There always seems to be a “diet du jour” out there. In the ’70s and ’80s, it was Atkins; in the ’90s and early 2000s, it was South Beach. Today, people are embracing variations of the Paleo or Caveman diet, the Whole30 program, and dietary approaches that depend on protein shakes and vitamin supplements.
While some of these diets can, in fact, produce desired results, they can be hard to maintain unless you adopt a new lifestyle to support the change in the long-term.
Of all the diets and nutritional patterns studied to date, there is an effective lifestyle change that has been scientifically proven to produce major long-term health benefits: The Mediterranean diet. In fact, the Mediterranean diet has strong evidence showing that it can reduce your risk of:
The science behind the Mediterranean diet rises above the rest. Calling it a “diet” doesn’t accurately reflect what it is. It is a way of eating: a series of nutritional choices and a philosophy for eating. And it works.
The Mediterranean Diet
The Mediterranean diet is meant to mimic what has been eaten by people living along the Mediterranean Sea throughout history, specifically Greece, Crete, southern France, and parts of Italy. There is a strong emphasis on:
- Minimally processed whole grains
- Moderate wine consumption with dinner (Read here about the benefits and drawbacks of alcohol consumption.)
- Bakery goods (containing refined flour and sugar)
- Red and processed meats
The breakthrough Mediterranean diet study came in 1999 with the Lyon Heart Study. This study demonstrated that in a high-risk population—all subjects had already suffered a heart attack—those randomly assigned to a Mediterranean diet had a 70 percent relative risk reduction in:
- Heart attacks
- Cardiac deaths
- Overall deaths
This was true after two years and four years of follow up. Impressively, all of these results occurred without any significant change in participants’ LDL cholesterol levels, which are often assessed when evaluating the risk of future heart disease.
While there were significant concerns about this study (for instance dietary compliance information was available for less than half of the participants), it was still a statistically valid trial and provided strong evidence in favour of this style of eating, paving the way for future studies.
Four years after the Lyon Heart Study was published, the official Spanish agency for scientific research, Instituto de Salud Carlos III, funded the PREDIMED (Prevención con Dieta Mediterránea) study. In this study, subjects without pre-existing heart disease (a much lower-risk group than those who participated in the Lyon Heart study) were randomly assigned to one of three possible diets:
- Mediterranean diet with added extra-virgin olive oil (1 liter per week)
- Mediterranean diet with extra mixed nuts (30g per day)
- Control low-fat diet that was low in bakery goods and processed foods
Both Mediterranean diet intervention groups had a three percent reduced risk of cardiovascular disease over five years.
Other key findings from this study include:
- People found it easier to comply with the Mediterranean diet than they thought, and so the low drop-out rate contributed to the outcome. The drop-out rate in the low-fat control group was 11 percent compared to 4.9 percent in the Mediterranean diet.
- As in the Lyon Heart study, the benefits occurred without any significant reduction in LDL cholesterol. This is more evidence that LDL reduction is not the primary target for health. Rather, reducing cardiovascular risk with healthy lifestyles should be the ultimate goal.
- Other analyses have shown that both Mediterranean diet groups had a reduced risk of diabetes and cholesterol oxidation (less oxidation makes it less likely that it will lead to dangerous plaque formation)
The Lyon Heart and PREDIMED studies were randomized, controlled trials, and therefore represent the highest quality of evidence. There is also observational data showing that a greater adherence to a Mediterranean diet may promote healthy aging and also reduce the risk of:
Go Beyond the “Type” of Food
It is important to note that the above-mentioned studies did not focus on a single nutrient or a single food type. Instead, they investigated a cultural style of eating that went beyond just the categories of food they ate or did not eat.
It also included appropriate portion sizes, the freshness and quality of the ingredients, and the social environment and mindset of the individuals as they ate.
Based on this research, the logical conclusion is to follow a Mediterranean-style diet based on real foods with the following characteristics:
- Eat lots of fresh vegetables, fruit, nuts, olive oil, fish, avocados, and whole grains
- Avoid sweets, baked goods, processed meats, and processed foods
- Focus on higher quality ingredients and emphasize high-quality fat
- Eat appropriate portion sizes
- Be vigilant to avoid added sugars
It is empowering to know that a nutritional intervention such as this can lower your risk of cardiovascular disease, possibly even better than medications.
So in the end, will the Mediterranean diet save your life? According to the science, it just might.