
- With Mayo Clinic nutritionists
Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
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Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
Katherine Zeratsky and Jennifer Nelson
Jennifer K. Nelson, M.S., R.D., L.D., C.N.S.D.
Jennifer Nelson is your link to a better diet. As specialty editor of the nutrition and healthy eating guide, she plays a vital role in bringing you healthy recipes and meal planning."Nutrition is one way people have direct control over the quality of their lives," she says. "I hope to translate the science of nutrition into ways that people can select and prepare great-tasting foods that help maintain health and treat disease."
A St. Paul, Minn., native, she has been with Mayo Clinic since 1978, and is director of clinical dietetics and an associate professor of nutrition at Mayo Clinic College of Medicine.
She leads clinical nutrition efforts for a staff of more than 60 clinical dietitians and nine dietetic technicians and oversees nutrition services, staffing, strategic and financial planning, and quality improvement. Nelson was co-editor of the "Mayo Clinic Diet" and the James Beard Foundation Award-winning "The New Mayo Clinic Cookbook." She has been a contributing author to and reviewer of many other Mayo Clinic books, including "Mayo Clinic Healthy Weight for EveryBody," "The Mayo Clinic Family Health Book" and "The Mayo Clinic/Williams Sonoma Cookbook." She contributes to the strategic direction of the Food & Nutrition Center, which includes creating recipes and menus, reviewing nutrition content of various articles, and providing expert answers to nutrition questions.
Katherine Zeratsky, R.D., L.D.
As a specialty editor of the nutrition and healthy eating guide, Katherine Zeratsky helps you sort through the facts and figures, the fads and the hype to learn more about nutrition and diet.A Marinette, Wis., native, she is certified in dietetics by the state of Minnesota and the American Dietetic Association. She has been with Mayo Clinic since 1999.
She's active in nutrition-related curriculum and course development in wellness nutrition at Mayo Clinic in Rochester, Minn., and nutrition related to weight management and practical applications of nutrition-related lifestyle changes.
Other areas of interest include food and nutrition for all life stages, active lifestyles and the culinary arts.
She graduated from the University of Wisconsin-Madison, served a dietetic internship at the University of Iowa Hospitals and Clinics, and worked as a registered dietitian and health risk counselor at ThedaCare of Appleton, Wis., before joining the Mayo Clinic staff.
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Nutrition-wise blog
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May 19, 2009
The new Mediterranean Diet Pyramid
By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.
A new Mediterranean Diet Pyramid? Was something wrong with the old one? No! The creators of the Mediterranean Diet Pyramid have just updated it to reflect the latest science.
Here's what's new:
- All plant foods — fruits, vegetables, grains, nuts, legumes, seeds, olives and olive oil — are grouped together and form the largest part of the pyramid.
- Herbs and spices are now part of the pyramid. They add flavor and aroma and reduce the need for fat and salt when cooking.
- Fish and shellfish are recommended more often, at least twice a week, in recognition of their unique health benefits.
The pyramid still emphasizes:
- Being physically active and enjoying meals with others as the foundation of a healthy lifestyle.
- Choosing the least processed forms of plant foods. Fresh, raw and lightly cooked vegetables, fruits and whole grains retain fiber and most of their nutrients.
- Using olive oil for cooking, baking, and for dressing salads and vegetables. Extra virgin olive oil is highest in monounsaturated fat and phytonutrients.
- Enjoying cheese and yogurt in moderation — preferably low-fat versions.
- Serving poultry more often than red meat. Lean red meat should be limited to several times a month.
Since the Mediterranean Pyramid was introduced in 1993, extensive research has corroborated the healthfulness of this cuisine, which has demonstrated the highest average life expectancy and the lowest rates of chronic diseases among adults. People have taken notice: Over the past 15 years, many restaurants, cooking shows and cookbooks have embraced this way of meal planning.
Even so, many still struggle with eating red meat only a few times a month. I know I've gradually (sometimes even grudgingly) changed my eating habits to make plant foods the main focus of meals. I now fill at least three-quarters of my plate with vegetables, whole grains and fruit. I'm also eating fish and seafood at least twice a week, choosing low-fat cheese and yogurt, and limiting eggs to once a week.
How have you adjusted your eating habits over the past 15 years? Tell me your stories.
- Jennifer
46 comments posted
May 27, 2009 10:32 a.m.
I have always found this quite interesting since the people in Mediterranean countries I have visited in the past and more recently have always enjoyed thier lamb (particularly greece) and pork. I understand also the people in Mediterranean countries and asia are prone to Thallasemia. Perhaps we should aim for a more balance diet. Say two white meat, two fish, one red meat and a couple of veg (eash week) for a proper balance. I also heard that we also need some sunflower oil in our diet is this not the case?
- Pat
May 27, 2009 9:53 a.m.
My comment: Due to borderline/pre-diabetes, I modify the so called Meditarean diet out of necessity by eating more protein- which, yes, tends to be beef, pork, chicken, as well as fish due to IBS interfering with using grains. Any comments? I stick closer to the low carb type diet whenever I can.
- Ellen-Sue
May 27, 2009 9:47 a.m.
A previous writer cited Dr. Esselstyn at Cleveland Clinic. Add his son, Rip, who has some profound things to say about diet (The Engine2 Diet). Their view (along with Dean Ornish) is that meat & the meat industry does not promote health, nor does dairy or eggs (and their industries). Human health comes from plants. The Esselsytns (and many others) have the science on heart patients to back up the return of patient disease indicators to normal and better from a plant based diet. I would suggest to Ms. Nelson & Zeratsky they give the plant based diet a try like I have. Too radical? The taste buds change, weight falls off and all the health indicators become amazing. In regard to those who have good health despite their diet, there is a percentage of the population that is immune to most health problems. They won the genetic lottery. The question is, did you?
- Hal
May 27, 2009 9:10 a.m.
You can see the new Mediterranean Diet Pyramid at: http://www.oldwayspt.org/med_pyramid.html
- MayoClinic.com staff
May 27, 2009 8:39 a.m.
Our biggest adjustments over the last 2 years have been changing where our red meat and eggs come from. We now purchase locally grown, grass fed beef by the 1/2 side, and eggs from local, happy, chickens that run around a field and eat grass and bugs all day. It is difficult to find beef and eggs that are raised in an outdoor space with natural grasses as food, but the omega 3 to omega 6 ratios make the effort well worth it. In America, most of our animals are sick and stressed in huge, confined feed lots that care nothing for them except the bottom line. Is it any wonder we are sick and stressed as well?
- Sherri Naughton
May 27, 2009 8:21 a.m.
Ladies: Where is the actual pyramid?
- Warren
May 27, 2009 12:21 a.m.
6 years ago went thru a quad bypass, 6 weeks later learned 3 of the 4 bypasses were occluded, leaving me with one bypass operational. I also have Type II diabetes, and the daily physical creakinesses of old age (I'm now 73). Diet-wise, I have greatly reduced sugar in diet, use almost no canned sauces, soups, etc. I now eat 3 times as many whole grain foods as before sx, carefully watch ingredients in any prepared foods, rejecting those loaded with with sugar or syrups, sodium, "bad" fats/oil, and so forth. I have greatly reduced my sodium intake. I only use olive and canola oils, stay away from other fats, except I use L/F butter spread @ 50 cals per Tbsp. My diet includes low fat or 1% dairy foods, lots of fresh veggies and fruits. Instead of white rice and white pasta I have switched to brown rice, cornmeal mush (i.e., polenta), baked or boiled in skin potatoes in small amounts, rarely eat white breads, and when I "fall off the wagon", I am right back on it the next day trying to continue eating right, including more poultry & fish, 1 red meat per week, & 3 eggs per week. I also exercise at the heart rehab gym facility, although I am guilty of sometimes not sticking to my goals. I have been doing this for six years, & am still in reasonably good health, I believe because of good diet, medium exercise, medications to help with cardio & diabetes, staying mentally "fit" (being happy vs depressed), and a great cardiolog
- Marilyn Fraser
May 27, 2009 12:18 a.m.
Based on my own experience, the Med Diet Pyramid was the crutch I needed to start a weight reduction program; from 230 to 195pds. In the process I discovered Olive oil and balsamic vinegar on fresh salads which beat the hell out of those Kraft concoctions on the store shelves. The net result: I was able to bring my blood pressure down to a level that I can now control, and excercising is no longer a challenge. Two items: Wild Fish off the northwest coast IS safe to consume - It is fresh halibut season up here and it is literally outstanding, and because of my belief in how healthy I feel, you should see my golf game Now!!
- Warren Sutherland
May 26, 2009 7:56 p.m.
With the oceans so polluted I'm not sure that I want to eat fish so often even though I love it. I have heard that one should not consume fish caught off the Oregon coast more than once a month, Washington coast twice a month. Alaska's northern waters okay so far. Perhaps going vegan would be best.
- Diane Kaufman
May 26, 2009 6:34 p.m.
I am on a food plan for an eating disorder that requires 16 oz veggies at lunch and dinner, fruit at each meal, 1 fat at breakfast, 2 at lunch and 4 at dinner. I feel great strong and I don't eat sugar or anything containing it or any kind of flour. All cravings for sugar and flour are gone by not eating those things. The clarity of mind is significantly better and happiness is way above what it has been when eating these things. Thanks for your information.
- HReilly
May 26, 2009 5:58 p.m.
I LIVE NOW IN COLOMBIA. S-A--FOR THE PAST FOUR YEARS I HAVE GROWN MY OWN GARDEN VEGETABLES IN AN ORGANIC WAY, NO CHEMICAL FERTILIZERS AND NO FUMIGATION. THERE IS A T.V. CHANNEL THAT PUTS EMPHASIS ON ORGANIC CULTIVES: TVAGRO.COM-SPANISH ONLY. THANK-YOU FOR THE NEWSLETTER.
- carlota lopez
May 26, 2009 5:52 p.m.
Research indicates that the less fat you consume, the healthier you will be. The fat-free diet profiled by Dr. Esselstyn of the Cleveland Clinic is a plant-based, legume-oriented diet, and it may do a much better job of unclogging arteries than any diet that includes olive oil, dairy, or meats of any kind. Let's hear it for green leafy vegetables!
- Gene Bammel
May 26, 2009 2:43 p.m.
Dear Jennifer/Katherine: What about the daily cup of wine. Can we eat bread, potatoes and rice?. Thank you.
- Gustavo Mourraille
May 26, 2009 1:25 p.m.
I have been looking for a good Mediterranean cook book with menus that has LOTS of photos. No luck yet. Do you know of one? Thank you, Stephanie
- Stephanie Mosqueda
May 23, 2009 9:47 a.m.
"The creators of the Mediterranean Diet Pyramid have just updated it to reflect the latest science." What is that science? I thought all the science was showing that low fat continues to fail on weight loss, CVD and diabetes. Latest science I saw said monounsaturated fat was worse than saturated fat. "For a 5% lower energy intake from SFAs and a concomitant higher energy intake from PUFAs, there was a significant inverse association between PUFAs and risk of coronary events" Jakobsen MU, et al: Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 2009, 89:1425-1432.
- rumford
May 22, 2009 5:35 p.m.
All anyone needs to know about the old USDA Food Guide Pyramid is contained in it's name. With all due respect to the fine professionals there, USDA stands for US Department of Agriculture, the same government agency responsible for making loans to, and collecting loan payments from, ranchers and wheat and corn farmers. Not coincidentally, they also issue certain food-based public assistance and school food programs. So, it isn't hard to see the USDA's prime motivation in developing their old pyramid to be keeping government assistance costs down by promoting relatively cheap but nutritionally vacuous tummy-fillers and ensuring the financial stability of the farms that produce them. I, too, would like to see a graphic of the Mediterranean food pyramid, and a citation for the science behind it. I look forward to the day when nutritional and dietary guidance is published by the National Institutes of Health based on sound medical science, not the USDA.
- Denise
May 21, 2009 2:03 p.m.
I eat mediterranean style because I like it, so no problem there. But I would like very much to see a graphic showing the new pyramid, please, in case I need to adjust anything.
- Martha Aitchison
May 20, 2009 2:54 p.m.
So in essence, you are saying the USDA Food Guide Pyramid is old science. As Registered Dietitians, I applaud you for stepping out and saying it. The USDA Food Guide Pyramid is based upon VERY old science.
- Bonnie Minsky, MA, MPH, LDN, CNS
May 20, 2009 11:02 a.m.
I've been eating Mediterranean-style since 2000 or so. That was when the Atkins diet was peaking (again!) and the low-fat eating style was starting to fade. I had done research into various diets since my patients were asking my advice on how to both lose weight and get healthier. The obvious choice was the Mediterranean diet. I've wondered how much of the health benefit derives from the spices common in Mediterranean cuisine: cumin, paprika, turmeric, cinnamon, ginger, coriander, anise, Spanish saffron, lemon,mint, parsley, garlic, dill, pepper, and sumac. I look forward to reading Oldways rationale for adding spices to the pyramid. -Steve Parker, M.D. -Health Lifestyle Blog: http://AdvancedMediterraneanDiet.com/blog/
- Steve Parker, M.D.
May 20, 2009 9:49 a.m.
Well, ladies, have the pyramids not done enough damage? Take the vegan edition--- I have outlived all of them already on a non-diet , consuming your weekly red meat quota once a day. At 84 all systems Normal! No vitamins, medicines supplements. In order to define obesity I chose to coin a new word ( disease?); Carbohydritis.
- Hart Oldenburg
May 20, 2009 9:31 a.m.
My husband and I have started eating more chicken and using less salt around 1991. Now I focus on adding more fish, fresh fruits, and olive oil to our meals. Like you, giving up the red meat is difficult for my husband.
- Joan

46 comments posted