The Mediterranean diet is not a diet in the traditional sense of the word (short term weight loss), but is based on a lifelong eating pattern that was historically followed in countries around the Mediterranean Sea, such as Spain, Greece, and Southern Italy. The Mediterranean diet is widely regarded as the best nutrition pattern in the world and earlier this year (2019) an influential USA survey found that the historical Mediterranean diet is not only the best diet overall, but also the best diet in the categories for diabetes, heart-health, healthy eating and easiest diet to follow.
Origin of the Mediterranean diet:
The Mediterranean eating pattern and physically active lifestyle became well known after Dr. Ancel Keys launched the Seven Countries Study in 1958, researching the relationship between dietary patterns and the prevalence of coronary heart disease in Greece, Italy, Spain, South Africa, Japan, Finland and the Netherlands. The findings of the study showed that dietary patterns in the Mediterranean were associated with low rates of coronary heart disease and all-cause mortality. A healthy diet and lifestyle with ample physical activity, non-smoking and moderate alcohol consumption are associated with a low risk of cardiovascular disease and may also postpone cognitive decline and decrease the risk of depression. This study has led to the recognition, definition, and promotion of the eating and lifestyle pattern they found in Italy and Greece in the 1950s and ’60s, now popularly called the Mediterranean diet.
This diet at the time reflected the circumstances under which these people had to live, coping with poverty and limited resources, coupled with intense physical activity as the men generally worked as peasants and the women as housewives. Modernization over the past few decades, however, has seen people in these areas straying from this traditional eating and lifestyle pattern.
Characteristics of the historical Mediterranean diet:
Olive oil was the most important source of fat.
A high intake of fruits, vegetables, home-made bread, pasta, cereals, legumes, beans, potatoes, nuts and seeds.
A moderate consumption of dairy products, fish and poultry.
Eggs were consumed from one to four times a week.
Very little red meat was consumed.
Wine was consumed regularly with meals in low or moderate amounts.
Health benefits of the Mediterranean diet:
No diet is a magic bullet that can improve your health or reduce weight overnight, but studies have shown that following the Mediterranean diet over the longer term can potentially reduce the risk of cardiovascular disease and other diseases.
Researchers from Harvard Medical School did a comprehensive study to try to determine why the Mediterranean diet is beneficial to heart health. The study monitored the health of 25 000 woman over a 12 year period, comparing the women’s diets and 40 different biomarkers.
The study found that women who diets closely resembled the Mediterranean diet had a 25% reduced risk of heart and blood vessel problems when compared to women whose diets least resembled the Mediterranean diet. The reduced risk of cardiovascular problems was attributed to a 29% reduction in chronic inflammation in the body (which is a risk factor for heart disease); 27.9% from improved glucose metabolism and a reduction in insulin resistance; and 27.3% from a lower body mass index. Smaller improvements in cholesterol levels and blood pressure were also noted.
Other studies amongst adults of both sexes have shown that the risk for developing diabetes reduced by 52%, while specifically for men the risk of stroke went down by 39%.
A study by De Longeril et al. (1999) amongst 605 middle aged men and women who had already suffered a heart attack, has shown that 4 years later the group following the Mediterranean diet was 72% less likely to have had a further heart attack or have died from heart disease.
A study in Greece on the duration and quality of sleep when adhering to the Mediterranean diet, has found a noticeable improvement in sleep amongst the 1639 adults aged 65 and older who participated in the study, ascribed to the anti-inflammatory nature of the Mediterranean diet.
Endocrineweb concluded from a literary review that dietary patterns (such as the Mediterranean diet), and not individual foods, are the most closely related to the prevention of disease.
Modern Mediterranean diet guidelines:
(Please see the Mediterranean diet Pyramid below, where food to be used sparingly is indicated in the apex and food to be eaten in abundance indicated in the larger base of the Pyramid.)
Virgin olive oil or extra virgin olive oil should still be the main source of fat, as it contains oleic acid, a monounsaturated fat that is characteristic of olive oil, olives and avocado. Oleic acid increases the “good cholesterol” HDL, which contributes to a reduced risk of cardiovascular disease. Oleic acid is present in olive oil at a ratio of about 70-75%, about 70% in avocado and only about 31% in conventional sunflower oil.
Lots of vegetables, fruits and legumes should form the bulk of meals.
Refined carbohydrates should be avoided, stick to non-refined carbohydrates such as whole grain bread.
Fish, especially oily fish such as salmon or sardines, can be eaten at least three or four times a week.
Dairy products can be used daily, but stick to plain yogurt to avoid added sugars.
Three or four eggs can be eaten per week.
Meat and meat products which contain trans-fats should be limited.
One or two small glasses of wine can be taken with the main meals. Meals should be a relaxing social occasion, to be shared with family and friends.
The Mediterranean diet can be viewed as more of an approach to eating than a specific diet – and the secret ingredient is lifestyle. Not only eating the foods on the table, but also following the Mediterranean lifestyle where people linger around the table animated in conversation, eating slowly and savoring every bit.
Mediterranean diet works by adding up small improvements. Published March 2019. Harvard Women’s Health Watch. Harvard Medical School. (www.health.harvard.edu)
Mediterranean diet. Sixty years later. Published online and updated 31 March 2018. The Mediterranean Diet. (www.mediterraneandiet.com)
What is the Mediterranean diet? Published online 26 February 2017. The Mediterranean Diet. (www.mediterraneandiet.com)
Mediterranean diet guidelines. Published online 14 April 2017. The Mediterranean Diet. (www.mediterraneandiet.com)
What is the Seven Countries Study? Published online. The Seven Countries Study. (www.sevencountriesstudy.com)
5 Studies on the Mediterranean diet – Does it really work? Published online. Healthline. (www.healthline.com)
Mediterranean diet: Anti-inflammatory foods behind health benefits. Published online and information updated 14 december 2018. Endocrineweb. (www.endocrineweb.com)
Is the Mediterranean diet the best choice for health? Published online and updated on 16 August 2018. Endocrineweb. (www.endocrineweb.com)