of the many fad diets that plague us, one of the most persistent also happens to be a balanced diet, backed by science. The Mediterranean diet, named for the cuisine associated with countries around the sea, promotes the consumption of foods that are high in fat, low in carbohydrates and little processed.
The diet is characterized by whole grains, abundant fruits and vegetables, olive oil as the main culinary fat, and proteins mainly from fish and legumes. But part of the success of the diet may come from a certain X factor, something that cannot be quantified or tested in a clinical setting.
Where does the Mediterranean diet come from?
Arguably, the Mediterranean diet has been around as long as humans lived and ate around the Mediterranean Sea. When and how it became a popular diet for the rest of the world is another story.
In 1958, American physiologist Ancel Keys launched the Study of seven countries. Keys aimed to find a relationship between diet and the prevalence of coronary heart disease in seven countries with contrasting lifestyles and diets: Greece, Italy, Spain, South Africa, Japan and Finland. One crucial connection she looked for was how dietary fat affected blood cholesterol levels. She found that participants from Japan, Greece and Italy had the lowest incidence of not only coronary heart disease but also all-cause mortality. Interestingly, the Japanese participants had a low-fat diet, while the Mediterranean groups (Greece and Italy) had a high-fat diet. In particular, the diet was effective in older people who did not smoke, exercised regularly, and drank alcohol moderately.
Beginning in the 1960s, what we now know as the Mediterranean diet took off.
What makes the Mediterranean diet healthy?
While the term “healthy” is relative, the pillars of this diet come from its emphasis on fresh fruits and vegetables, legumes, nuts and seeds, fatty fish, moderate alcohol consumption, and avoiding ultra-processed foods and sugars. The diet is high in monounsaturated fats, what most people call “healthy” fats, high in fiber, and has a low glycemic index.
In May 2022, an article published in The American Journal of Clinical Nutrition directly compared keto and mediterranean diets. In this study, 40 participants with prediabetes or type 2 diabetes spent 12 weeks on the Mediterranean diet and another 12 on the ketogenic diet. One of the study’s authors, Christopher Gardner, a Stanford University nutrition researcher, notes that during both diets, participants lost significant amounts of weight, had better control over their glucose levels, and had lower triglycerides (a value that reflects the fat content in the diet). blood), although the ketogenic portion had even lower triglycerides. On the other hand, the keto diet seemed to increase LDL cholesterol.
It was the follow-up that he found interesting. Twelve weeks after both test diets ended, Gardner and her team checked what dietary habits the participants were following. Most followed a more Mediterranean diet, which he believes is because the ketogenic diet is more restrictive.
Is there more to the Mediterranean diet than food?
As interesting as this comparison is, Gardner thinks something is missing from the discussion of why the Mediterranean diet works, and it has nothing to do with food.
Gardner recalls a publication called the Nutrition Action Healthletter from the Center for Science and the Public Interests. He recalls about 20 years ago, when fad diets were all the rage, the Healthletter cover story featured the diet.
“They said: ‘The Mediterranean is not just a diet, it’s a way of life,’” he says. The cover tells you Reverseit evoked Western European behaviors: walking for hours every day, eating a big lunch, taking a three-hour nap, meeting friends late at night for a light dinner and a glass of red wine.
The idea is that in addition to the food you eat, it is the way of eating and living. This image of the Mediterranean diet is about enjoying not just food but life itself. There is no need to restrict or ban certain foods, and eating is a joyous communal practice. The brilliant health benefits stem from the diet itself, as well as from living a highly connected, low-stress life.
However, Gardner points out, it’s hard to quantify things like joy. As such, it is difficult to test for multiple factors associated with life satisfaction in the same way that one tracks multiple macros in a diet.
But there is some support that there is more to a healthy diet than the food itself. This notion stems from what is now known as blue zones, or communities around the world where people live longer and healthier lives. Gardner recalls from the data that Blue Zones centenarians had two big things in common: a relaxed, physically active lifestyle, and beans. High in protein and fiber and low in fat, beans seem to make sense, and that can be easy to track. Even physical activity is easy to track. But the relative levels of relaxation and life satisfaction can be difficult to measure, since they affect diet.
“I can’t really randomly assign you to be at peace with yourself and with nature,” says Gardner.
Why is it still around?
According to Gardner, the key to this diet’s staying power is simple: “It tastes good.”
There is no need to sacrifice carbohydrates or fats. It’s flexible and inclusive, as Gardner points out, because the Mediterranean diet can encompass Greek, French, Italian, Turkish and Middle Eastern foods.
As recently as 2018, nutrition researchers are still investigating the science behind the Mediterranean diet. In 2013, the PREPARED (Prevention with Mediterranean Diet) the study that investigates the effects of the Mediterranean diet in more than 7,400 people is published. They found an inverse relationship between diet and cardiovascular disease risk, as Keys had done, and compared them to a group assigned a low-fat diet.
In 2018, the researchers modified their study after PREDIMED was withdrawn, although Gardner still considers the original article to be legitimate and influential. Moreover, the reissued document reached the same conclusions.
While it may still be a fad diet, the benefits of the Mediterranean diet lie in its non-restrictive nature and the value that not only is it possible to live a healthy life while enjoying food, but that it is, in fact, holistic.
