July 2022
THE MEDITERRANEAN DIET
While other diets come and go, for over 50 years, there has been one constant. The Mediterranean Diet consistently ranks as one of the healthiest diets, and there are data to prove it. Not only can this diet protect your heart, but there are also additional ways it can keep you healthy.
The Mediterranean Diet is consistently rated a top diet every year, yet it’s not your typical diet. The plan isn’t dictated by calorie or macronutrient guidelines, restrictions or even serving sizes. It was somewhat unknowingly developed in the 1950’s and 60’s when researchers happened to notice the significantly lower prevalence of heart disease in countries bordering the Mediterranean Sea, including Spain, Italy and Greece. They attributed the low prevalence of heart disease to the overall lifestyle observed, but particularly to the pattern of foods consumed. Meals centered around vegetables, fruits, nuts, seeds legumes and whole grains, most of which were whole or minimally processed. Protein came mostly from plant sources and seafood, with other sources like eggs, dairy and poultry incorporated only a few times during the week. Red meat was eaten only occasionally (less than 1 time per week), as were desserts and foods and drinks with added sweeteners. The diet also included liberal amounts of daily olive oil and moderate amounts of wine. It’s from these observations that the “Mediterranean Diet” became known, and today many know the diet best for specific foods in the traditional eating pattern like extra-virgin olive oil, spinach, beans, nuts, herbs and red wine. There is no doubt that the inclusion of specific foods and food groups plays a role in the diet’s health benefits, as does the avoidance and minimization of processed foods, high-fat red meats, added sugars, refined oils, and trans-fats. However, researchers are quick to point out that the diet’s health benefits appear to be a synergistic effect from the overall food pattern. No one or two foods or nutrients can by themselves offer the benefits of the Mediterranean Diet: it’s the balance and combination of foods.
There are other aspects of the traditional lifestyle that may play into these synergistic effects. Leading an active lifestyle plays a role, and foods are incorporated based in locality, seasonality, cultural customs and traditions, and the use of whole foods meant meals required preparation and cooking. Mealtimes were a time to gather for conversation with family or friends. Even though these aspects are difficult to measure, they likely played a role in reducing health risks.
Most of the diet’s benefits appear to stem from the emphasis on plant foods and the overall fat composition. The traditional Mediterranean food pattern is a plant-focused approach where meals are centered around whole or minimally processed vegetables, fruits, legumes, whole grains, nuts and seeds. This pattern not only promotes higher fiber intake but also higher intake of antioxidants and phytochemicals (beneficial bioactive compounds found in plants). In terms of fat, a traditional Mediterranean diet often falls within the upper end of the recommendation (30-35 percent of calories from fat), with the majority coming from unsaturated fat thanks to the daily consumption of olive oil as well as fats in avocados, nuts and seeds. The diet’s low to moderate inclusion of dairy products and animal proteins keeps saturated fat intake low, and the consumption of fish and seafood provides beneficial omega-3 fatty acids.
The Mediterranean diet was “discovered” because of its impact on heart disease, and research continues to support the protective and therapeutic effects it can have on heart health. The benefits are likely due to the anti-inflammatory effects of antioxidants in produce, phytochemicals in plant foods and olive oil, omega-3 fatty acids and the lack of inflammatory ingredients like added sweeteners like high fructose corn syrup. These components are associated with improving risk factors like blood pressure and lipid values that in turn lower the risk of cardiovascular diseases, including heart attacks and strokes. These same anti-inflammatory effects also appear to be why the diet offers benefits beyond heart health. This way of eating appears to increase longevity and can be an effective way to lose weight. It also appears to aid in the management of autoimmune diseases and offer protective and therapeutic benefits for other health conditions.
Cardiovascular disease and type 2 diabetes (T2DM) share many of the same risk factors (obesity, abdominal area body fat, inactivity, low HDL cholesterol and high triglycerides). Following a Mediterranean style of eating has been shown to be beneficial for the prevention and management of T2DM, including a reduction in body weight, especially abdominal adiposity, improving insulin resistance, and reducing blood glucose/A1c and triglyceride levels. The diet may also reduce the risk for developing cancer, as the eating pattern is associated with reduced risk for all cancers but especially for cancers of the GI tract, followed by breast, head and neck cancers. Risk is lowered for all cancer in adults 30 years and older, with a risk reduction even stronger among women.
The Mediterranean diet’s combination of antioxidants, anti-inflammatory compounds, and omega-3 fatty acids promotes optimal brain functioning and offers a protective effect when it comes to memory, cognition and mental health conditions like depression. Higher adherence to a Mediterranean food plan is associated with a lower risk for depression and cognitive decline and is positively associated with memory. A variation of the Mediterranean diet known as the MIND diet has also made waves in recent years, suggesting the diet’s potential to slow cognitive decline as well as degenerative brain diseases like Alzheimer’s. The MIND diet is patterned after both the Mediterranean and DASH (Dietary Approaches to Systolic Hypertension), diet plans and emphasizes key foods such as berries and leafy greens that may have a greater influence on the brain as compared to other types of produce. Findings suggest that individuals who had the greatest adherence to the MIND diet showed significantly slower cognitive decline and a significantly lower risk of developing Alzheimer’s disease.
It's rare to find a nutrition or diet topic where there’s an almost overwhelming consensus among both research findings and healthcare providers, but the Mediterranean diet is one exception. It’s difficult to deny the potential benefits that this approach to dining may offer.
Carolyn Williams, PhD, RD