Mediterranean Diet

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Some distinctions
During the last few years the Mediterranean Diet (Meddiet from now on) has ceased to be just the regional food pattern of a specific area. It became first chic, then a regular fad, for some people a passing fancy, and finally the object of scientific studies [1], including clinical intervention trials [2].

This is partly because of the attested benefit of this diet, partly because it was adopted by people outside the Mediterranean Basin, partly because it was adulterated by processed foods to the point of being in danger of extinction, but also partly because some people lay claim to the Meddiet by proudly proclaiming: "We eat potatoes too." To avoid this kind of confusion, but also in order to lay the foundations for a somewhat more serious discussion, it seems best to start by describing what the Meddiet is.

Historically, the Meddiet was defined as the nutrition culture, or food pattern if you like, originating around the triad of "olive-wheat-wine." This has become a cliche nowadays, that you are bound to read in any serious discussion of the Meddiet. But few people realize this was for the purposes of distinction from the Near Eastern triad of "seed oils-barley-beer." In other words, it served a historical and archeological purpose, and at least to that extent, both definition and distinction are certainly valid.

The nutritional angle
Nutritionally, however, this is both oversimplified and somewhat misleading. Other ancient peoples outside the Mediterranean Basin used wheat and wine, as for example the Egyptians and the Persians. The large majority of ancient Greeks and Romans ate also barley (alfita, maza), while wheat (sitos) was reserved for the wealthy and for days of feasting. By contrast, olive oil was and still is considered often diagnostic, because the olive tree does not normally grow at more than 200km from the shores of the Mediterranean and sometimes a lot less.

Yet the ancient Thracians and some Macedonians used animal fat and butter instead of olive oil, because the olive tree did not grow well in their lands, and even though some of these are right beside the Mediterranean Sea. On the other hand, Persia has used olive oil for a long time, and even though its western borders are a lot more than 200 km from the Mediterranean. Thus, although olive oil is a basic ingredient of the Meddiet, this fact alone cannot adequately define it.

Mediterranean diet definition
When we speak of the Meddiet, we usually mean a diet where,

  1. Olive oil is the principal fat, where the olive tree grows naturally. Olive oil has over 70 percent monounsaturated fatty acids, and makes up about 30-40 percent of total calories.
  2. A variety of cereal products, often whole-grained, are eaten mainly in the form of
    wheat bread, pasta or pita.
  3. There is a large consumption of fresh fruits and vegetables, the latter partly eaten raw in salads or as accompaniments of other dishes.
  4. Legumes or pulses are also eaten in large quantities, particularly so in winter.
  5. Dairy products mostly from sheep and goats are taken mainly in the form of yogurt and cheese and much less as milk.
  6. Dried fruits, seeds and nuts are traditionally eaten, especially during winter.
  7. Meat is eaten sparingly, and most of it is free ranging lamb and goat, often pork, and least of all beef, while fowl meat consumption is variable.
  8. Frequent consumption of fish, especially of fat varieties.
  9. Moderate wine often accompanies meals, except in Islamic countries.

Inconsistencies and benefits
Needless to say this has changed considerably during the last two decades, and especially during the 1990s. Now for example, the French and the Greeks are the biggest meat eaters of Europe. But this kind of meat eating hardly qualifies to be included under the rubric "Traditional Mediterranean Diet." Again, the Greeks are still the biggest consumers of olive oil in the world. But unlike the rest of the world, the consumption of olive oil in Greece is falling while that of seed oils is rising.

Similar inconsistencies may be voiced about a number of other foods. Nevertheless, the diet described above is still eaten in relatively isolated areas. Equally, by older people still attached to their traditional foods. And certainly, by informed persons who realize that the Meddiet may well be one of the most effective protections against the chronic degenerative diseases, which today are responsible for up to 8 out of 10 overall deaths in western societies.

This diet has proven itself superior to even the prudent diet of the American Health Association for the prevention of heart disease. Until the 1960s decade, the Greeks had the longest life span of all nations monitored by the WHO, and even today they are second only to the Japanese. But even more to the point, chronic degenerative diseases were appropriately low, which is what attracted health specialists and expert nutritionists to this diet in the first place.

The Meddiet before the recent accretions, may be portrayed by the pyramid shown.