More accolades for the Mediterranean Diet

Our appreciation and understanding of the traditional Mediterranean Diet helped shift the nutrition paradigm from emphasizing “low-fat” diets to “good fats” after researchers, including the famous physiologist, Ancel Keys, noticed in the 1960s that populations consuming a high-fat, plant-based diet in Crete and Italy had less heart disease than those in other parts of the world.

Now that the Mediterranean Diet’s heart-healthy reputation is well established, experts are encouraging people to eat more of the diet’s cornerstone foods to improve other health outcomes, including weight loss, cancer prevention and even brain health.

And the benefits of a high-fat, plant-based Mediterranean Diet go well beyond nutrition — they extend to our planet and cultural heritage as well.

Heart health

The Mediterranean Diet’s inclusion of good fats from olive oil, nuts, seeds, avocados and fatty fish has been endorsed by the American Heart Association and the U.S. Department of Agriculture’s Dietary Guidelines for Americans 2015-2020 as an example of a heart healthy diet plan.

Olives are a key nutritional resource for the Mediterranean region (Italy, Spain, Greece), and olives and olive oils are found in recipes throughout the region. Olive oil’s healthful reputation comes from both the type of fat it contains (monounsaturated) and the high levels of antioxidants in the olives. Together, these nutrients improve blood flow, strengthen blood vessels, prevent oxidation of cholesterol in the blood, and improve our blood cholesterol levels — so it’s no surprise that the olive oil-rich Mediterranean Diet helps prevent heart attacks.

Evidence supports consuming 3 to 4 tablespoons of extra virgin olive oil each day to maximize the health benefits of this healthy fat. (See page 4 for tips for choosing and storing good extra virgin olive oils, as well as a few of our favorites at PCC. Our recipes on page 5 provide delicious inspiration!)

Eat fat to lose weight

“The fear of weight gain from high-fat foods needs no longer be an obstacle to adherence to a dietary pattern such as the Mediterranean Diet.” That was the conclusion of a 2016 analysis of the PREDIMED study, finding that a high-fat Mediterranean Diet helped prevent weight gain, when compared to those struggling with a low-fat diet. The high-fat Mediterranean Diet supplemented with olive oil especially was helpful in preventing abdominal fat, which is most strongly associated with chronic health problems.

A 2017 study found that a high-fat Mediterranean Diet also can help reduce the chronic pain often associated with obesity. The healthful fats and phytonutrients found in fatty fish and plant proteins such as nuts and beans were key in reducing the inflammation (related to obesity) that results in chronic pain. A Mediterranean Diet, in other words, helps prevent and alleviate the health impacts of obesity.

More health conditions

The more we learn, the better the Mediterranean Diet appears to be for a variety of health outcomes. Researchers continue to find that the Mediterranean Diet potentially is helpful in a wide range of conditions, from diabetes and bone health to sperm quality and fertility.

A study published in the International Journal of Cancer in March made headlines when it found that post-menopausal estrogen-receptor-negative breast cancer was 40 percent less prevalent in those who adhered closely to the Mediterranean Diet.

Researchers also are exploring the potential benefits of a Mediterranean Diet on a range of cognitive and mood related conditions, including Alzheimer’s, ADHD and depression. A high-fat Mediterranean Diet has been shown to reduce the brain shrinkage that is associated with cognitive decline as we age.

Longevity

As we reported in 2016 (“Are whole grains the secret to living longer?”) the Mediterranean region is home to several of the world’s “Blue Zones” where the local population is most likely to live to 100. Italy and Greece are the two nations most associated with the traditional Mediterranean Diet, and both nations are renowned for their longevity.

In March, Bloomberg’s Global Health Index of 163 countries showed that Italy is home to the world’s healthiest people. “A baby born in Italy,” says the report, “can expect to live to be an octogenarian,” with far less incidence of high blood pressure than the United States, UK or Canada. Meanwhile the United States ranked 34 — and is one of the world’s heaviest nations. We appear to have a lot to learn about health from Mediterranean nations.

A sustainable diet

In 2015 the Food and Agriculture Organization (FAO) acknowledged that the Mediterranean Diet wasn’t just good for our health, but also for the planet.

“The Mediterranean Diet is widely considered as a healthy dietary pattern and a greater adherence to the Mediterranean Diet has been associated with significant improvements in health and nutritional status. It also has been recognized as a sustainable diet because of its lower environmental impact.”

Research indicates a high-fat Mediterranean Diet can help prevent weight gain

The FAO report expressed concern about the impact of globalization on the traditional diet of the Mediterranean region, and the need to “preserve the cultural heritage of the Mediterranean Diet” to support a more sustainable food system. The traditional Mediterranean Diet embodies multiple principles of sustainable diets: a plant-based diet, emphasizing unprocessed whole foods, rooted in a traditional cuisine that is reflective of local food products.

Food culture

The traditional Mediterranean Diet observed by Ancel Keys in Crete and Italy was a part of an overall lifestyle where food practices are integrated into the culture. This healthy Mediterranean lifestyle also included working outside, social interactions, communal meals, moderate alcohol consumption and a deep appreciation of local foods.

The Mediterranean Diet also has been acknowledged as part of the cultural heritage of humanity by the United Nations Educational, Scientific and Cultural Organization (UNESCO). In 2013 UNESCO stated that “eating together is the foundation of the cultural identity and continuity of communities through the Mediterranean basin,” highlighting the cultural and social implications of the Mediterranean Diet.

In the United States we use the word “diet” to describe a restrictive way of eating, such as following a low-fat diet, or consuming diet sodas, or not eating a specific food group because of a restrictive diet (vegan, gluten free, etc.). But the word “diet” comes to us from the Greek word diaita, which translates to “a way of life,” or a prescribed way of life that includes food and other lifestyle habits including sleep, work, activity and place of residence.

If we truly want to appreciate the Mediterranean Diet and its health benefits, perhaps we should pay attention not just to the foods consumed in the region, but also to the attitude toward food and diet found in the Mediterranean.

Today’s nutrition paradigm is undergoing another shift and seems to be taking a big lead from the Mediterranean Diet. We’re finally revising our outlook as evidence becomes more supportive of diets plentiful in healthy fats but low in added sugars and processed foods. This new outlook on healthful diets, combined with the public’s increasing demand for sustainable food systems and traditional cuisines, appears to suggest we still have a lot to gain from deepening our appreciation and understanding of the Mediterranean Diet.

Nick Rose is a nutrition educator at PCC.