THE MEDITERRANEAN DIET STUDY

The Mediterranean Eating Plan

Foreword

EXPERIENCE MEDITERRANEAN EATING!

Thank you for choosing a Mediterranean Diet!

Previous research has found that people who eat a traditional Greek-Mediterranean diet have lower rates of cancer

and cardiovascular diseases. This makes us think that this style of eating will be useful for cancer prevention.

This diet targets important aspects of the Mediterranean diet: more fruits, vegetables, fish and mono-unsaturated

fats instead of high fat meats and processed foods. We cannot exactly follow the traditional Greek-Mediterranean

diet since the foods that we have available today are different, but we can get close. For example, you can’t find

wild greens at the grocery store. We can, however, get dark green vegetables such as spinach, kale, collards and

Swiss chard that are packed with preventive compounds. We can also try to match the fat intake of the traditional

Greek diet by eating only low-fat meats, more fish and more olive oil.

It is important to note that other foods will be substituted out to keep your calories the same as you usually eat.

We hope that you will enjoy learning about the Mediterranean way of eating.

JOURNEY TO GREECE THROUGH HEALTHY FOODS

Sharing in the Healthful Benefits 3-4

Using Your Food Lists 5

Your Mediterranean Eating Goals 6

Fats 7-8

Omega 3 Fats 9

Vegetables 10-12

Alliums and Herbs 13

Fruits 14

Grains 15

Proteins 18

Milk 21

Sweets and Snacks 22-23

SHARING IN THE HEALTHFUL BENEFITS:

WHAT IS IN THESE FOODS?

Crete is an island in Greece. Just like in most countries, the diet has changed over time, but the traditional Cretan diet was

associated with a long life expectancy and a very low incidence of heart disease and cancer.

The typical Cretan consumed 2-4 tablespoons olive oil every day. Their staple foods were whole grain breads, large

amounts of beans and vegetables, plentiful fruits, such as grapes and figs, and smaller amounts of meat. Red meat was

consumed about once a week and poultry once or twice a week. Animals grazed on wild greens not grains; therefore, the

milk and meat were naturally higher in omega-3 fats. Eggs were consumed several times weekly. The main proteins were

legumes (chick peas, broad beans, fava and lima beans) and fish. Nuts were often used in desserts.

Cretans are well known for eating many vegetable dishes and still have one of the highest vegetable intakes of any

population. Wild greens such as purslane, sow thistle, amaranth and spinach were regularly sauté and mixed with other

produce. Other garden fresh produce include onions, garlic, cabbage, tomatoes, green beans, okra. Onions were prepared

more as a vegetable than a spice. Basil, Parsley, Thyme, Dill, Mint, Sage, Oregano and Rosemary were eaten daily and in

large quantities.

What are some of the micronutrients found in Mediterranean foods?

GREENS AND OTHER VEGETABLES - Leafy greens are rich in the antioxidant carotenoids lutein and

zeaxanthin. Folate is also rich in leafy greens and is noteworthy for its link to colon cancer prevention.

Dark orange vegetables are high in alpha-carotene, and lycopene is high in red produce such as tomatoes and

watermelon. All of these compounds, plus the compounds that have not been discovered yet, likely work

together to protect from cancer using a multi-pronged defense. We think that is what makes the whole food

mother nature’s own best vitamin pill.

FRUITS - Fruits provide a variety of vitamins including vitamin C, fiber, phytonutrients such as beta-

cryptoxanthin, anthocynanins and catechins. Ellagic acid (high in berries and pomegranate) is being studied

for its promising anticancer effects on intestinal cancers.

OLIVE OIL & OLIVES- Olives and olive oil are rich in heart-healthy monounsaturated fat and phenolic

compounds which taste great! The phenolic compounds from olives give extra virgin olive oil its green color,

and they seem to have anticancer effects. In addition, olive oil can help the body absorb phytonutrients from

fruits and vegetables more easily. Natives of Crete enjoyed olive oil so much that it accounted for one third of

their daily calorie intake.

HERBS-The village gardens of Crete are filled with many flavorful herbs such as garlic, oregano, marjoram,

thyme and sage for use with olive oil, breads, vegetables and stews. Herbs generally contain concentrated

levels of phytonutrients, which is why their flavor is so intense. Try using liberal amounts of herbs in

cooking or sprinkled on foods for extra zest.

ALLIUM VEGETABLES Onions, leeks and garlic contain many flavonoids such as quercetin and sulfur

compounds that have antioxidant and cancer preventative properties. When cooked, they are especially easy

to eat. For kids, try cooking them longer or microwaving first, and the onion will seem to melt away in

mixed dishes like casseroles and soups.

FISH- Fish such as salmon, anchovies, rainbow trout and herring are high protein and high in omega-3 fats

(EPA and DHA). Omega -3 fats may reduce risks of heart disease, stroke, inflammation and cancer. The

people of Crete consumed an average of 5 to 15 ounces of fish per week, preparing seafood meals usually

once or twice per week. Fish soup was one of the most inexpensive and common dishes served.

USING YOUR MEDITERRANEAN

FOOD CHOICES AND EXCHANGE LISTS

Eating a Mediterranean style diet is your main goal. This diet includes different types of fat than what is in the usual

American diet. It also includes a higher variety and amount of fruits and vegetables. Other important goals include

maintaining your current weight and keeping food records. This booklet will help you meet your Mediterranean goals.

This booklet lists foods so that you will know which specific foods you can choose from each category. It also tells you

how much of each of these foods is counted as one exchange.

STEP 1: WHAT TO EAT?

You will find foods categorized into groups. Your dietitian will give you a certain number of exchanges that you can eat

from each group. You will learn how to add new foods to your diet while taking some foods away. Your own

Mediterranean goals are made so that you will not change your calorie or total fat intakes.

It is important that you do not gain or lose weight.

This is STEP 1: knowing WHAT TO EAT.

STEP 2: HOW MUCH TO EAT?

These exchange lists give a specific serving size for each food choice listed. This will help you substitute, or

“EXCHANGE”, foods in your day so that you meet study goals while eating foods that you like. If you follow the serving

sizes for the exchanges you should be able to maintain your weight.

This is STEP TWO: knowing HOW MUCH TO EAT.

NEED SOME HELP?

Maria will be happy to assist you (615-4832). Thank you for your efforts!

MY MEDITERRANEAN HEALTHY EATING GOALS

FAT Exchanges ______/day

Omega-3 Foods 2/week

Vegetable & Fruit Exchanges per day

Dark Green ______

Red ______

Orange & Yellow ______

Allium (garlic & onion) ______

Herbs ______

Other Vegetables ______

Fruit ______

Grain Exchanges ______

(including at least 3 whole grains)

Protein Exchanges ______

Milk/Dairy Exchanges ______

FATS LIST

7-10 exchanges/day (check your own Mediterranean goals on page 7)

One Exchange is: 5 grams fat and 40-50 calories.

One Exchange is 1 teaspoon oil, nuts in the amounts listed or 2 teaspoons nut butter.

HIGH MONOUNSATURATED FAT CHOICES

(High MUFA)

Choose most of your fats from this High MUFA list.

✓Olives (10 small, 8 medium, 5 large)

✓Olive Oil (1 tsp.)

Avocado (1/6 medium)

Avocado Oil (1 tsp.)

Hazel Nuts (10 nuts)

Hazel Nut Oil (1 tsp.)

Macadamia Nuts(3-4 nuts)

Macadamia Nut Oil (1 tsp.)

Pesto (see recipes, 1 TB)

Tapenade from olives (see recipes, 1 TB)

Trail Mix with hazelnuts (see recipes, 1/4 cup:

count as 2 fats and 1 fruit)

MODERATE MUFA CHOICES

Choose a fat from this list no more than twice a day.

Almond Butter (2 tsp.) Almonds (6 nuts)

Bacon (2 small slices) Butter (1 tsp. or 1pat)

Butter (whipped – 2 tsp.) Cashew Nut Butter (2 tsp.)

Cashews (6) Chocolate (½ oz)

Chocolate Chips (1 TB) Light Cream Cheese (1 TB)

Olive-it Spread (1 ½ tsp.) Pecans (4 halves)

Pistachios (16 nuts)

LOW MUFA FAT CHOICES

Choose a fat from this list no more than twice a week.

(If you eat 3 oz. of medium-fat meat (p.20), that would

be 3 tsp. of lard!)

Canola Oil (1 tsp) Canola Mayonnaise (1½ tsp)

Lard (1 tsp.) Light Mayonnaise (1 TB)

Low-Fat Mayonnaise (2 TB) Peanuts (10 nuts)

Peanut Butter (2 tsp) Peanut Oil (1 tsp)

Pinenuts (2 tsp) Pumpkin Seeds (1 TB)

Sesame Seeds (1 TB) Sesame Oil (1 tsp)

Coconut, sweetened, shredded (2 TB)

PLEASE AVOID THESE FATS

These fats, high in poly-unsaturated fats and trans-fatty acids are NOT part of your Mediterranean Diet.

Many processed, prepackaged and snack foods contain these fats.

ALWAYS CHECK THE FOOD LABEL AND INGREDIENT LIST!

If the ingredient list contains these fats, please select an alternate food.

Brazil Nuts

Corn Oil

Shortening

Margarine

Mayonnaise (if made with oils on this page)

Safflower Oil

Soy Bean Oil

Soy Nuts

Sunflower Oil

Sunflower Seeds

Vegetable Oil

Walnuts

Walnut Oil

Hydrogenated Oil

Partially-Hydrogenated Oil

CHOOSE OMEGA-3 FOODS

2 servings/week

As part of a healthy diet, omega-3 fats (EPA, DHA & alpha-Linolenic acid) come from animal and plant sources.

Omega-3 fats are thought to have benefits for many aspects of health including cardiovascular diseases, immune function,

inflammation and cancer. You can use any of the foods in the table twice/week. The low-fat fish you can eat more of.

Please limit fish higher in mercury (swordfish, shark, tilefish and mackerel) to 7oz per week.

Fish and Flax

Edible Serving Size

Omega-3

Grams/serving

Protein Exchanges

Salmon,Lox,Trout,Bluefish,

Herring,Whitefish,Anchovies,

Bass,Sardines in oil,3.75oz,

(Available in olive oil)

3 oz

1 to 2

3 protein

Flax Oil

1 Tbsp

0 protein

Flaxseed, Fresh ground

3 Tbsp

1 protein

Sardines, Water packed

3.75 oz can

1.5

2½ protein

Sardines, Water packed

4.75 oz can

1.8

3 protein

Flounder, Sole, Cod, Pollock,

Halibut, Carp, Whiting,

Tilapia

3 oz

0.5

3 protein

(these have almost no fat)

VEGETABLE LIST

4-5 Exchanges/day (not counting herbs and onions), check your own goals page 7

One Exchange is:

1 cup raw

2 cups raw leafy greens

½ cup cooked

1 medium vegetable

½ cup juice (please don’t use more than 2 servings/day of juice in your count. Juice has no fiber)

* Some vegetables are high in starch and these are starred. Count these as 1 vegetable and 1/2 starch. ** Two stars

means count as 1 vegetable and 1 starch.

Each day you should eat some Dark Green Herbs and Allium Family (onion) vegetables. These have almost no calories. In

addition, your diet will have 4-6 servings of vegetables from the following four categories:

Dark Green, Red, Yellow/Orange, and Other.

Each vegetable category is rich in a specific micronutrient (carotenoid or flavonoid). As you increase your intakes, the levels of

these micronutrients should increase in your blood.

One serving of a vegetable contains: 5 grams Starch, 2 grams Protein, no Fat and 25 Calories

Note about the categories: Carotenoids and flavonoid type compounds are responsible for the colors and flavors in vegetables.

Color and flavor can be used as a guide for increasing the variety of micronutrients that we consume.

Note about allium vegetables and herbs: The Allium Vegetables and the Green Herb Category do not have specific serving sizes

and contain virtually no calories. We suggest that you use these vegetable choices liberally and often. Cretans used herbs like

dill and parsley in abundance and some allium family vegetables were served as vegetables and not just used as flavoring.

These vegetables contain high levels of antioxidants and loads of flavor! Get in the spirit and Spice it Up!

VEGETABLES

Use at least 1 exchange/day of each category

DARK GREEN VEGETABLES

Leafy Greens

(2 cups raw or ½ cup cooked)

Grape Leaves

Greens (all types: amaranth, beet, chicory, collard,

mustard, turnip and Swiss chard)

Lettuce, dark green (all types: endive, escarole,

red leaf, romaine)

Kale

Purslane

Spinach

Watercress

Other Green Vegetables

(1 cup raw, ½ cup cooked)

Broccoli

Brussels Sprouts

Celery

Nori (seaweed)

Okra

*Peas, green or snap

Zucchini (with skin)

* One star means count as 1 vegetable and ½ starch

** Two stars count as 1 vegetable and 1 starch

RED VEGETABLES

Tomato Products

*Catsup (2 TB)

Salsa (¼ Cup)

Spaghetti Sauce (¼ Cup)

Tomatoes (1 Medium or ½ Cup

chopped)

Tomato Juice (½ Cup)

Tomato Paste (2 TB)

Tomato Sauce (¼ Cup)

**Tomato Soup (1 Cup)

V-8 Cocktail (½ Cup)

Fruits that can be used as a red

vegetable (contain lycopene)

*Guava

*Pink/Red Grapefruit (½ med)

*Watermelon (1 cup)

VEGETABLE LIST (Continued, 1 exchange/day from each category)

YELLOW/ORANGE VEGETABLES

Baby Carrots (4)

Bell Peppers (red, orange and yellow)

Carrots

Carrot Juice (1/4 Cup)

*Plantains

*Pumpkin

Snap Green Beans

**Sweet Potato or Yam

Tangerines (2 small)

Vegetable Juice, canned

*Winter Squash (yellow/orange interior)

*Minesterone soup (1 cup)

Vegetable-beef soup (1 cup)

Vegetarian vegetable soup (1 cup)

* One star means count as 1 vegetable and ½ starch

** Two stars count as 1 vegetable and 1 starch

OTHER VEGETABLES

Artichoke Asparagus

Baby Corn Bamboo Shoots

Bean Sprouts Beets

Bok Choy Cabbage

Cauliflower Celery

Chayote *Corn

Cucumber Eggplant

Fennel Green Beans

Green Peppers Kohlrabi

Mushrooms *Parsnip

Pea Pods **Potatoes

Radish Rhubarb

Rutabaga Sauerkraut

Sugar Snaps *Taro Root

Water Chestnut Turnips

ALLIUM VEGETABLES AND HERBS

Have at least 1 from each category every day.

ALLIUM FAMILY VEGETABLES

1 serving/day

Use liberally and often

Garlic (2 cloves = 1 tsp powder)

Green Onion

Leeks

Onions

Scallions

Shallots

GREEN CULINARY HERBS

1 serving/day

Try for at least

1 Tablespoon Fresh Herb or

1 Teaspoon Dried Herb

sprinkle liberally on food.

Basil Bay Leaves Chervil

Chives Cilantro Dill Weed

Fennel Marjoram Mint

Oregano Parsley Peppermint

Rosemary Sage Savory

Sorrel Thyme

FRUIT LIST

2-4 exchanges/day, choose at least 1 fruit from each category. One exchange is:

1 medium or 1 cup fresh

½ cup canned

¼ cup or 4 TB dried

½ cup juice (juice can only be used to satisfy 2 exchanges/day)

If you would like to eat more fruit than your goal, remember to exchange it for a carbohydrate choice.

VITAMIN C FRUITS

Cantaloupe (small or 1 cup cubed)

Grapefruit (½ large)

Grapefruit juice (½ cup)

Guava

Kiwi fruit

Mandarin oranges (2 small)

Mango (½ medium)

Orange

Orange juice (½ cup)

Papaya (½ papaya)

Strawberries, whole (1 ¼ cup)

Tangerines

OTHER FRUITS

Apple, small

Applesauce (½ cup)

Apple juice, cider

Apricot: dried (8 halves)

cooked or canned (½ cup)

fresh (4 med.)

Banana (small or ½ large)

Blackberries

Blueberries

Cranberries, whole

Cherries (12 each)

Cherries, canned

Dates (3 med.)

Figs, fresh (2 med.)

Figs, dried (2 each)

Fruit cocktail (½ cup)

Grapes (17 each or 1 cup)

Grape juice

Honeydew melon (1/2 cup)

Nectarine

Pineapple, fresh or canned

Pineapple juice

Plums (2 small)

Plums, canned

Prunes (3 dried)

Prune juice

Raisins (4 TB.)

Raspberries

Peach, fresh or canned

Pear (½ large)

Starfruit (2 med)

Watermelon (1 cup)

GRAINS LIST

6-13 exchanges/day (see page 7), with at least 3 being whole grains

One exchange is 15 grams carbohydrate, 3 grams protein, 0-2 grams fat and 80

calories. One exchange is generally 1 oz of a grain product.

Please use low-fat carbs most often.

HOW DO I FIND WHOLE GRAINS? The food label and ingredient list will have the words “WHOLE WHEAT”, “100%

WHOLE” or “WHOLE GRAIN”. Whole grain products will have at least 3 grams of fiber per serving.

BREAD

Bagel (1 oz, about ½ a bagel)

Bread, reduced calorie or light (2 slices)

Bread, 100% Whole,regular (1 slice)

Bread sticks, crisp (2 small or 1 large)

English muffin, Whole Grain (½ muffin)

Hot Dog or Hamburger Bun, Whole Wheat (½ bun)

Pita, Whole Wheat (1 oz., ½ regular pita)

Roll, plain (1 small)

Raisin Bread, unfrosted (1 slice)

Tortilla, corn, Whole Grain (1 - 6 inch tortilla)

Tortilla, flour (1 - 8 inch tortilla)

Tortilla Chips, Baked, no added fat (1 oz, 6-16 chips)

Waffle, Whole Grain (1 small)

CEREALS AND GRAINS

Bran Cereals (½ cup)

Bulger, cooked (½ cup)

Cereals, Oatbran & Oatmeal, cooked (½

cup)

Cereal, steel-cut oats, cooked (¼ cup)

Cereals, unsweetened, ready-to-eat (¾

cup)

Cornmeal, dry (3 Tbsp.)

Couscous, cooked (1/3 cup)

Flour, dry (3 Tbsp.)

Grape Nuts cereal, (¼ cup)

Granola, Fat-Free (¼ cup)

Grits, cooked (½ cup)

Muesli (¼ cup)

Pancake, Whole Grain (1 small)

Pasta, cooked, (½ cup, try whole wheat past!))

Brown Rice, cooked (⅓ cup)

Sugar-frosted Whole Wheat Cereal (½ cup)

CRACKERS AND SNACKS

Animal Crackers, 1 gram fat or less (8 crackers)

Matzoh (¾ large matzoh)

Melba Toast (3 pieces)

Ryvita (2 each)

Popcorn, plain, air-popped (3 cups)

Pretzels (¾ oz)

Crackers,Whole Grain,low fat (2-5)

Crackers, fat-free (5-6 crackers)

Muffin, fat-free (1 small)

Graham Crackers, low-fat or fat-free

(1½ full crackers)

IMPORTANT TIPS AND NOTES

• Most commercially prepared breads, crackers and snacks are made with hydrogenated vegetable oil, trans-fat or other

fats high in poly-unsaturated fatty acids. Try homemade versions using Mediterranean fats and oils. See your recipe

packet.

• At restaurants, ask for your bread, toast and bread sticks, dry with no butter. Any bread that is buttered counts as 1

fat exchange (5 g fat) per slice. If you wish, you can dip your bread in olive oil and count it towards your high

MUFA fats.

• Carefully monitor the amount of high starch foods you are eating. It is important that you eat less breads and snack

grains than before, so that you can eat more vegetables and fruits without eating more calories.

• Remember that portion sizes are very important! Use measuring cups and spoons to know for sure.

• Starchy vegetables, like corn, peas, potatoes and squash count as ½ a starch exchange and 1 vegetable.

• You also get starch from legumes: remember that ½ cup legumes or dried beans count as 1 starch and 1 protein.

AVOID THESE CARBS because of HIDDEN FATS

Biscuit

Corn Bread

Crackers, regular

Croutons, regular

Fried Noodles and Rice

Granola cereal, regular

Granola bars

Pie Crust

Snack Cake

Snack crackers (unless fat-free)

Snack chips (unless fat-free or fried

in olive oil)

Sandwich crackers, (with filling)

Muffin, regular

Sandwich crackers, (with filling)

Stuffing (dressing)

Taco Shell

Most commercially prepared snacks,

sweets and desserts

What are some Whole Grain Cereals?

Cheerios

Granola

Grape-Nuts

Oatmeal

Mueseli

Raisin Bran

Shredded Wheat

Total

Wheat Germ

Wheaties

What are some Whole Grain Snacks?

Popcorn

Ryvita crackers

Triscuits

WASA crackers

Wheat Thins, multi-grain

Whole Grain Fig Newtons

Whole Grain Chips Ahoy

Whole Wheat Ritz crackers

What about Brown Rice?

Instant brown rice cooks the same as instant white rice.

For regular rice, brown rice needs more cooking time (40-60 min).

What about Whole Wheat Pasta?

Although it may look dark while dry, whole wheat pastas

lighten up after cooking and can be easily substituted for white

flour pasta. Several brands make whole wheat pasta, like Hodgson Mills

and Barilla, but selection may vary by store.

PROTEIN LIST

5-9 exchanges or ounces/day, check your own plan on page 7

One Exchange of Protein is 35-75 calories, 7 grams of protein and 0-9 grams fat

One exchange is: 1 ounce meat, poultry, fish, cheese

1 egg, ⅓ cup Textured Vegetable Protein (TVP)

½ cup legumes or dried beans*

1 slice lunch meat, ½ hot dog, ⅓ bratwurst

Note: If you want to use nuts for protein, 1 ounce nuts or 2 Tbs. nut butter is 1 protein and 3-4 fat exchanges (see

your fats list for nuts)

In order to meet your study goals, choose proteins from the very low-fat and low-fat categories most often.

One serving or portion of meat is different than an exchange. A typical portion size of meat is about 3 ounces or the

same size as a deck of cards. So, a 3 ounce portion of meat is actually 3 EXCHANGES from the protein list.

A note about fat in protein foods: Some seafood, legumes, fat free cheese and skinless white meat poultry have almost

no fat. Other protein foods contain quite a lot of fat, and it is not the right kind of fat for your Mediterranean diet. In

particular, the high-fat red and processed meats, dark meat poultry and breaded and/or fried meats are

high in saturated and/or polyunsaturated fat.

Because of that, it is important to choose very low-fat and low-fat proteins most often.

VERY LOW-FAT PROTEINS (1 oz = 0-1 g fat)

Cheese: Any cheese labeled Fat-Free or containing 0-1

grams of fat, including fat-free cottage cheese (1/4 cup), or

any other fat-free cheese (1 slice)

Eggs: Egg whites (2) and fat-free egg substitute (1/4 cup).

Fish: Bass, cod, flounder, grouper, haddock, halibut, lox,

mahimahi, monk fish, perch, pickerel, smelt, sole, trout,

tuna

Legumes: Beans, lentils, peas (1/2 cup, cooked)

*Count these as 1 protein and 1 carbohydrate exchange.

Meat substitutes: vegetarian protein products, burgers, hot

dogs, etc., with less than 1 gram fat per ounce. Check

packaging and count 1 carbohydrate choice for each 15g

carbohydrate listed on the label.

Other Meat: Fat-free deli meat, fat-free hot dogs, kidney,

fat-free sausage.

Poultry: White meat chicken, turkey or pheasant without

skin.

Seafood: Clams, crab, imitation shellfish, lobster, octopus,

oyster, prawns, scallops, shrimp, squid.

LOW-FAT PROTEIN (1 oz = 3 g fat)

Beef: Select or Choice grades all fat trimmed of chuck,

round, sirloin, flank steak, tenderloin, roast also T-bone,

porterhouse and cubed steak.

Cheese: Any cheese labeled with about 3 grams of fat per

ounce, 4.5% fat cottage cheese (1/4 cup), Parmesan (2

Tbsp).

Fish: Herring, salmon, sardines.

Lamb: All fat trimmed. Roast, chop, leg or loin.

Meat substitutes: Vegetarian protein products, burgers,

hot dogs, etc., about 3 grams fat per serving. Check

packaging and count 1 carbohydrate choice for each 15g

carbohydrate listed on the label.

Other: Hot dogs, sausage and cold cuts with about 3

grams fat per ounce.

Pork: Ham (trimmed), Canadian bacon, tenderloin and

well trimmed center loin chop and sirloin chops and roast.

Poultry: White meat with skin or dark meat without skin.

Veal: All fat trimmed. Chop (lean), cutlet or roast.

Please try to avoid higher fat meats. If you must have it, please limit to 1 serving a week or 1 serving every other

week. Three ounces of a medium-fat meat would have the same fat as 3 tsp of lard. Three ounces of high fat

meat would be 5 tsp of Lard! The 2 tsp of lard/week from the fat list can be saved up for higher fat meats.

MEDIUM-FAT PROTEIN (1 oz = 5 g fat)

Beef: Select or Choice grades, fat not trimmed, of round,

sirloin, flank steak, tenderloin, roast also T-bone,

porterhouse and cubed steak.

Cheese: Feta (1oz), mozzarella (1oz), ricotta (1/4 cup).

Eggs: Whole egg (1 egg); pasteurized liquid eggs (1/4

cup)

Fish and Shellfish: Any fried fish and shellfish. Note:

Unless you fry your fish at home in olive oil, it is probably

high in poly-unsaturated fat and not part of your

Mediterranean diet.

Soy: green soy beans (1/3 cup), mature soy beans (1/4 cup

cooked), tofu (1/2 cup or 4 oz), tempeh (1/4 cup).

Meat substitutes: Vegetarian protein products, burgers,

hot dogs, etc., about 5 grams fat per serving. Check

packaging and count 1 carbohydrate choice for each 15g

carbohydrate listed on the label. Note: check ingredients

for type of fat. Many of these products are high in poly-

unsaturated fat!

Other: Hot dogs, sausage and cold cuts with about 5

grams fat per ounce.

Poultry: Dark meat with skin.

HIGH-FAT PROTEIN (1 oz = 8

g fat)

Beef: Prime grade cuts and untrimmed choice and select

cuts.

Cheese: Most regular cheeses.

Fish: Breaded and fried fish. Avoid if commercially

prepared.

Lamb: Untrimmed cuts.

Other: Most hot dogs, sausage and cold cuts.

Pork: Untrimmed cuts. Ribs and sausage.

Poultry: Breaded and fried. Avoid if commercially

prepared.

Veal: Untrimmed cuts.

MILK LIST

One exchange = 12 grams carbohydrate, 8 grams protein, 0-8 grams fat and 80-

150 calories. One exchange is generally 1 cup.

Dairy foods and some dairy substitutes are sources of calcium, vitamin D and protein. Dairy fat is low in

poly-unsaturated fat but high in saturated fat. When following your Mediterranean eating plan,

choose fat-free and low-fat foods. For higher fat dairy, count the fat like lard on the fat list.

Note: When choosing a milk substitute like soy milk, make sure that the substitute is fortified with calcium and vitamin D and check

the label for protein content to make sure you are getting at least 6 grams of protein per cup. For sweetened vanilla or chocolate soy

milk, count one additional carbohydrate exchange.

**For chocolate milk and soy milk, count one extra carbohydrate exchange.

FAT-FREE AND LOW-FAT MILK: Best Choices

0-3 grams fat per serving

Fat-free milk (1 cup)

½% milk (1 cup)

1% milk (1 cup)

Buttermilk, fat-free or low-fat (1 cup)

**Chocolate milk, fat-free or low-fat (1 cup)

Dry milk, fat-free (1/3 cup, dry)

Evaporated fat-free milk (1/2 cup)

Kefir, non-fat or 1-2 grams fat (1 cup – if flavored add 1

starch)

*Soy milk, fat-free or low-fat, fortified (1 cup)

Yogurt, flavored, fat-free and sugar-free (3/4 cup or 6 oz)

Yogurt, plain, fat-free or low-fat (3/4 cup or 6 oz)

Yogurt, flavored, regular low-fat (6 oz =1 milk and 2

starch)

REDUCED-FAT MILK

5 grams fat per serving (count as 1 milk + 1 fat

exchange of lard)

2% milk (1 cup)

Soy kefir, 4-5g fat (1 cup – if flavored add 1 carb)

*Soy milk, regular, fortified (1 cup)

Soy yogurt (1 cup – if flavored add 1-2 starch)

Yogurt, plain, reduced-fat (1 cup)

WHOLE MILK

8 grams fat per serving (count as 1 milk + 1 ½ fats)

Whole (vitamin D) milk (1 cup)

Evaporated whole milk (1 cup)

Goat or sheep milk (1 cup)

Kefir, plain, whole milk (1 cup – if flavored add 1 starch)

Yogurt, plain, whole milk (6 oz, if flavored add 2 starch)

SNACKS, SWEETS AND OTHER CARBS

The nutrition label can help you figure out how to count the foods you choose.

1 Carbohydrate Choice or Exchange = about 80 calories and 15 grams of carbohydrate.

1 Fat Choice or Exchange = about 45 calories and 5 grams of fat.

YOUR BEST CHOICES FOR SWEETS AND SNACKS

1 serving counts as 1 Carbohydrate Choice, unless otherwise noted. Check the recipe packet for new things to try.

Fat Free Candy

Gum drops, 6 pieces

Gummie bears, 10 pieces

Jelly beans, 8 large

Jolly Ranchers, 3 pieces

Life Savers, 8 pieces

Marshmallows, 3 large

Peppermint Patties, 2 pieces

Tastetations hard candy, 3 pieces

Twizzlers, 3 pieces

Fat-Free, Sugar-Free Frozen

Desserts

Fudgicles, 2 pops

Popsicles, 2 pops

Fat-free or Low-fat Frozen

Desserts

Ice cream, fat-free, 1/3 cup

Juice bars, 1 bar

Sherbet, 1/3 cup

Sorbet, 100% fruit, 1/3 cup

Frozen yogurt, 1/3 cup

Baked Chips

Potato chips, no-fat added, 10 chips

Tortilla chips, no-fat added, 15 chips

Other Snacks

Angel food cake, 1 oz, 1/12 cake

Animal Crackers, 8 crackers

Fat-free brownies, No Pudge brand,

2 inch square

Fortune cookie, 3

Gelatin dessert, ½ cup

Gelatin dessert, sugar-free, (free

food)

Ginger snaps, 3 cookies

Graham crackers, 1½ cracker sheets

Newtons, fig or other, 1½ newtons

Popcorn, air-popped, 3 cups

Pretzels, 1 ounce

Pudding, fat-free, sugar-free, ½ cup

Pudding, fat-free, ½ cup, (2 starch)

Rice cakes, plain or flavored, 2 large

or 6 mini

Vanilla wafers, fat-free, 5 cookies

OCCASINAL SNACK CHOICES

Choose a snack from this list no more than once a day.

Count as one carbohydrate choice unless otherwise noted

Brownie, homemade with butter or canola oil, 1 x 2 inches

Chocolate candy, ½ ounce

Chocolate candy bar, Fun-Size, 1 bar

Cookie, homemade with butter or canola oil, 1 2-inch cookie

Hershey’s Kisses, 3 kisses

Light ice cream, ¼ cup

Malted milk balls, 9 pieces

Pudding, regular with whole milk, 1/3 cup

AVOID THESE

SWEETS, SNACKS AND OTHER CARBS

Most commercially prepared desserts and snacks are made with fats that are high in poly-unsaturated fats, trans fats and

saturated fats that should be avoided on your Mediterranean Diet. ALWAYS CHECK THE FOOD LABEL AND

INGREDIENT LIST! If the ingredients contain a poly-unsaturated fat (soybean oil, corn oil, safflower oil, sunflower oil,

vegetable oil, margarine, shortening, partially hydrogenated oil), please make another choice.

Doughnuts

French Fries

Popcorn made with oil or movie style

Potato or Tortilla Chips

Cinnamon Rolls

Commercially prepared cakes

Commercially prepared cookies

Snack Cakes

Sweet Rolls