March 14, 2016
The Mediterranean Diet
When people imagine the Mediterranean region, pastoral images of ancient hill towns, picturesque island fishing villages, sunshine, warm smiling people, and of course good food and wine are often part of the picture. Not surprisingly, the “Mediterranean” diet is associated with the good things in life too–and perhaps a longer life in which to enjoy them. And while some (but not all) studies of the Mediterranean diet are indicative of longer life-spans, they are strongly associated with a healthier life, especially for people who suffer from cardiovascular disease, or are at risk of developing it.
Key components of the Mediterranean diet include:
- Mainly consuming a broad range of plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
- Using spices and herbs, especially those high in trace mineral and vitamin content rather than much salt
- Using olive oil rather than other oils or butter
- Consuming some lean red meat, but only two or three times a month
- Eating fish and/or poultry several times a week
- Drinking (mainly red wine) but always in moderation. This is entirely optional, especially if there are any problems associated with alcohol consumption–such as diabetes, alcoholism, liver problems or simply personal preference or religious belief.
- Sharing and enjoying meals with both family and friends
- Staying active–walking, dancing, swimming, playing sports, music, etc.
An extremely important aspect of this diet is the role that fresh vegetables, nuts and whole grains play in it. It’s an antioxidant rich diet where fats are mainly derived from nuts and olive oil rather than dairy products or meat. The least processed forms of olive oil contain antioxidants and help reduce LDL (low density) cholesterol associated with coronary diseases and many other illnesses. The nuts and oily types of fish in the diet also provide a regular supply of Omega-3 fatty acids that improve cardiovascular health by lowering blood sugars, decreasing blood clots, lowering blood pressure and strengthening the entire vascular system. The nuts, chicken and fish all provide a reasonable amount of high quality protein as well because they are nutrient dense. That is, it doesn’t take a lot of nuts or small oily fish to provide a solid amount of protein and healthy fats in a compact form.
Researchers have noticed that in many parts of the Mediterranean, especially where people adhere to traditional diets, life expectancy is quite long. Cardiovascular diseases are also less common than in other developed countries. Many clinical studies have been conducted to understand why this is so.
One of the most widely cited recent, large cohort studies was carefully conducted over nearly 5 years. Known as the PREDIMED study, it compared a low fat control group with two different Mediterranean diet subgroups–one with additional olive oil in their diet, and the other with additional nuts. The PREDIMED study generated many specific studies of various subgroups such as diabetics, or those with heart disease, and also contained some overall large scale findings.
A recent review of 5 of the major publications  showed that both of the Mediterranean groups fared much better than the low-fat diet group on virtually every measure, including not dropping out of the study (which many of the low-fat diet group did).
The Mediterranean diet was statistically significant for men in many ways, but generally not so much for women. Statistical significance means that a result is highly unlikely to be due to chance. In the broadest terms, the diet with extra nuts was marginally better than the one with increased amounts of olive oil–especially for those with what is called metabolic syndrome. This is a grouping of metabolic measures that combine to increase the risk of heart disease, stroke and diabetes. They include increased blood pressure, high blood sugar levels, abnormal cholesterol levels and abdominal obesity. Over the course of the five years, far fewer of those on the Mediterranean diet actually became diabetic than those on just the low fat diet. In one of the largest cohort comparisons (7,216 participants) the risk of death was significantly lower for those who consumed nuts compared to the other groups. This may be largely because those consuming Omega 3 rich diets had far fewer heart attacks than those of the other groups–and heart attacks are often fatal. The diet also has been shown to reverse metabolic syndrome markers by very large percentages in controlled comparisons.
One final factor associated with this diet is the ability of people to change their lifestyle and stay on it. In that respect, the Mediterranean diet tends to work. It is a traditional diet which emphasizes the social role that food (and moderate drink) play in helping people to lead fulfilling lives. It’s not a diet associated with denial, or dietary restriction of calories, but with lifestyle changes that improve overall health and life satisfaction through what people eat, and how they eat. It can lead to some gradual weight loss if people eat “sensibly” (not too much) and don’t drink very much (or any) alcohol, and avoid any sweets other than fresh fruits and some honey.
Overall, the Mediterranean Diet points to the simple fact that healthy eating should not be about living a dull, unfulfilling life. On the contrary, a focus on denial not only diminishes life itself, but it just doesn’t work. After reading through the comparisons, many readers may wonder why anyone actually stayed in the low-fat diet cohort during the entire course of study. Perhaps someone should have invited them over for a nice Mediterranean style dinner. Given the numbers of controls who left the study, maybe that’s just what happened: they gave up, called some friends, and finally just went out “for Italian”. Gunnars, Kris https://authoritynutrition.com/5-studies-on-the-mediterranean-diet/ November 2015