The Mediterranean diet is among the most famous dietary patterns in the world and one that has been studied repeatedly in relation to several aspects of human health. But it is not just a list of nutritional guidelines. It is a complete system of life, with principles that apply not just to food preparation and consumption but also to farming, stock raising, food preservation, always with respect to nature, seasons and traditions.
“The Mediterranean diet involves a set of skills, knowledge, rituals, symbols and traditions concerning crops, harvesting, fishing, animal husbandry, conservation, processing, cooking, and particularly the sharing and consumption of food. Eating together is the foundation of the cultural identity and continuity of communities throughout the Mediterranean basin. It is a moment of social exchange and communication, an affirmation and renewal of family, group or community identity.”
(Quoted from Unesco’s declaration on the Mediterranean Diet as an Intangible Cultural Heritage of Humanity, after its inscription in 2013 on the Representative List of the Intangible Cultural Heritage of Humanity.)
The Mediterranean diet is, indeed a legacy, left to us by our wise ancestors. The countries around the Mediterranean basin, despite their cultural differences, share a long past of traditions regarding food and lifestyle with many common characteristics.
The History of the Mediterranean Diet
The history of the principles of the Mediterranean Diet goes way back into the ancient years. The Mediterranean basin has been the cradle for many civilizations and the starting point for many agricultural activities such as cereal cultivation and the production of olive oil. The Greeks, Romans and Phoenicians cultivated the three main plants which comprise the foundation of the Mediterranean Diet: olive trees, wheat and grapevines. The production of olive oil, bread-making and the fermentation of grapes into wine were typical processes of the food-related history of those countries and also significant symbols of their cultures. Bread symbolized agriculture and human civilization and olive oil was the identity of the Mediterranean lands. The above cultivating and food-processing practices were spread to most Eastern and Western Mediterranean countries. And the concept that is known to us today as the Mediterranean Diet is one of the most significant achievement of these civilizations.
However, it wasn’t until the 1950’s that the term “Mediterranean Diet” was originally conceived. It was first used by Ansel Keys, an American physiologist who studied the effect of diet on health. In his “Seven Countries Study”, he investigated diet and lifestyle along with other risk factors for cardiovascular disease, across contrasting countries and cultures and over an extended period of time. These countries were the USA, Finland, former Yugoslavia, the Netherlands, Japan, Italy and Greece. The Seven Countries Study included four Mediterranean cohorts: Crete and Corfu in Greece, Dalmatia in Croatia (then, part of former Yugoslavia) and Montegiorgio in Italy. In the 1960s the Greek diet had the highest content of olive oil and was high in fruit, the Dalmatian diet was highest in fish and the Italian diet was high in vegetables. In line with their diet, these cohorts were characterized by low mortality rates from CHD (Coronary Heart Disease). Ancel Keys was the first researcher who associated the traditional Mediterranean diet with a low risk of CHD.
In 2007, the Ministers of Agriculture of Spain, Greece, Italy and France announced to the Agriculture and Fisheries Council of the EU, their initiative to highlight the values of the Mediterranean Diet and requested the inclusion of the Mediterranean Diet on UNESCO’s list of Intangible Cultural Heritage of Humanity. One year later, Greece, Italy, Morocco and Spain submitted the transnational nomination file to UNESCO.
On November 16, 2010, UNESCO’s committee decided to include the Mediterranean Diet in the Representative List of Intangible Cultural Heritage of Humanity and declared Koroni (on behalf of Greece), Cilento (on behalf of Italy), Chefchaouen (on behalf of Morocco) and Soria (on behalf of Spain) as Emblematic Communities. On December 4, 2013, the final inscription of the Mediterranean Diet on the UNESCO Representative List of the Intangible Cultural Heritage of Humanity was made and three more countries were added to the multinational group, along with their own Emblematic Communities: Agros (on behalf of Cyprus), Brač and Hvar (on behalf of Croatia) and Tavira (on behalf of Portugal). Each country selected an emblematic community in order to describe the Mediterranean Diet on its territory, as a way of life and fruit of constant sharing. Emblematic communities were selected in a symbolic way, as examples of communities that maintain and preserve the Mediterranean Diet in their respective countries.
The health benefits of the Mediterranean Diet
Ever since the first use of the term by Ansel Keys until today, the Mediterranean Diet has become the object of numerous studies which have tried to identify the correlation between diet, lifestyle and several health conditions. Most of the findings come to prove that adherence to the principles of the Mediterranean Diet is a strong foundation for longevity, overall health and well-being.
Below you can find some of the most important results from the substantial number of studies and meta-analyses that have been conducted on the health benefits of the Mediterranean Diet.
- It has a cardioprotective role which substantially lowers the risks for cardiovascular disease and coronary heart disease. Compared to a low-fat diet, it has much more beneficial effects on the risk factors. Adherence to a Mediterranean-style dietary pattern was also associated with better quality of life and lower all-cause mortality in patients with cardiovascular disease.
- It protects from several types of cancer and reduces overall cancer risk.
- It is associated with a reduced risk of type 2 diabetes and it is considered a suitable dietary model for diabetes patients as studies have associated the Mediterranean Diet with better adherence to diabetic nutritional guidelines.
- It reduces the risk of obesity and it plays a significant role in maintaining metabolic health for people who are already overweight or obese.
- It protects from major chronic degenerative and neurodegenerative diseases, like cognitive impairment, dementia, and Alzheimer’s disease.
- It enriches the gut microbiota with bacteria that promote an anti-inflammatory environment. Therefore, it can be used in the prevention and treatment of gut-related diseases.
- It has been shown to reduce the risk of rheumatoid arthritis and osteoarthritis.
- It reduces the risk of depression.
- It promotes longevity. Studies have shown that greater adherence to the Mediterranean diet is associated with a significant reduction in total mortality. It also maximizes the prospects of survival in older people.
- It positively affects overall sleep quality and different parameters of sleep, such asleep duration, daytime sleepiness, and insomnia symptoms.
The nutritional value of the Mediterranean Diet
One of the conclusions of the Seven Countries Study was that coronary heart disease death rates were much lower in areas that had olive oil as the main dietary fat. A diet rich in plant foods like fruit, vegetables, cereals, legumes, nut, seeds and olive oil as the main dietary lipid seemed responsible for profound health benefits. In the years that followed, that notion was spread in the scientific community. The main mechanisms behind those benefits are the anti-inflammatory and anti-oxidative properties of the Mediterranean Diet. Many studies have tried to relate the individual effects of singular nutrients in the diet, and most of them have reached the conclusion that the whole dietary pattern, as well as the eating behavior and the certain lifestyle, all have a synergistic beneficial effect on health. Nevertheless, the key nutrients that are thought to contribute the most to its beneficiary role on health are:
- high levels of monounsaturated fatty acids (MUFAs) provided by the consumption of olive oil
- high levels of polyunsaturated fatty acids (PUFAs), especially n-3 fatty acids, mainly provided by the consumption of fish
- low levels of saturated fatty acids (SFAs), due to the low consumption of meat and the moderate consumption of dairy products
- no trans fatty acids (TFAs) from industrial sources, due to the absence of packaged foods
- high levels of plant-derived substances like dietary fiber, phytochemicals and vitamins
You can find even more information on the Mediterranean Diet by visiting the following websites:
https://ich.unesco.org/en/Rl/mediterranean-diet-00884
https://dietamediterranea.com/en/
References
– Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/20810976
– Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. https://www.ncbi.nlm.nih.gov/pubmed/16818923
– Epidemiology of cardiovascular risk factors in Greece: aims, design and baseline characteristics of the ATTICA study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC270056/
– Randomization to 6-month Mediterranean diet compared with a low-fat diet leads to improvement in Dietary Inflammatory Index scores in patients with coronary heart disease: the AUSMED Heart Trial https://www.sciencedirect.com/science/article/pii/S0271531717311053?utm_campaign=MCRED_HMS_FB_Nutrition&sf198569483=1
– The mediating role of Mediterranean diet on the association between Lp(a) levels and cardiovascular disease risk: A 10-year follow-up of the ATTICA study. https://www.ncbi.nlm.nih.gov/pubmed/30055165
– The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease. https://www.ncbi.nlm.nih.gov/pubmed/24172306
– Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis of observational studies. https://www.ncbi.nlm.nih.gov/pubmed/26471010
– Mediterranean dietary pattern and cancer risk in the EPIC cohort. https://www.ncbi.nlm.nih.gov/pubmed/21468044
– Impact of a Mediterranean Dietary Pattern and Its Components on Cardiovascular Risk Factors, Glucose Control, and Body Weight in People with Type 2 Diabetes: A Real-Life Study. https://www.ncbi.nlm.nih.gov/pubmed/30103444
– Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. https://www.ncbi.nlm.nih.gov/pubmed/18511765
– Adherence to the Mediterranean diet in metabolically healthy and unhealthy overweight and obese European adolescents: the HELENA study. https://www.ncbi.nlm.nih.gov/pubmed/30121807
– Association between the prevalence of obesity and adherence to the Mediterranean diet: the ATTICA study. https://www.ncbi.nlm.nih.gov/pubmed/16457990
– Mediterranean diet and mortality in the elderly: a prospective cohort study and a meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/30157978
– Adherence to a Mediterranean diet and survival in a Greek population. https://www.ncbi.nlm.nih.gov/pubmed/12826634
– Association of mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/24164735
– Mediterranean diet and risk for Alzheimer’s disease. https://www.ncbi.nlm.nih.gov/pubmed/16622828
– Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. https://www.ncbi.nlm.nih.gov/pubmed/23720230
– Mediterranean diet and risk of rheumatoid arthritis: a population-based case-control study. https://www.ncbi.nlm.nih.gov/pubmed/30092814
– Osteoarthritis and the Mediterranean Diet: A Systematic Review. https://www.ncbi.nlm.nih.gov/pubmed/30087302
– Mediterranean Diet and Sleep Features: A Systematic Review of Current Evidence. https://www.mdpi.com/2072-6643/16/2/282
– Mediterranean Diet to Prevent the Development of Colon Diseases: A Meta-Analysis of Gut Microbiota Studies. https://pubmed.ncbi.nlm.nih.gov/34209683/
