Compliance to an Exchange‐list Mediterranean Diet

Abstract

A Greek‐Mediterranean dietary pattern has great potential for cancer prevention. We developed an exchange list diet that would target key nutrient intakes of the Mediterranean eating pattern. The goals were to replace half of usual polyunsaturated fat intake with monounsaturated fats (MUFA) and to increase intakes of a wide variety of fruits and vegetables, including dark green vegetables, allium vegetables and herbs. A total of 69 women, ages 25–59, were enrolled in the study and randomized to the Mediterranean diet or not for 6 months. Subjects in the Mediterranean diet arm received individualized telephone counseling. Menus were provided as examples, but the diets were self‐selected. Compliance to the dietary goals was assessed by 7‐day food records and by levels of plasma fatty acids, lipids and carotenoids. The women were able to make large changes. Intake of MUFA increased by 48% without a change in overall fat intake. Fatty acids levels in plasma changed in the same direction as dietary fatty acids, but were smaller in magnitude. Intakes of carotenoids more than doubled in the Mediterranean diet arm, and plasma total carotenoids increased by 65%. A statistical model was developed to identify clustered outcome variables. This modified Mediterranean diet will be tested for its effects on markers of cancer risk in future studies.Supported by AICR grant #03B043.