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Mediterranean Diet

Updated: Jul 6, 2023

The Mediterranean Diet has been talked about a lot lately, and given all the confusion about different diets I think it’s important to understand what it is, and what it isn’t.

The Mediterranean Diet isn’t really a “diet”, exactly. In the 1940’s, a physiologist and scientist named Ancel Keyes, PhD, wanted to understand why American men were dying at an early age from heart attacks and strokes. He was a world-traveler, and had observed in his travels that men and women of other countries lived to very old ages.

Dr. Keyes embarked on the Seven Countries Study to look at lifestyles of men and women in seven countries (USA, Netherlands, Italy, Greece, Yugoslavia, Finland, and Japan) to see which group lived longer and healthier lives.

The most well-known finding from The Seven Countries Study was that men and women from groups adhering to a “Mediterranean diet” had a significantly lower risk of heart attacks.

What is this “Mediterranean diet”? In truth, it should really be called a “lifestyle”, as the very foundation of this program is being active and social in your community. Importantly, it’s less about what you do and how long you do it, but that you make activity and a social life part of your everyday life, and not smoke while doing it.

For example, the group with the best health would walk to the store or work, and visited neighbors and family on foot rather than by car. To be sure, the neighborhood was structured to allow citizens to live in this way.

The Mediterranean Diet contained mostly plant-based eating, but didn’t exclude meat. Instead, people who lived most healthfully ate much less red meat, more fish, and got protein from beans and legumes. Their diets also weren’t “low fat”, but they ate healthy fats in the form of olive oil, nuts, and avocados. These foods were more satisfying so they ate less, and contained many nutrients and minerals that are missing from most highly processed American foods.

The Mediterranean Diet also didn’t say you couldn’t eat sweets, but rather that you ate less sweets, more fruits, and less processed desserts. No one counted calories, weighed foods, or bought packaged meals. They chose foods that were fulfilling, satisfying, and delicious, but they also got daily exercise through their social and life activities.

Dr. Keyes lived to 104 years old and died in 2004. He and his wife wrote and published the first books on the Mediterranean Diet. When asked at his 100th birthday if he lived so long because of his lifestyle, he said, “Very likely, but no proof.”

In 2013 the New England Journal of Medicine published the “Predi-Med Trial”, a trial done in Spain with more than 7,000 participants. This is the largest and best study that we have which shows that participants who adhered to the diet most closely had the fewest vascular events in the form of strokes (no significant reduction in heart attacks).

The study has many problems and criticisms, mainly with study design. That said, it remains the largest and best study we have that shows such a benefit.

Since that study, more observational studies of “Blue Zones” support the Mediterranean lifestyle to improve health and longevity. That is why I encourage my clients to learn more about the Mediterranean lifestyle, and use it as a model for making healthier choices.

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