These are the other major source of fat in the Mediterranean diet. Nuts contain antioxidants and are high in healthy fat. Walnuts, for example, have been shown to reduce dangerous triglycerides and boost heart-protecting HDL; in fact, if you are going to indulge in a high-fat meal, including walnuts can help minimize artery damage. Other nuts to snack on: pecans, pistachios, and hazelnuts, says Michael Miller, M.D., director of the Center for Preventive Cardiology at the University of Maryland Medical Center.
Alcohol (in moderation) raises HDL, and the grape skins used to make red wine contain the antioxidant resveratrol, which may help prevent blood clots and keep vessels flexible.
Don't forget that the Mediterranean lifestyle includes plenty of walking and relaxation time. "Stress is an underestimated risk factor," says Dr. Miller.
The New Skinny on Weight
There's no doubt that hauling around too much body fat is hard on the heart. But after years of estimating risk with the body mass index (BMI), a 150-year-old formula that roughly calculates body fat using height and weight, doctors are now being encouraged to look more closely at body shape instead. In a 52-country study, researchers compared the BMI with a number of other measures and found that the best predictor of heart attack risk was an individual's waist-to-hip ratio. Pear-shaped people—those who have small waists in relation to their hips—are at lower risk. People with an apple shape, who have wider waists and more fat around the abdomen, have greater reason to be concerned.
To lose that tummy fat, get moving. Diet alone won't do it, but exercise can, even before you see a difference on the scale. Exercise may also make belly fat less risky. In a recent study at Wake Forest University, women who cut calories lost weight and lowered their body fat; those who dieted and added a moderate or brisk walk several days a week also shrank the size of the fat cells around their bellies by 18 percent.
Even if you're thin, you need to exercise. In fact, for maximum heart protection, you need two kinds of workouts: (1) a moderate-intensity activity, such as brisk walking, dancing, or biking on level ground, which increases HDL and lowers LDL; and (2) something a little more active, like jogging, aerobic dance, or biking uphill, to boost heart and lung fitness.
How often? You should aim for at least 30 minutes of exercise a day on most days of the week. But researchers say that you need to push yourself only slightly beyond your comfort level, just enough to raise your pulse and speed breathing.