The Mediterranean diet: definition:
The Mediterranean diet is defined as a healthy and sustainable diet that is based on the consumption of abundant plant based foods (fruit, vegetables, cereals, potatoes, beans, and seeds), olive oil as the main source of fat, a small amount of dairy products, low to moderate amount of fish and poultry, low amount of red meat, and low to moderate amount of red wine. It is the traditional eating pattern of people who live in the Mediterranean areas, including Greece, Italy and Spain. This diet is very low in saturated fats (<7-8% of energy) and it is high in antioxidants (>80%). For example, olive oil contains a lot of monounsaturated fatty acids (MUFA) which are healthy fats as well as oleic acid and vitamin E, which are strong antioxidants that protect the body against cardiovascular disease. Research suggests that it is beneficial to your health to consume olive oil over other sources of fat. As well as olive oil, fruit, vegetables and pulses have antioxidant properties and are highly nutritious.
The diet was very much used in the 1960s. However, nowadays there is evidence that people have switched to western diets which are based on the consumption of more animal protein and higher amounts of saturated fats. The adherence to the western diet has been associated with a higher risk for metabolic chronic diseases.
The Mediterranean diet pyramid:
The health benefits of the Mediterranean diet:
Let’s look at each component of the Mediterranean diet:
Olive oil: a very important study known as the PREvention con DIeta MEDiterranea (PREDIMED) conducted with 7447 high-risk participants for cardiovascular disease shows that 10 g/day of extra-virgin olive oil decreases the risk of cardiovascular problems by 10% and decreases the risk of mortality by 7%.
Cereals: they are a very good source of fibre which provides satiety. Aune et al., 2016 show that 90 g/day of whole cereals decrease the risk of cardiovascular disease by 22%. Another study conducted by Gil et al., (2011), that included a sample of 127,536 people, showed that the substitution of 5% of saturated fatty acids calories with an equivalent percentage of calories deriving from whole cereals carbohydrates reduced coronary heart disease risk by 9%.
Red wine: epidemiological studies have shown that a moderate consumption of alcohol is associated with a lower risk of cardiovascular disease.
Vegetable and fruit: they contain bioactive compounds and antioxidant agents that decrease the risk of cardiovascular disease. 200 g/day of fruit and vegetables reduce the risk of stroke and cardiovascular disease by 90%.
Overall, this diet, abundant in minimally processed plant-based foods, rich in monounsaturated fat from olive oil and lower in saturated fats, meat and dairy products, is an ideal nutritional model for cardiovascular health.
Sustainability:
The Mediterranean diet is a sustainable diet. This has been shown by several studies, as the diet is based on a high consumption of plant-based food and a low consumption of meat. As we know nowadays, plant-based diets have smaller water footprint and lower greenhouse gas emissions (GHG) than other dietary patterns. In an Italian study, adherence to the Mediterranean dietary pattern (MDP) was shown to significantly reduce the food environmental footprint on natural resources, especially for water consumption. Moreover, the diet encourages the use of local products such as seasonal fruit and vegetables and it is identified as a “hotspot” of biodiversity. People from the Southern part of Italy view this diet not only as an eating pattern but as a cultural way to gather the family, eat together and avoid food waste. It is therefore a sociocultural historical heritage linked to the lifestyle of Mediterranean people.
References:
Miguel, A., Gonzalez, M., Gea, A., Ruiz-Canela, M (2019). The Mediterranean diet and cardiovascular health. A critical review. Circulation Research, 124 pp. 779-798.
D’Alessandro, A., De Pergola, G (2018). The Mediterranean diet: its definition and evaluation of a priori dietary indexes in primary cardiovascular prevention. International Journal of Food Sciences and Nutrition.
S, Dernini., EM Berry, L Serra-Majem, C La Vecchia, R Capone, FX Medina, J Aranceta-Bartrina, R Belahsen, B Burlingame, G Calabrese, D Corella, LM Donini, D Lairon, A Meybeck, AG Pekcan, S Piscopo, A Yngve,A Trichopoulou (2016). Med. Diet 4.0: the Mediterranean diet with four sustainable benefits. Public Health Nutrition.
C Willet, W., Sacks, F., Trichopoulou, A., Drescher, G., Ferro-Luzzi, A., Helsing, E., Trichopoulous, D (1995). Mediterranean diet pyramid: a cultural model for healthy eating, 61 pp.140-146.
Huang, C., Sumpio, B., (2008). Olive Oil, The Mediterranean Diet, and Cardiovascular Health. Journal of the American College of Surgeons, 207 pp. 407-416.
Ros, E., Martinez-Gonzalez, M., Estruch, R., Salas-Salvado’, J., Fitò, M., Martinez, J., Corella, D (2014). Mediterranean diet and cardiovascular health: teachings of the PREDIMED study, pp. 330-336.
Aune, D., Keum, N., Giovanni, E., Fadnes, L., Boffetta, P., Greenwood, D., Tonstad, S., Vatten, L., Riboli, E., Norat, T (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. The British Medical Journal, p.353.
Gil, A., Ortega, R., Maldonado, J (2011). Wholegrain cereals and bread: a duet of the Mediterranean diet for the prevention of chronic diseases. Public Health Nutrition, 14(12A), pp. 2316-22.