We have been told for two decades that eating like Italians, Spaniards, and Greeks is good for us, because epidemiological studies have shown that people from those Mediterranean countries have lower rates of heart disease. It was not possible, however, to tie those findings directly to their diets—until now.
The first major trial to actually test the Mediterranean diet’s direct effect on the number of heart attacks, strokes, and deaths suffered by participants, concluded that the diet reduced the risk of heart disease by a whopping 30 percent, according to a study published in the New England Journal of Medicine in February.
So what is a Mediterranean diet? The study defined it generally as a “high intake of olive oil, fruit, nuts, vegetables, and whole-grain cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.” The research involved 7,447 people in Spain who were randomly assigned to one of three groups—two that followed variations of the Mediterranean diet and a control group. Participants were not told to limit calories, nor were they encouraged to exercise or told to avoid it.
Five a Day More specifically, the two Mediterranean diet groups were told to eat at least three servings of fruits and two servings of vegetables every day, and to cook and eat a tomato sauce made with garlic, onion, and herbs at least twice a week. They were asked to eat fish and legumes, including beans, peas, and lentils, at least three times a week. Both groups were to eat white meat instead of red, and for those already used to drinking alcohol, to have a glass or two of wine with meals. Finally, both groups were advised to avoid commercially-made cookies, cakes, and pastries, and to limit their consumption of dairy products and processed foods, including processed meats such as sausage and ham.
Both of the Mediterranean diet groups were asked to increase their intake of extra-virgin olive oil and nuts, but in differing amounts. The first group was encouraged to consume at least 50 grams, or four tablespoons, per day of extra-virgin olive oil, both for cooking and to dress dishes. The second group was encouraged to consume 35 grams of nuts (walnuts, hazelnuts, and almonds) per day, equivalent to a large handful. The control group was simply asked to reduce fat intake, but was not directed to consume any foods in particular. Over the five-year course of the study, participants in the control group weren’t able to reduce their fat intake by much, so their diet mirrored that of the average modern European or American, including the consumption of processed foods and sweets.
Dramatic Results The results were so dramatic that the study was ended early on ethical grounds—the Mediterranean diet had such a profound positive health impact that researchers decided it was unethical to withhold the information from the control group. There was little difference in the positive results between the two Mediterranean diet groups.
It’s important to note that study participants were older (55–80 years old for men, 60–80 years old for women) and already had risk factors for heart disease, though none had yet developed it when the study began.
Researchers plan to follow up with a study aimed at people who are at lower risk, but many experts expect eating a Mediterranean diet will have a similar effect on them, and that its benefits would start in childhood.
So what should we take away from this study? Following a Mediterranean diet clearly promotes better health, especially if you are at risk for heart disease. Consume lots of fruit and veggies every day, and include whole-grain cereals (wheat, rice, oats, etc.) in your meals. Eat fish and legumes and avoid red meat. Make sure you consume at least 4 tablespoons of extra-virgin olive oil a day, or a handful of mixed nuts, including walnuts, every day. Avoid processed foods and sweets. It may be advice we’ve heard before, but now there’s even more reason to heed it. And go ahead and have a glass of red wine with dinner, and toast to your good health!
Disclaimer: Always consult your healthcare professional before beginning a new exercise or diet regime. _________________
Rebecca Taggart is a San Francisco-based writer, teacher, and yoga instructor.