Seasonal fruits, meat and red wine are part of the Atlantic diet that can reduce belly fat, high blood pressure and cholesterol levels
4 March 2024
Commentary by Dr. Donald Greig
Recently I discussed, blueberries as one of many ‘superfoods”. I would now like to focus on a new and perhaps startling perspective on healthy eating that's creating quite a buzz. Imagine indulging in some of the most gratifying foods – cheese, bread, rice, potatoes, and pork – and topping it all off with a savoury glass of wine. Sounds too delightful to be anywhere near the vicinity of 'healthy,' doesn't it? I’m about to dive into an unconventional approach that advocates for just that. The Times article published on 17th February 2024 takes you on an Atlantic journey with dietary principles which are similar to the better known Mediterranean diet.
The concept isn't about reckless abandon towards high-calorie or high-fat foods but about balance, quality, and joy in eating that might challenge our entrenched beliefs about dieting and health.
Reconsidering 'Forbidden' Foods
For decades, bread and rice have been unjustly demonized in many diet plans, labelled as the nemesis of weight loss due to their carbohydrate content. Potatoes have been tossed into the same bin, while cheese and pork — oh, they've been accused of many dietary crimes for their fat content. But what if we've been too harsh on these foods?
Recent studies suggest that when consumed in moderation, these food items can be an integral part of a balanced diet. Whole-grain bread and brown rice, for instance, are rich in fibre and essential minerals. Potatoes are loaded with vitamins, and when not deep-fried, can be a healthy side item. Cheese, believe it or not, is a fantastic source of calcium and protein. Pork, particularly lean cuts, can be as nutritious as other meats.
The French Paradox and Beyond
Here's where it gets intriguing. Our culinary musings take us to France, where the French paradox has baffled experts for years. Despite a diet rich in saturated fats from cheese and meats, the French have a remarkably low incidence of heart disease. The secret might lie in the quality of the food and portion control, as well as the inclusion of red wine, which contains resveratrol – a compound linked to numerous health benefits.
It's time to expand our understanding further afield. The Mediterranean diet, one of the most extensively studied diets, shares similarities with the French approach. It emphasizes plant-based foods and healthy fats, but does not shy away from carbs and wine, and it's associated with longevity and reduced risk of various chronic illnesses.
Moderation is Key
The crux, we're discovering, isn't just about what we eat, but also how much and how often. Substantial evidence suggests that eating smaller portions, focusing on the quality of ingredients, and enjoying a variety of foods can contribute to a healthier lifestyle.
Yes, you can have your cheese, bread, rice, potatoes, and pork – they're not inherently 'bad' foods. The key is moderation and aiming for wholesome, unprocessed versions of these foods. Cheese from grass-fed cows, bread from whole grains, naturally farmed pork, organically grown potatoes, and minimally processed rice are all examples of how you can enjoy these foods healthily.
Enjoy Your Meal (and a Glass of Wine)
It's not just about nourishment; it's about pleasure too! A strict diet that bars you from enjoying the foods you love can be unsustainable and frankly, no fun at all. A glass of wine with your meal might offer not just potential health benefits but also a moment of relaxation and indulgence.
Choosing a diet that includes a variety of foods, encourages portion control, and focuses on quality might be challenging in our fast-paced, fast-food world. However, it promotes a sustainable and pleasurable relationship with food that could very well be the healthiest way to eat.
Before making significant changes to your diet, I recommend speaking to a healthcare professional, a nutrition or a dietitian.
A Toast to Health
So, could the Atlantic diet be the healthiest way to eat? There's no one-size-fits-all answer, but if integrating cheese, bread, rice, potatoes, pork, and a modest amount of wine into a balanced and mindful eating plan works for you, it might certainly add not just years to your life, but life to your years.
The article takes you through a more descriptive Iberian meal driven initiation of a conversation for a healthier eating life style without necessarily subjecting yourself to the purgatory of unsustainable dieting.
In future newsletters, I will be discussing the use of appetite supressing medications which may help alleviate cravings for the less healthy foodstuffs and help you on this journey.
The Atlantic Diet
It might sound too good to be true but adopting a diet that advocates eating cheese, bread, rice, potatoes and pork — washed down with a glass of red wine — could be a good move for your long-term health.
A study published last week found that a diet based on the eating habits of people living in northwestern Spain and Portugal — known as the Atlantic diet — can reduce belly fat, high blood pressure and cholesterol levels. The risk of heart disease and diabetes is also lowered. Increasingly, there’s a buzz around the diet among nutritionists and scientists. Other studies have suggested that it may even reduce depression and increase longevity.
For the latest study, published in the Jama Network Open journal by scientists from several Spanish universities, a team of researchers recruited 250 families (574 people) from rural northwestern Spain. Participants were asked to follow either the principles of the Atlantic diet, based on the traditional local cuisine and seasonal produce, or their usual diet.
“The Atlantic diet typically contains local, fresh and minimally processed seasonal foods such as vegetables, fruits, whole grains, beans and olive oil,” says Alex Ruani, a researcher in nutrition science at UCL and chief science educator at the Health Sciences Academy. “But it also features moderate amounts of meat, mainly pork, some starchy-based carbs like bread and pasta, dairy including milk and a little wine.
”Before the start of the study — then again six months later — the scientists took measurements of waist circumference, cholesterol and blood sugar levels and blood pressure from those taking part. Results showed that compared with those eating their usual diet, those on the Atlantic diet had reduced levels of LDL “bad” cholesterol,had had a “significant decrease in waist circumference”, losing almost 2cm from their middle. Increased levels of cholesterol and belly fat are considered risk factors for metabolic syndrome and heart disease.
Dr Linia Patel, a dietician and a spokeswoman for the British Dietetic Association who is also a nutrition researcher at the University of Milan, says it is not the first time that the Atlantic diet has been proven to boost health and longevity. “It’s a cousin of the much-lauded Mediterranean diet,” Patel says. “And there’s mounting evidence that it is a very healthy way to eat.”
It’s been received wisdom for years that the Mediterranean diet — with its emphasis on fresh, seasonal vegetables, fish, olive oil and pulses — is the healthiest way to eat. Now it is becoming increasingly clear that the Atlantic diet may have equally impressive benefits, without the need to cut out red meat, potatoes and dairy products entirely. The Atlantic diet allows for more beef and pork and tends to be starchier than the Mediterranean diet.
In another study, published in BMC Medicine three years ago, Spanish and Portuguese researchers analysed the diets and health of 3,165 people in their sixties or older for more than a decade. They concluded that sticking to the Atlantic diet was associated with a lower risk of early death from any cause among older adults. With no faddy fasting or calorie counting, researchers reported in the Journal of Functional Foods that older adults found the Atlantic diet relatively easy to follow. “It is a lifestyle diet rather than a short-term weight-loss plan,” Patel says. “But it will bring long-term benefits to health.” Here’s how.
Eat plenty of eggs and dairy
Dairy and eggs feature prominently in Atlantic-style eating. “Most Spanish and Portuguese people consume the equivalent of a glass of milk a day and cheese is included in a lot of dishes,” Patel says. “Both are an important source of calcium in the diet.” Eggs are added to many popular dishes, from Spanish tortilla and huevos rancheros (Spanish baked eggs) to the tomatada (eggs poached with tomatoes and vegetables) and ovos verdes (a boiled egg coated in breadcrumbs with a herby filling), which are among the favourites in Portugal. We each consume an average 202 eggs a year in the UK, but are beaten by the Portuguese who eat even more, with an average intake of 220 eggs each a year. Containing magnesium, iron, selenium, vitamin D and B vitamins, choline (a vitamin-like compound used to make cell membranes) and phosphorus (which is important for healthy bones and teeth as well as being a key source of protein, important for muscle maintenance and growth), they are a “compact and convenient health food,” Patel says. A study in the Molecular Nutrition and Food Research journal reported that one egg a day could lower the risk of type 2 diabetes.
Like milk, cheese is a complete protein food, with all the essential amino acids needed for health, along with a similarly long list of nutrients. “Aged cheeses, including parmesan, are fermented and contain a range of beneficial bacteria that boost the gut microbiome,” says Eli Brecher, a nutritionist. “With a low glycaemic index [GI], cheese won’t trigger unhealthy blood sugar spikes.”
Get stuck in to potatoes — they’re packed with micronutrients
Potato-based dishes such as patatas bravas, tortilla and Portuguese garlic-roasted potatoes feature prominently in the Atlantic diet. Far from being calorific stodge, Ruani says that potatoes are an underrated source of micronutrients, such as vitamin C, vitamin B6, folate, potassium and iron, and contribute a significant amount of fibre to the diet. In a review of evidence published in the journal Nutrients by researchers from the University of Surrey, potatoes were also “reported to be more satiating than other starchy carbohydrates, such as pasta and rice, which may aid weight maintenance”.
Obviously too many deep-fried chips and salty crisps are to be avoided, but potatoes served with other vegetables, such as tomatoes, as in patatas bravas, and in salads are a healthy addition to the diet. Adding a little milk or olive oil to potatoes will lower their glycaemic load, Ruani says, and the Surrey team reported how cooling cooked potatoes or serving them cold in a salad, changes the structure of the starch they contain, so that blood-sugar spikes after eating them are reduced.
Stewing meat and vegetables is far more healthy than frying
Eat stews — not just in winter
How you cook your food can be as important as the kind of food you eat. “In northwestern Spain and Portugal, cooking methods often include hearty stews and soups and not just in the winter,” Ruani says. Portuguese stews such as cozido, made with different types and cuts of meat and vegetables, are nutritious and filling, and also bring health benefits.
Red meat — pork and beef — is allowed
“Meat is a definite feature of the Atlantic diet,” Patel says. The most popular types are pork and lean beef. “Meat is a good source of protein nutrients, including iron, B12, zinc and B vitamins, and can play a part in a healthy diet but do stick to healthy guidelines,” she says. The best and most easily absorbed form of iron is the heme iron found in red meat. In the UK, the NHS says “red meat, including pork and beef” can form part of a balanced diet, although government advice is to eat no more than 70g a day of cooked weight of red meat and to avoid processed meat products such as salami and sausage.
“Stewing meat is a big part of the Atlantic diet and is a great way to enhance the bio-availability of nutrients — the amount of vitamins and minerals our bodies can absorb from the food,” Brecher says. “Compared to grilling, roasting or frying meat, it also reduces the production of damaging AGEs [advanced glycation end products[, the compounds created when some foods are cooked at high temperatures that are associated with causing harmful inflammation and oxidative stress in the body.”
Paella rich in vegetables and seafood provides valuable nutrients
Yes, you are allowed bread, rice and pasta
Starchy carbs such as bread, rice and pasta are definitely on the Atlantic menu, although Patel says it’s best to opt for wholegrain versions, which are preferable for their added fibre content. Rather than eating a massive bowl of pasta or a doorstep sandwich, little and often is the attitude, with people typically consuming mini portions of these carbs up to six times per day. Traditional rice-based dishes such as Spanish paella and Portuguese rice with beans (arroz de feijao) tend to be rich in vegetables and seafood, providing additional valuable nutrients. A review of 38 papers on pasta in the journal Nutrients last year could find no association between the amount of regular white pasta that people consumed and weight gain. Neither did it send blood sugar soaring, considered a risk factor for type 2 diabetes. “A little of these foods is fine,” Brecher says.
Eat at least one portion of pulses each week for gut health
From Portuguese beans made with pinto beans to Spanish bean stew with butter beans, pulses and legumes (including chickpeas, beans and lentils) feature prominently in the Atlantic way of eating. Patel says that in the UK we eat nowhere near the 50g a day of legumes that the World Health Organisation recommends for all-round health. Patel says they are packed with fibre, plant polyphenols and nutrients that boost gut and digestive health. “Our intake of legumes in the UK is around 28g per person per week,” Patel says. “We would definitely benefit from following the higher intakes of the Spanish and Portuguese.”
Stick to seasonal fruit and veg
One key aspect of the Atlantic diet is consuming more of whatever fruit and vegetable is in season locally. This makes absolute sense, Brecher says, and making use of local greengrocers, pick-your-own farms or farmers’ markets is a good move. “Seasonal and local produce tends to be more nutritious because it doesn’t have to travel far to get to you, so flavour and freshness are not compromised,” she says. “Waxes and preservatives are often used to make non-seasonal fruits and vegetables last longer, but since nutrient content starts to deplete as soon as they are picked, it means they might be far lower than expected by the time you eat them.”
Use olive oil in almost everything to protect your brain
Statistics show that Spain is among the largest consumers of olive oil worldwide, with each Spaniard consuming an average 11-14 litres per year. In Portugal, the intake is lower (6-8 litres per person per year) but it is still well ahead of the UK, where the estimated annual intake is just under one litre per person. And yet replacing other fats with olive oil can boost health and longevity. A 2022 study in the Journal of the American College of Cardiology showed that consuming half a tablespoon (7g) or more of olive oil daily led to a 29 per cent reduced risk of early death from neurodegenerative disorders such as Alzheimer’s disease and Parkinson’s disease, and a 19 per cent lower risk of death from cardiovascular disease compared with those who rarely or never consumed olive oil.
Marta Guasch-Ferré, a research scientist at Harvard TH Chan School of Public Health’s department of nutrition and an author on the paper, was born in Spain and says that olive oil is traditionally the staple fat used in Spanish and Portuguese homes. “[During my childhood] We baked with olive oil, fried with it, added it to salads and used it in anything that required a fat,” Guasch-Ferré says. “In my research I’ve noticed health gains with people using really very small amounts of olive oil compared to those having none of it.”
Eat more oily fish for heart health
It is rare to find a menu in Spain or Portugal that doesn’t feature oily fish such as sardines, mackerel and boquerones, or fresh anchovies. Rich in heart-healthy omega-3 fatty acids, oily fish is also a source of lean protein, vitamins A and D as well as B vitamins, and minerals such as iron, iodine, selenium and zinc. The official recommendation from Public Health England is that we consume two 140g portions of any fish a week, one of them the oily variety. With an average weekly intake of only 54g we fall well short of that.
“The Spanish and Portuguese eat plenty of oily fish and we should follow their lead,” Patel says. “Fatty fish consumption is associated with lower incidence of heart disease and omega-3 fatty acids are important for brain and eye health.” Steer clear of high-salt options, she says, such as smoked, canned or pickled fish that may contribute to hypertension risk. “Opting for fresh or frozen fish varieties when possible can help keep sodium intake in check,” Ruani says.
Tomatoes contain disease-fighting and health-boosting antioxidants
Increase your intake of tomatoes
Tomatoes have high levels of lycopene, an antioxidant released when they are cooked that is linked to a reduction in the risk of prostate cancer, and are also rich in other disease-fighting and health-boosting antioxidants. According to the British Tomato Growers’ Association, we consume about 160g of tomatoes (equivalent to two regular-sized tomatoes) a week or 8.32kg each per year, which is encouraging but some way short of the Spanish intake, which is 12.98kg per person per year. “Using tomato-based sauces and adding tomatoes to salads and stews is a great step towards the Atlantic way of living,” Patel says.
Eat your biggest meal in the middle of the day
In the UK we tend to consume most of our daily calories in the evening. Marta Garaulet, a professor of physiology and nutrition at the University of Murcia in Spain, who studies meal timing and its effects on health and weight, says the Spanish and Portuguese favour a large midday lunch followed by evening tapas (small plates of food), often not until 9pm. “In Spain our main meal of the day is between 2pm and 3pm when we consume 35 to 40 per cent of our calories,” Garaulet says. “Despite eating our dinner late by UK standards, we don’t eat very much at all in that last meal.” A 2022 review of nine published papers in Obesity Reviews journal found that people who consumed most of their calories earlier in the day lost more weight and had greater reductions in blood sugar and cholesterol levels than people who ate more later on.
Drink red wine (in moderation)
Wine is allowed on the Atlantic diet — just don’t overdo it. While red wines, such as Spain’s rioja and ribera del duero, contain the highest concentrations of beneficial polyphenols, antioxidants that help reduce inflammation, white wines also contain a decent amount, Brecher says. Moderation is key and no more than one glass with a meal is the rule of thumb. “There is room to enjoy one glass of wine with a meal a few times a week,” she says. “Drinking alcohol with your food may impair digestion in those with a more sensitive gut, and alcohol can have a negative impact on the quality of our sleep, so aim for at least two alcohol-free days per week and don’t exceed the 14 unit weekly upper limit.” Where the Spanish and Portuguese score extra points is in their habit of making a glass of wine last an entire meal. I’ll raise a glass of rioja to that.
‘I’ll never stop being astonished at Portugal’s propensity for double carbs’
When I first visited Portugal just over 12 years ago,gambas da costa (prawns from our coast), amêijoas (clams), dourada (sea bream) and robalo (sea bass) and the simple way of cooking it all enthralled me. People here want to taste the seafood, not the sauce. That led me to a love affair with the country where I now live: after spending one of the lockdowns on the Portuguese coast I decided not to return to London. The move has completely changed my eating habits because this wonderfully seasonal produce is not only abundant but much more affordable. Here I use extra virgin olive oil (sometimes pork lard) as my main cooking fat, and I eat more citrus fruits, almonds, tomatoes, peppers, onion, garlic and carrots, and feel better and lighter all round. Crucially, I can go for a blow-out mariscada (seafood platter) lunch with friends, and not feel in need of a nap afterwards.
The Atlantic diet, which is particularly identified with northern Portugal and Spain’s northwestern coast, is a close cousin of the Mediterranean, but with added the addition of meat, beans, potatoes and rice — as well as even more fish (the Portuguese are the biggest fish and rice eaters in Europe). It’s the Atlantic cooking style that seems particularly conducive to good health: grilling, soups and stews, which accrue nutrients in the broth.
Cozido à Portuguesa (slow-cooked pork, beef, sausages, vegetables and potatoes) is a national dish; feijoada (black bean and pork stew) is another; and the traditional Christmas Eve meal is bacalhau cozido com todos (stewed salt cod with everything, including potatoes and cabbage, fresh garlic and olive oil).
Soup is a cornerstone of life, and the favourite, caldo verde, or green soup, showcases another treasure of the national diet — cabbage. Brassicas here are king, adored in a way that the Scottish child in me sometimes finds unfathomable.
I will also never stop being astonished at the propensity for double carbs at lunch and dinner — rice and potatoes or rice and chips (gorgeous, yellow, hand-cut chips, mind) are a table staple — and this is no country for vegetarians who like to eat out. But when I’m sitting in an old-school neighbourhood tasca and notice a customer handing an empty Tupperware to the staff, I remember there’s not a lot of processed food eaten at the average Portuguese table; a takeaway largely involves stopping at a family restaurant to pick up the dish of the day. The social benefits of eating like this are high, as well as the nutritional ones.
Source (The original article cannot be viewed unless you are a subscriber to the Times.)
If you or anyone you know would like a consultation, please make an appointment with Dr. Greig at Hong Kong Surgical Specialists.
Contact us
Tel: +852 2715 4577
Email: info@hkss.info