You’ve probably heard about the Mediterranean Diet. It’s likely the diet most rigorously studied and most promoted in health circles. And it’s consistently rated as the best diet out there.
What is the Mediterranean Diet?
Like its name, the Mediterranean Diet is based on food patterns of people living along the northern side of the Mediterranean Sea. It primarily consists of a high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets, along with wine in moderation. And it was this food pattern that likely began in Ancient Greece and Roman times.
But it wasn’t until the 1950s the health benefits of the Mediterranean Diet began to be realized. It was Ancel Keys who studied the diet as part of his Seven Countries Study. This study included Italy and Greece among other countries such as the United States, Japan, the Netherlands, Serbia, Finland, and the former Yugoslavia. The results of this study found people in Italy, Greece, Serbia and Japan had the lowest rates of heart disease compared to the other countries.
It’s important to note, the Mediterranean Diet focuses on types of food, not macronutrients such as fat, carbohydrate and protein. This type of diet is considered a food pattern diet. Years ago, most diets were focused on macronutrients, so we had low-fat diets, low-carb diets and high-protein diets, to name a few. With the realization it’s easier for people to focus on foods, rather than macronutrients, food pattern diets emerged. In fact, many popular diets, from plant-based to carnivore, are types of food pattern diets.
While the Mediterranean Diet doesn’t focus on macronutrients, it would be considered a high fat diet. It’s estimated the Mediterranean Diet has approximately 35% to 40% of its calories from fat. Higher than the traditional definition of a low-fat diet being <30% of calories from fat. Much of the fat comes from olive oil, other plant-based sources of fat and fatty fish, which are predominantly unsaturated fats. A modest amount of saturated fat is permitted from dairy and meats.
While suggestions the Mediterranean Diet may have health benefits began in the 1950s, it wasn’t until the Lyon Diet Heart Study was published in 1994 that evidence supported these claims. This was a randomized study over two years in people after they had a heart attack. It demonstrated the Mediterranean Diet was less likely to lead to another heart attack or death during the study period. A further follow-up after four years showed the Mediterranean Diet reduced the chances of early death by 56%.
About 25 years later, results of another randomized study showed the Mediterranean Diet was effective at preventing heart attacks and strokes in people without heart disease. These studies together, make the Mediterranean Diet the only diet that has been studied in a randomized trial looking at outcomes of early death and heart attacks. Since these early studies, the Mediterranean diet has been associated with weight loss, reduced cognitive decline and also less chances for dementia. There is also evidence to suggest it may help prevent certain cancers.
The benefits of the Mediterranean Diet are likely due to it having anti-inflammatory and anti-oxidant properties, high amounts of potassium, polyphenols and poly-unsaturated fats, as well as being rich in various vitamins and other nutrients. It also should be noted, the Mediterranean Diet has no highly processed foods. And any diet that focuses on whole foods is likely to be associated with better health compared to the typical Western diet.
Is the Mediterranean Diet for You?
The Mediterranean Diet is the only one that has been tested in long-term randomized studies. And because of that, it gets the a lot of publicity from a health perspective. But this doesn’t mean it’s necessarily the best diet around, it’s really the only one that’s been rigorously tested. Other diets may have similar benefits but just haven’t been studied. So is the Mediterranean Diet the best for you?
First, the Mediterranean Diet is a bit of a misleading name. Really, it’s a diet based on what people eat in Spain, Italy and Greece. This excludes the majority of the other 20 or so countries along the Mediterranean such as those from Northern Africa, Middle East, and Eastern Europe. Again, it doesn’t mean foods common to those countries are any less health.
The other consideration is that many of the foods are quite specific, such as olive oil and fatty fish. Not everyone likes these foods. And they may not be available everywhere. Or, if they are, they may be expensive. But it is possible to find local substitutes. For example, nuts or mustard seed oil can replace olive oil, soy can replace lentils or chickpeas, canned fish (salmon, herring, sardines, shellfish) can replace fresh fish.
But is this diet the best for you? It’s unlikely there’s a single diet that’s best for everyone. We’re all different, plus our tastes and financial circumstances differ. A diet is only good if one can follow it. And there can be many reasons why one diet is harder to follow than another. In the end, the key foundations of the Mediterranean Diet are plants (fruit, vegetables, legumes and complex grains), more unsaturated fats compared to saturated fats, and minimal highly processed foods.
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