The Mediterranean Diet: Nutribollox or evidence-based?

We hear it all the time; The Mediterranean Diet works- it’s a whole lifestyle approach, it helps weight loss and maintenance, it’s good for cognitive health and heart health, it reduces risk of diseases like type 2 diabetes and metabolic syndrome….As such, it is being widely recommended by public health bodies to Western populations.

But is it truly this magical?

Maybe not.

The Mediterranean Diet gained attention in the 1950s when Ancel Keys began The Seven Countries Study. The study claimed the Med Diet was the answer to worsening health in the West. The diet has remained popular among health professionals as a sustainable healthy lifestyle. The key components are high consumption of fruit, vegetables, grains, moderate alcohol consumption and limited meat and dairy intakes. The updated version of the Med Diet (2011) also takes into account other lifestyle factors that can influence our health, such as:

  • Physical activity

  • Sleep

  • Socialisation (i.e. eating and cooking with family and friends)

  • Buying, preparing and cooking our food (i.e. culinary activities)

The combination of a nutrient dense diet and the above lifestyle factors can certainly have a positive impact on our health, with research suggesting it can reduce our risk of cognitive decline (Valls-Pedret et al. 2015), including diseases such as Alzheimer’s and dementia, and certain cancers, such as gastric cancer (Praud et al. 2014).

Knowing this you may be surprised by the following stats:

  • Mild cognitive impairment affects an estimated 45% of Italians aged 65-84 (Scafato et al. 2010); while in the UK, 5-20% of over 65s are affected (Ray and Davidson 2014, for Age UK).

  • According to EUCAN (the International Agency for Cancer Research), gastric cancer incidence (number of times it occurs) and mortality (deaths as a result) rates are lower in the UK than in Italy, Spain, Greece and Croatia (although France has slightly lower rates than the UK).

So it seems as though the Mediterranean’s could do with taking their own advice! But was it truly their own advice? You may have noticed that the main principles of the Med Diet are similar to our own healthy eating guidelines (if you need a reminder, check out my “What is healthy?” Blog). That leads us into some problems with calling it the Med Diet:

  • The Mediterranean is a large geographical area and the countries it takes in have very different cultures, and therefore food preferences. E.G. the spice palette of Morocco is quite different to that of Italy although both are Mediterranean countries. Generalising the diet of such a large area is thus an inaccurate representation of true food intakes.

  • The Med Diet principles are based on research that began during the 1950s, when parts of Europe were in a recession. Therefore, the diet was likely to have been based on plant foods out of necessity rather than choice.

  • However, this does not account for the popularity of cured meats and cheeses in many parts of the Mediterranean, and the increase in diseases supposedly low among those who consume a Med Diet.

  • Moreover, the Med Diet has become popularised mostly by non-Mediterraneans. Key, who carried out the Seven Countries Study, was American and many research teams assessing the diet are based in the UK and USA. This may mean that the dietary interventions used in their research, based on the principles listed above, are not comparable to the diets of actual Mediterraneans. In fact, even studies on Mediterranean populations use these principles as indicators of a “good” diet, rather than assessing current food intakes in comparison to the so-called Med Diet. (i.e. nobody is checking that what we call the Med Diet is still the Med Diet and disease incidence indicates it is not!).

  • So, that means we are just recommending a healthy, balanced diet, but calling it Mediterranean because it is how the Mediterranean’s ate 50 years ago. Or, we may be just “cherry-picking” aspects of the Med Diet that fit in with our idea of a healthy diet in Western populations. However, it does seem to work well in our populations, perhaps due to it being perceived as a lifestyle approach (Phull 2015).

Key message:

Eating food perceived as Mediterranean will not magically reduce your disease risk. Yes, the overall message of the Med Diet is great; eat lots of plants, move more, eat less meat, have alcohol in moderation and socialise. But, this is just general healthy living guidance dressed up with an appealing name and some rules. (Because we all want to be gorgeous, tanned Mediterraneans and we love to have rules to follow!). Unfortunately, the truth is less sexy. No special books or foods are necessary; just eat a variety of foods, including veggies, fruit, fats, protein sources and wholegrains and make sure to get a good sleep, move regularly, and make time for friends and family.

Lots of love,

Little O x

#mediterraneandiet #meddiet #diet #dieting #health #healthyliving #healthydiet


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Protecting the public and promoting high standards in evidence-based science and professional practice of nutrition.

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