Don't be put off by Mediterranean diet's fat content

Q. How can I know whether a Mediterranean diet is too high in fat for me?

A. Mediterranean diets are higher in overall fat content than some other approaches to promote weight loss or heart health. But because the fat comes mainly from olive oil, nuts and fish, rather than meat and butter, it is considered a heart healthy eating pattern.

Cheese, the other major source of cholesterol-raising fat, is used in only limited amounts.

So unless you have some medical condition that requires careful limitation of all types of fat - in which case you should consult with your physician and a registered dietitian - concern about fat content relates mainly to weight control. A Mediterranean diet can promote weight control because it includes an abundance of vegetables, fruits, whole grains and beans, foods low in calorie density.

One key for weight control is to match the amount of oil and nuts you eat to your calorie needs. The Mediterranean Diet was consumed by active Mediterranean farmers decades ago to meet their high calorie needs, so using large amounts of oil was appropriate. Most of us today are more sedentary; we can still use olive oil as our primary type of fat, but just use smaller amounts. A second key to weight control is that you shouldn't consider this healthy approach "all you can eat." The Mediterranean approach to eating means savoring moderate portions of delicious food, rather than focusing on vast quantities of food.

Q. Are the "live active cultures" in yogurt the same thing as probiotics?

A. Not necessarily. Live active cultures are living microbes in food. Probiotics are live microbes shown to provide health benefits.

The starter cultures used to produce yogurt and kefir are often helpful for people with lactose intolerance and sometimes reduce antibiotic-induced diarrhea. But don't assume that all types of probiotics or live cultures have the same benefits.

Studies have begun to document health effects of specific probiotics, but we need much more research to know how and when to best use them.

Q. What is the TLC diet?

A. The Therapeutic Lifestyle Changes (TLC) diet is designed to lower elevated blood cholesterol. It is low in saturated fat, trans fat and dietary cholesterol. (It limits saturated fat to no more than 7 percent of daily calories and cholesterol to no more than 200 milligrams per day, while keeping total fat between 25 and 35 percent of daily calories).

If the diet does not bring your blood cholesterol low enough, it can include added dietary fiber and/or compounds called stanols or sterols that help lower cholesterol levels.

It's important to note that the TLC diet is just one part of the TLC program, which also includes regular physical activity and weight management. The TLC diet and overall program are available through the National Institutes of Health.

You can download a free booklet that provides details about the plan or order a print copy at the NIH Web site.