The New Mediterranean Diet Cookbook: A Delicious Alternative for Lifelong Health

We invent all sorts of rationales for holding back on changing diets, especially where families are involved. But there are compelling reasons for making the switch, and most of the obstacles are easily overcome. Just remember that where families are concerned, change sometimes has to come slowly. Whatever you do, don’t make a big deal out of it. Small, quiet, almost unnoticeable changes are more effective than noisy family food fights.

Get out of the butter habit. A little butter from time to time is fine, but butter is never on the Mediterranean table, never assumed to be an automatic accompaniment to bread. Even at breakfast, only a little jam garnishes the bread, which is appreciated for its own good flavor. (And contrary to American restaurant custom, bowls of olive oil, even of the finest extra-virgin, are never put on the table, except during the autumn harvest when the flavor of new oil is appreciated.)

Use more whole grains. Even though Mediterranean cooks seldom use whole-wheat pasta or brown rice, they still get plenty of whole grains through dishes like tabbouleh, the hearty Lebanese salad, and bulgur pilafs. And breads throughout the Mediterranean are often made with unrefined wheat and barley flours. Fortunately we have much greater access to really high-quality bread than we had 15 years ago when I compiled the first edition of this book, but if you can’t find the kind of bread you want nearby, try making it yourself. It really isn’t time consuming once you get the hang of it, and that’s quickly acquired. And presenting a homemade loaf of high-quality bread on the table is just eminently satisfying.

Children and the Mediterranean Diet

Enjoyment is the key to supporting great nutrition, especially for young children, because if they don’t enjoy their food, they simply won’t eat it. But if you present food that is freshly prepared and tasty, even broccoli, children will almost always come around, especially if they see that everyone else at the table is enjoying the same thing.

All children seem to go through periods when they will eat only one thing—only white food, perhaps, or only peanut butter and jelly sandwiches (not a bad thing, as long as they’re made with whole-grain bread). The best course of action, we are assured by everyone from Dr. Spock on, is not to stress out, not to wring hands, not to indicate the least shred of anxiety—and above all, not to rush to offer an alternative. But almost all children love pasta and pizza, so start your Mediterranean diet campaign with one of those, prepared to be appetizing and full of flavor, presented as a family meal to be enjoyed all together—and you may find the battle is over before it’s even begun.

The Fat Picture

Few subjects of nutritional research are more confusing than the question of what fats to eat—or not to eat. Reams have been written on the subject, in prestigious peer-reviewed professional journals as well as in the popular press, and the books alone would fill a small-town library. Yet much of the advice is conflicting and each season, it seems, new evidence is presented to support the benefits or detriments of this fat or that fat or no fat at all. The more we know, it seems, the more we discover that we don’t know.

Saturated fat increases the risks of heart disease, primarily by raising blood cholesterol levels, and has been linked to other chronic diseases such as cancer and degenerative ailments. Many researchers believe that consumption of saturated fat should be limited, as it is in the traditional Mediterranean diet, to just a few times a month, or more often in small amounts—a good example of the latter is the use of a couple of ounces of meat or sausage in a pasta sauce to serve four to six people. Or the garnish of sautéed chopped lamb that tops Lebanese hummus bi tahini. Or the little bit of meat that adds richness of flavor to Greek or Turkish stuffed grape leaves. Saturated fat shouldn’t be banned from the diet—it often accompanies other valuable nutrients—but it should be used much more moderately than it is in America, where our meat-focused diet is the cause of a lot of health problems.

But there are worse fats than saturated fats. Far worse. Trans fats are quite possibly the most dangerous fats we can put in our mouths. These are for the most part artificial fats, created through the process of hydrogenation, heating polyunsaturated liquid oils in the presence of hydrogen. Why was hydrogenation invented? Because, as any baker knows, it’s hard to make a buttery cake with a liquid polyunsaturated fat such as corn oil. But hydrogenating makes the oil harder, more solid at room temperature—just like margarine, which is supposed to be just like butter, except that, as a plant-based fat, it is free of cholesterol, and we were told that cutting back on dietary cholesterol was the way to good health.¹ Et voilà, cakes, cookies, all manner of baked goods coming out of the oven, cholesterol free but tasting like and feeling like they had been made with butter. Along the way, it was also discovered that these hydrogenated fats have great shelf stability, meaning products made with them will last not quite forever, but darned close. Which has led the processed food industry—and we’re talking an enormous industry here, one that reaches into all our lives all over the world—to rely on trans fats. Unfortunately, however, the effect of consuming trans fats is precisely the reverse of what is desirable—they increase bad LDLs, lower good HDLs, and initiate an immune system response that may lead to diabetes, heart disease, and other chronic inflammatory conditions. (Commercially prepared fried foods—french fries, fried onion rings, chicken nuggets, et cetera—are also often fried in cheap hydrogenated fats and should be avoided for that reason.)

So let’s put the saturated fats high up on the pantry shelf where we won’t use them often, and let’s throw the trans fats out entirely. That leaves us with polyunsaturated and monounsaturated fats.

But it’s still not simple. Because among the polyunsaturated fats are two that are essential to human health (“essential” meaning that if you don’t consume them, you die). These are the omega-6 and omega-3 fatty acids, which help produce the material to regulate an enormous range of vital body functions like heart rate, blood pressure, and the immune system, among others. The best-known omega-3s (EPA or eicosapentaenoic acid, and DHA or docosahexaenoic acid—but you don’t have to remember that) are found in fatty fish such as salmon, anchovies, tuna, mackerel, sardines—most of them, incidentally, prevalent in the Mediterranean diet. (If your mother, like mine, called fish “brain food,” she was right, because they contribute to the DHA in our own brains.)

Another equally important omega-3, alpha-linolenic acid (ALA), comes from certain vegetable oils (soybean, flaxseed, and cold-pressed canola or rapeseed oils) and from walnuts; ALA is also found in certain green leafy vegetables—kale, spinach, leeks, salad greens like arugula and purslane, turnip greens, and so forth. Interestingly, it’s the prevalence of ALA in many greens that accounts for its appearance in the flesh of animals and fish that eat those greens (but not in animals or fish fed a corn-based diet, as most animals are in the United States).

EXTRA-VIRGIN OLIVE OIL

Capodacqua is a little village in the Umbrian hills south of Assisi, where during the season of the olive harvest I like to drop in on the Fancelli mill, or frantoio as it’s called in Italy, to watch and smell and taste as the big stone presses whirl around, crushing the olives, and the fragrance rises on the air, and, finally, the thick, luscious oil flows sedately onto a crust of toasted bread, ready for the first sampling of the new oil. I like Mr. Fancelli’s place in part because the oil he produces is the rich green stuff of the region that, when young and fresh from the frantoio, slides down the throat with the peppery pizzica, the catch at the back of the palate, that is typical of oil pressed from immature, half-green Umbrian moraiolo olives.

This is the oil connoisseurs seek out much as they do the fine red Sagrantino wines of the region. Like the wines, the oil has a unique character. It speaks of the terraced hills around Capodacqua with a voice that is subtly different from that of oils from nearby Orvieto or Cortona. And these strong-flavored, green-tasting central Italian oils are very different themselves from the rounder, more succulent oils from Puglia or Sicily. Which again are distinct from the oils of Catalonia with their hints of almond, and the richer, full-bodied oils from Greece and farther east in Lebanon, and the bland, sweet oils from North Africa.

The olive harvest begins in Capodacqua, as it does throughout the Mediterranean, in mid-autumn as farmers accompanied by family and friends work quickly to strip the trees by hand of their fruit.

The greenish violet olives, engorged with oil, are brought to the frantoio by the tractorload and tumbled through a hopper down into the crusher, two giant stone wheels that stand on edge and turn steadily, mashing the fruits to a thick, oily paste that is spread on round mats, once made of esparto grass, now made of plastic. The big mats are stacked high, one on top of the other, and carted by dolly to the presses. Gently but firmly the mats are compressed and the precious oil, glistening gold in the dim light of the frantoio, oozes out and trickles slowly down over the mats and into waiting receptacles below.

And that’s it. Cloudy, greenish gold, and heady with fragrance, the new oil is ready. Most of Mr. Fancelli’s clients don’t bother filtering their oil because the residues precipitate, just like wine residues, with the cold winter temperature.

Mr. Fancelli’s is one of the last of these traditional mills left anywhere around. Apart from the fact that electricity is the driving force, rather than mules or human labor, the system in essence is unchanged from Roman times or even earlier. Nowadays, almost everyone else has switched over to modern stainless-steel continuous-cycle machinery, which extracts the oil quickly and efficiently but without the inherent drama and romance of the Capodacqua mill. Some say you’ll never get clean oil with the old-fashioned system—it’s too slow, it exposes the crushed olives to oxidation—while others claim the modern method produces clean oil, yes, but without the character, the stamp of individuality, that the older mills produced.

Whether old-fashioned or newfangled, however, this is all extra-virgin olive oil. That’s because the process is essentially one of simply squeezing good, sound, healthy olives to extract their oil, along with the vegetable water that is removed by precipitation or centrifuging. But no chemical solvents are used to extract or to clean the oil, and no heat is applied. This is what food writers like to call a “first cold pressing,” although the term is deceptive since there is no second pressing, no hot pressing.

There are other ways of getting oil out of olives with chemical solvents, a process used only with olives that, for one reason or another, are not sufficiently high in quality to produce extra-virgin oil. The oil from poor-quality olives is stripped of its bad flavors and aromas, leaving a colorless, tasteless, aromaless oil to which a little extra-virgin is added to give some reason for calling it olive oil, plain and simple, but never extra-virgin. The only virtue of “olive oil” is that, like extra-virgin, it’s primarily a monounsaturated fat, but as it’s also a highly processed fat, I don’t recommend using it except for deep-fat frying.

It is chilly in the frantoio, but that doesn’t stop it from being a sort of community center during the brief weeks that it’s operating. Besides the workers, there are farmers and farm wives dropping in to check the progress of their oil, buyers and curious onlookers, and always a group of old men of the village who do nothing much but make comments on the action, comments that are sometimes received as wisdom, sometimes as the foolishness of age.

In the back room a fire burns brightly on an old hearth that just escapes being an antique. The men gather around the hearth, toasting thick slices of bread on long forks until they’re blackened and crusty. Then they rub the slices with a cut clove of garlic and drizzle them thickly with the newly decanted oil. A sprinkle of salt from a nearby jelly jar and the bruschetta is ready, its crust softened with oil to the point that weak old teeth can masticate it with evident satisfaction. It is a scene that has been repeated every year at this time for as long as the old men can remember, for as long as they’ve heard tell.

Is it strange that a product as ancient as olive oil has been given new life and validity by the discoveries of modern science? Not really. Not when you understand that for thousands of years olive oil has been the foundation of the Mediterranean diet, this diet that nutritionists and medical researchers tell us approaches an ideal. Olive oil is not the only healthy factor in the Mediterranean diet by any means, but scientists suspect that it is one of the most significant.

As nutritional science evolves, so does our knowledge about olive oil, its physical characteristics and chemical composition and its impact on human metabolism. We know that all olive oil, extra-virgin and regular alike, has impressive health benefits because of its high quotient of monounsaturated fat. But extra-virgin olive oil has the further virtue that, because it is so minimally processed, it retains many of the valuable phytochemicals that are present in olives, especially antioxidant carotenoids and tocopherols (vitamin E)—and these are lost during the processing that results in plain olive oil.

Vitamin E is a powerful antioxidant; like beta-carotene and vitamin C, it fights against free radicals, damaging elements that seem to suppress the immune system and may contribute to heart disease, cancer, and lung disease as well as to the aging process. Free radicals are produced in the body by pollutants like tobacco smoke and fuel exhaust, but they are also a normal, constant, and inevitable by-product of human metabolism. Anything that inhibits the formation of free radicals is likely to be beneficial in disease prevention.

Olive oil is the only fat that is high in monounsaturated fatty acids, that is easy and relatively inexpensive to produce by simply expressing the juice of olives, and that contributes welcome flavors and textures to the foods to which it’s added. Moreover, olive oil has a long tradition as the principal fat used by people with a well-documented history of long and healthy lives—the people of the Mediterranean basin.

With all the talk that goes on about reducing fat consumption, why should we bother with olive oil at all? Wouldn’t it be better just to eliminate all fats from our diets? No, it wouldn’t, for the very good reason that, beyond questions of taste (and fat, no matter what its structure, contributes powerfully to flavor in all our foods), our bodies need a certain amount of fat to function properly—grease for the gears, you might say, in the form of fat-soluble vitamins like A, D, E, and K and in the valuable, protective HDL cholesterol levels that, without some fat in the diet, might fall dangerously low, according to researchers.

At the Cambridge conference on the diets of the Mediterranean in 1993, Dr. Walter Willett, chairman of the Department of Nutrition at the Harvard School of Public Health, startled the assembly when he exclaimed, only half-jokingly, “As far as I’m concerned, you can take the whole food pyramid and just pour olive oil over it!” Yet there’s a certain amount of logic in that assertion: the Seven Countries Study of men on the island of Crete in the early 1960s showed that they received a full 40 percent of their daily calories from fat, the fat they ate was primarily olive oil, and their mortality rates from coronary heart disease and stroke were among the lowest in the world.