What is the Mediterranean Diet?
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“Diet” and “dieting” have long been entangled in our societal norms, shaping how we perceive our bodies and health. As a result, there is a constant influx of new trends and fads, each touted to be the next “best” solution, only to fizzle out almost as quickly as they arise, trapping people in a relentless and vicious cycle. Our culture emphasizes achieving and maintaining a certain body shape and size rather than prioritizing holistic health measures; externally and internally, physically and mentally.
The purpose of this post is not to shame or endorse diets or dieting. I am not an expert or certified in nutrition, but I have personally experienced the ups and downs of going through the cycle. Rather, I aim to provide accessible information and education about a way of eating characterized by the Mediterranean diet.
I know you may be thinking “Well, isn’t the topic ‘Mediterranean diet’ still a diet?” Unlike traditional diets, the Mediterranean approach emphasizes healthful eating patterns by prioritizing whole, nutrient-dense foods to lead a healthy and balanced lifestyle. In other words, focusing on eating behaviors and patterns rather than formulas. As always, speak with your doctor or a registered Dietitian to learn more about the diet and receive a customizable approach for your specific and unique dietary needs.
A plethora of studies showcase the expansive health benefits of the Mediterranean diet from improving cardiovascular health to supporting cognition. According to one source, following this way of eating may increase longevity and lead to happier, more fulfilled lives characterized in countries near and around the Mediterranean Sea. Evidence suggests that there is a strong correlation between eating behavior and activity with chronic diseases. It is important to note, that correlation does not mean causation as many intricacies and nuances are at play, requiring vast research.
What Exactly is the Mediterranean Diet?
At its core, the Mediterranean diet is a dietary pattern that prioritizes nutrient-dense foods and beverages. As referenced by the Cleveland Clinic, the Mediterranean diet emphasizes “plant-based foods and healthy fats - consumption of a variety of vegetables, fruits, and whole grains in conjunction with lean protein sources such as seafood.”
Nutrient-Dense Foods and Beverages
The Dietary Guidelines of Americans characterize a nutrient-dense food and beverage as a source containing “vitamins, minerals, and other health-promoting components with little added sugar, saturated fat, and sodium. Vegetables, fruits, whole grains, seafood, beans, lentils, unsalted nuts and seeds, fat-free or low-fat dairy products, and lean meats and poultry … are considered nutrient-dense.” Further, “a healthy dietary pattern consists of nutrient-dense foods and beverages across all food groups, in recommended amounts, and within caloric range” specific to each individual (Dietary Guidelines, IX).
Brief Background
The Mediterranean diet traces its origins to the eating patterns, behaviors, and traditions of regions surrounding the Mediterranean Sea and Persian Gulf. Items such as wine and olives were transported across the Mediterranean Basin, contributing to the dietary practices of the countries in the nearby regions. Influences from Judaism, Christianity, and Islam have helped shape the development and habits of the Mediterranean diet as referenced by Lăcătușu and colleagues.
American scientist, Ancel Keys, was the first to document the relationship between Mediterranean regions’ eating patterns and the prevalence of cardiovascular disease (CVD). After studying populations post World War II, Keys noted a decrease in heart attacks when famine plagued the regions. He went on to design the ‘Seven Countries Study’ examining diet, lifestyle, and medical data. The study identified Crete, Japan, and Corfu with the lowest incidences of heart attacks while Finland and the United States had the highest incidence rates. A strong relationship became apparent between CVD and the intake of saturated fat. For the medical community, these findings provided vital insight into understanding dietary patterns and overall lifestyle and disease risk across populations and cultures. Despite these findings, the Mediterranean Diet did not gain momentum until the 1990s. The Harvard School of Public Health provided support that showcases the prominence of this diet in countries such as Greece and Southern Italy. Health reports showcase lower rates of chronic diseases and life expectancy in these regions as opposed to their counterparts. “…includes daily intake of whole grains, olive oil, fruits, vegetables, beans, legumes, nuts and seeds (Harvard).”
The Mediterranean diet is rich in unsaturated fats, as these are the primary source of dietary fat, derived from staple sources such as olive oil, nuts, seeds, avocados, and fatty fish such as salmon which is rich in omega-3 fatty acids. Whole grains, fruits, vegetables, and legumes are integral components of the diet with less focus on poultry and red meat. Additionally, alcohol, mainly red wine, is enjoyed with meals. Despite there being variations in specific food choices and preparation across different surrounding regions to accommodate preferences and availability, the underlying principles of the Mediterranean diet remain consistent.
Three graphic representations articulate the Mediterranean Diet: 1) Oldway’s Preservation and Exchange Trust Pyramid, 2) Traditional Mediterranean Diet of the Greek Nutrition Guidelines, and 3) the Mediterranean Diet Foundation pyramid.
Health Benefits
Credit to Ancel Keys’ original findings and current literature, the Mediterranean diet is supported in having an integral role in reducing overall mortality and mitigating the onset of chronic diseases, such as CVD. Studies show that those who shape their eating patterns around the Mediterranean diet, see a reduction in inflammation and have success in managing blood sugar and body mass index. As referenced in an article published by the Harvard School of Medicine, stress and inflammation negatively impact the cells in our body leading to age-related diseases. Telomers, part of our DNA, shorten as we age - and long-length telomers have the capacity to serve as a protective agent against age-related diseases.
What are the health benefits?
The Mediterranean diet’s emphasis on nutrient-dense foods, boasting a variety of vitamins and minerals, has a positive impact on cognitive function and inflammation, thus supporting mood regulation and physical health and well-being.
Cardiovascular Health - Research suggests that the Mediterranean diet can significantly reduce the risk of CVD, stroke, and hypertension. This may be attributed to the emphasis on healthy fats, specifically unsaturated fats, namely, monounsaturated and polyunsaturated found in olive oils, fatty fish, nuts, and seeds. By integrating unsaturated fat sources in place of saturated fats, the diet can aid in lowering LDL (bad) cholesterol levels and aid in the reduction of inflammation in the body.
Weight Management - With a focus on nutrient-dense foods and a limited intake of saturated fats, the Mediterranean diet serves as an effective tool for managing weight. Research findings have shown that adherence to Mediterranean dietary patterns can protect against Type 2 Diabetes and aid in glycemic control, contributing to sustainable weight management long term.
Cognitive Function & Mental Health - Staples such as fruits, vegetables, whole grains, nuts, and seeds exhibit an abundance of antioxidants and anti-inflammatory properties supporting the notion that the Mediterranean diet is linked to improved cognitive function and mental well-being. Studies have suggested that these nutrients play a role in reducing oxidative damage and cell stress, which can help maintain telomere length and protect against age-related diseases. In the Nurses’ Health Study, participants following the Mediterranean Diet exhibited a reduction in the onset of Parkinson’s Disease.
Cancer Prevention - While the relationship between nutrition and cancer prevention is complex, current and future research remains optimistic in exploring and understanding the links. The Mediterranean diet has shown promise in reducing mortality and morbidity from cancer. The Lyon Diet Heart Study demonstrated these findings in both Swedish and United States populations. This has highlighted the potential benefits that can come from adopting these dietary and lifestyle patterns in primary and secondary cancer prevention.
Implementing the Mediterranean Diet
The Mediterranean diet’s emphasis on whole, nutrient-dense foods in conjunction with a balanced lifestyle makes it a powerful tool in promoting and maintaining overall health and well-being. By incorporating these dietary patterns into your daily life, or if you want to start slow, start with simple substitutions one meal at a time while enjoying the wide range of food options and health benefits.
Choose healthy fats - Investing in a good quality olive oil for cooking and drizzling over salads and vegetables, is paramount to adding flavor and unsaturated fats into your diet. Simply swap butter with olive oil in your skillet or on your toast.
Foods to consider: Extra Virgin Olive Oil, avocados, nuts, and seeds
Plant and Fruit Forward - Rather than planning your dish around a protein, focus on building a balanced plate that incorporates plenty of fruits and vegetables. Not only are these sources rich in vitamins and minerals, but they are packed with fiber, are a source of nourishing carbohydrates, and are satiating!
Foods to consider: Berries, citrus, pears, apples, dark leafy greens, potatoes, carrots, peppers, eggplant etc.
Whole Grains and Legumes - Unrefined grains should be opted for when possible, such as whole wheat or whole grain. Whole grains and legumes are a great source of additional protein, fiber, and nutrients such as Vitamin B complex, iron, zinc, and phosphorus just to name a few!
Foods to consider: Quinoa, old-fashioned oats, brown rice, whole wheat pita, lentils, black-eyed peas, pinto beans, etc.
Seafood and lean proteins - Protein is a pivotal macronutrient that is an essential building block for the body in addition to aiding several other functions such as cell repair. The main protein source in the Mediterranean diet is seafood with moderate poultry and limited red meat. Salmon and mackerel are great sources of omega-3 fatty acids.
Foods to consider: Salmon, mackerel, tuna, chicken, turkey, lamb - common red meat consumed in Greece
Reduced consumption of sodium - Use spices and herbs to enhance the flavor of your meals.
To consider: Lemon and/or lemon zest, garlic, oregano, thyme, dill, etc.
Mindful Eating - Take this time to enjoy being with friends and family, and observe what’s around you. In Greece, this is a time to socialize and share with those around you. The Mediterranean diet is not a way to restrict or cut out foods, rather, it’s about being attuned to the present moment and being aware of how you are feeling, mentally and physically. Consider asking yourself questions such as, “How hungry am I?,” “What tastes good?,” “What are the flavor profiles?”, “What energizes me or what makes me crash 30 minutes later?” Have grace with yourself and express gratitude for those around you and the food that sits before you.
The Mediterranean diet offers a balanced and sustainable approach to nutrition and is linked to numerous health benefits, including cardiovascular health, weight management, cognitive function, mental well-being, and cancer prevention. The emphasis on whole, nutrient-dense foods and healthy fats such as extra-virgin olive oil and salmon, coupled with moderate consumption of alcoholic beverages and an active lifestyle, aligns with the dietary and lifestyle recommendations for promoting optimal health and well-being. While further research is needed to fully understand the complexities of nutrition and health mechanisms, the existing evidence strongly signifies the adoption of Mediterranean eating behaviors for improved health outcomes and enhanced quality of life. If you’re curious about exploring the Mediterranean diet further, there are plenty of resources available from cookbooks to in-person and online communities.
Sources:
Dietary Guidelines for Americans 2020-2025, www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf. Accessed 27 Mar. 2024.
“Diet Review: Mediterranean Diet.” The Nutrition Source, 19 Apr. 2023, www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/.
Lăcătușu, Cristina-Mihaela, et al. “The Mediterranean diet: From an environment-driven food culture to an emerging medical prescription.” International Journal of Environmental Research and Public Health, vol. 16, no. 6, 15 Mar. 2019, p. 942, https://doi.org/10.3390/ijerph16060942.
professional, Cleveland Clinic medical. “Mediterranean Diet.” Cleveland Clinic, my.clevelandclinic.org/health/articles/16037-mediterranean-diet. Accessed 14 Feb. 2024.
