Protein: Fish, seafood, meat, egg Protein: whites, dairy, tofu, Carbohydrates: 20-25% Vegetables, fruits, beans, seeds, nuts, whole grains, Carbs 35-40% protein powder. beans, lentils.

Fats: Olive oil, olives, Fats 35-40% avocado, nuts, nut butter, nut oil, seeds, oily fish, dairy, egg yolks, meat (ideally

20 Healthy carbs

In moderation:

Conner Middelmann 21 Healthy fats Primarily: • Olives & olive oil • Avocados & avocado oil • Nuts, nut butters & oils • Seeds, seed butters (e.g., chia, flax, hemp, sunflower, pumpkin) • Oily fish • Omega-3 enriched/pastured eggs To a lesser extent: • Meat • Dairy (milk, butter, yogurt, kefir, cheese, etc.) • Coconut, coconut oil, MCT oil Healthy protein

Conner Middelmann 23 3. Eat lots of different, whole foods (variety)

Conner Middelmann 24 Dietary variety…

• Most closely mirrors the ancestral environment in which we evolved • Provides a broader range of nutrients than eating the same 4-5 foods • Reduces over-exposure to potentially harmful compounds (e.g., arsenic in kale or rice; oxalates in spinach (kidney stones); etc.) • Supports healthy gut flora • 30% lower mortality rate in people who eat lots of different healthy foods vs. those who eat the same healthy foods regularly

Conner Middelmann 25 Dietary variety strategy 1: Eat the seasons

• Seasonal vegetables: broccoli, broccolini, brussels sprouts, butternut squash, celery root, collards, fennel, kale, leeks, potatoes (maincrop), pumpkin, rutabaga, salsify, sweet potatoes, sunchoke, turnips • Seasonal fruits: Grapefruit, kiwi fruit, oranges, pomegranate, tamarillo, tangerines, ugli fruit • Seasonal meat & seafood: Duck, goose, quail, rabbit, venison, clams, crab, mussels, oysters, scallops www.eattheseasons.com

Conner Middelmann 26 Dietary variety strategy 2: Eat a rainbow Different colors represent different nutrients. Therefore, the more colors you eat, the more nutrients you get!

Conner Middelmann 27 4. Healthy gut bacteria (a.k.a. microbiome)

Conner Middelmann 28 Immune Blood Synthesis of function pressure vitamins, amino regulation acids & SFAs Blood lipid regulation Removal of (LDL, HDL, etc.) toxins Healthy gut bacteria are Blood needed for glucose Nervous system balance & mood balance

Healthy Weight bones loss or gain Digestive Hormone health balance

Conner Middelmann 29 Probiotic & prebiotic foods: Enjoy daily

Probiotic foods Prebiotic foods

• Kefir • Green leafy vegetables • Yogurt: Greek or regular • Garlic, leeks, onions • Probiotic cottage cheese • Potatoes cooked & cooled • Skyr (Icelandic yogurt) • Parboiled rice (e.g., Uncle Ben’s) • Sour cream • Legumes, beans and peas • Kombucha • Nuts & seeds • Water kefir • Oats, barley, rice (whole) • Raw, fermented sauerkraut, • Apples, bananas, berries kimchi, dill pickles (no vinegar) • Cocoa (unsweetened), coffee • Sourdough bread • Foods high in polyphenols (see list)

30 5. Prepare your own meals

Conner Middelmann 31 Health benefits of home cooking

• Healthier ingredients: Less sugar, refined carbs & salt, and more vitamins, minerals, protein, healthy fats than restaurant meals. • Better portion control: Restaurant meals often contain 50% more calories than the average person needs. • Saves money. See this and read this. • Saves time. Yes, really. ☺ If you plan your meals, make simple dishes and have ingredients to hand, it takes as much time to cook a meal than to eat out. • Psychological benefits: Cooking helps you “switch off,” fosters creativity & community. Research has found major benefits of home cooking and family meals in children and teens.

Conner Middelmann 32 Home-cooking made simple

• Meal planning: Use a meal planning app like RealPlans or design your own meal plans from scratch. • Make simple recipes • Cook in bulk and freeze so you don’t have to cook every day • Take cooking classes if you are new to cooking. Invest in a few good cookbooks. • Accessorize: Buy a few high-quality knives, pots and pans, a blender and a food processor that make cooking fun & easy. • Share the work: If you live with others, ask them to help with shopping & cooking.

Conner Middelmann 33 6: You Only Live Once (80:20 Rule)

If you eat this way most of the time, it’s OK to eat a slice of birthday cake or pizza occasionally, without guilt. Enjoy these moments as the rare treats they are becoming!

Conner Middelmann 34 Conner Middelmann 35 To Sum Up

1. Eat Real Food 2. Protein, Fat & Carbs at every meal 3. Mix it up: Variety 4. Love your gut 5. Ready, steady, cook! 6. Enjoy, don’t endure (80:20 Rule)

Conner Middelmann 36 All good things take time

Research has found that it takes people on average 66 days to sustainably adopt a new habit. This isn’t a race or a competition. There’s no deadline and no one will judge you. So take the time you need to make healthy changes. One step at a time.

Conner Middelmann 37 Assignment

1. Present this slideshow to a family member, friend or colleague, explaining the salient points to them. 2. For one week, track everything you eat & drink to see how you’re doing. E.g.: • How much “real food” (minimally processed) are you eating? • Do you eat protein, fat & carbs at every meal? • How diverse is your diet? • Are you cooking meals from scratch? • Are you eating pro & prebiotic foods? • How are you doing in terms of the 80:20 rule? For now, simply observe what you’re doing; no need to make any major changes. Show your food log to Isa, use it to compare notes with a colleague who is also on the Diaita program, or use it as a self-accountability exercise.

Conner Middelmann 38 Over to you! Nervous?

Excited? Questions?

Concerns? Curious?

Conner Middelmann 39 About me

• Conner Middelmann, nutritionist at Modern Mediterranean LLC. I work with individuals, families, companies and hospitals. Based in Boulder, CO since 2012, preceded by 11 years in the south-west of France. • I trained as nutritionist in the UK (DipION 2000). Prior to that, I worked in banking and financial journalism (Dow Jones, FT). • 17 years ago (prompting my career change) I was diagnosed with early- stage cervical cancer. My experience with cancer and years in France inspired me to write Zest for Life: The Mediterranean Anti-Cancer Diet. • I have 3 children and cook for my family most days. Check out what I eat on www.instagram.com/modernmediterranean.

Conner Middelmann 40 Any Questions? Contact me

Conner Middelmann, B.S., DipION Nutritionist at Modern Mediterranean, LLC

• Website: www.modernmediterranean.com • Email: [email protected] • Follow me on Instagram: www.instagram.com/modernmediterranean • My recipe & self-care blog: www.recipes-for-disaster.com

Conner Middelmann 41