Meet the Mediterranean Diet

Ah, the Mediterranean. A place known by many for captivating coastlines, awe-inspiring architecture, and countless museums holding treasures of ancient civilizations. Not to mention all the delicious delicacies this region of the world has to offer! Often for healthcare professionals, however, the first thing that comes to mind when someone says “Mediterranean” is the Mediterranean Diet.

Mediterranean History

As social studies classes throughout elementary school taught us, the Mediterranean Basin was home to some of the world’s oldest and longest lasting civilizations. It makes sense then, that the first traces of the “Mediterranean Diet” were found in ancient Roman civilizations of this region, whose diets consisted mainly of bread, wine, and oils. Along with these diet staples that the rolling hills abundantly provided, the seafood of the Mediterranean Sea was a great source of protein for this area’s inhabitants.

An artistic depiction of the Mediterranean Basin.

As time passed, the ancient Roman Empire expanded its reach and encountered many other civilizations with unique religions, cultures, and ways of eating. From clashing with Germanic tribes to Islamic nations providing new and accessible fruits and vegetables, the Mediterranean diet of the ancients began to slowly evolve. Another significant event in the development of this diet was the discovery of the Americas by Mediterranean nations.

It is interesting to think that while the America’s tomato was once thought to be an inedible exotic plant, it would eventually become a staple in and symbol of Mediterranean fare. Thus, through influence and transformation, the foods of the Mediterranean Sea shifted from those four staple items into the classic Mediterranean Diet pattern we know and love today.

The Mediterranean Mystery

But why do we know of the Mediterranean Diet at all? What makes the Mediterranean any better than the Indian Ocean or the Arabian Sea? Well, healthcare professionals first realized there was something special about the diet of people in the Mediterranean in the 1950’s when a Minnesotan physiologist, Ansel Keys, decided to dive into the mystery of what was causing cardiovascular disease. Through the “Seven Countries Study”, Keys followed 12,000 men for 15 years to observe the potential effects their diets and lifestyle behaviors had on rates of cardiovascular disease.

Ancel Keys on Time magazine's January cover in 1961.

The results of the study indicated not only that saturated fat intake was strongly linked to incidences of heart attacks, but also that populations adhering to the Mediterranean Diet had the lowest rates of cardiovascular disease out of all those studied. This relationship that started with a hunch from Ansel Keys back in the mid-twentieth century has now been explored and examined countless times by researchers throughout the world of science and health. The resulting evidence base strongly suggests that the Mediterranean Diet pattern has great potential to lower risks for cardiovascular disease, and its use in the treatment and prevention of countless other diseases are still being investigated.

It is important to address a final note regarding Ansel Keys and his Seven Countries Study. In the years since his death, many individuals have questioned the validity of the data collection methods and the data included in the final results of this study. In 2017, however, a white paper commissioned by the True Health Initiative was created in order to address these claims and misconceptions, reinforcing the data Keys collected and the conclusions he arrived at.

The Mediterranean Diet pattern can be seen in this pyramid image. It has several distinguishing features that contribute to its significant health benefits. Starting at the bottom, one can see that the foundation of the pyramid is built with an emphasis on frequent physical activity and social connections throughout life, and especially during mealtimes. The next tier showcases the colorful variety of food items that should create the base of every meal, and are included in the diet daily. Such items include:

Fresh and seasonal fruits and vegetables
Whole grains
Olive oil
Plant protein sources including beans, nuts, legumes and seeds
Seasonings like herbs and spices

The third tier shows the main animal protein in the diet in the form of fish and other types of seafood, which should be eaten at least two times per week. The final two levels of the pyramid describing the Mediterranean Diet call for poultry, eggs, and dairy products to be consumed in moderate portions anywhere from daily to weekly, and for all other meats and sweets to be consumed rarely. It is important to note that while water is given as the main beverage to be consumed on the diet, wine is also seen as a unique part of the Mediterranean Diet when consumed in moderation.

Throughout my remaining blog posts, I will be focusing in on some of the unique or significant qualities of the Mediterranean diet that make it so beneficial. These topics will highlight the Mediterranean diet’s inclusion of:

Daily consumption of seasonal fruits and vegetables, including plant proteins
Daily use of olive oil
Preference for seafood over other forms of animal proteins
The two main beverage suggestions, water and wine

Including any one of these habits in the diet has the potential to positively impact health and wellbeing. However, when multiple factors are combined, like they are in the Mediterranean Diet, the possibilities for health improvement abound. So, without further adieu, let’s dive into the magic of the Mediterranean Diet!

References

Altomare, R., Cacciabaudo, F., Damiano, G., Palumbo, V. D., Gioviale, M. C., Bellavia, M., … Lo Monte, A. I. (2013). The mediterranean diet: a history of health. Iranian Journal of Public Health, 42(5), 449–457.

Brody, J. E. (2004, November 22). Dr. Ancel Keys, 100, Promoter of Mediterranean Diet, Dies. The New York Times, 10. Retrieved from https://www.nytimes.com/2004/11/23/obituaries/dr-ancel-keys-100-promoter-of-mediterranean-diet-dies.html