Mediterranean diet

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This article is about the dietary recommendation that became popular in the 1990s. For food of the areas around the Mediterranean Sea, see Mediterranean cuisine.
Mediterranean diet
Gazpacho ingredients.jpg
Olive oil and vegetables
Criteria R1, R2, R3, R4, R5
Reference 884
Inscription history
Inscription 2013

The Mediterranean diet is a modern nutritional recommendation originally inspired by the dietary patterns of Greece, Southern Italy, and Spain in the 1940s and 1950s.[1] The principal aspects of this diet include proportionally high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of non-fish meat and non-fish meat products.[2]

There is tentative evidence that the Mediterranean diet lowers the risk of heart disease and early death.[3][4]

Health effects

The Mediterranean diet was estimated to decrease the risk of death by 9%.[4] A 2016 review found similar weight loss as other diets.[5]

Dietary factors may be only part of the reason for health benefits gained by certain Mediterranean cultures. Physically active lifestyle, lower body mass index, cessation of smoking and moderate alcohol consumption also may contribute.[6]

Heart disease

One meta-analysis of prospective cohort studies reported a 9% decreased risk of dying from cardiovascular disease among those who follow the Mediterranean diet.[4]

A 2011 systematic review found that a Mediterranean diet appeared to be more effective than a low-fat diet in bringing about long-term changes to cardiovascular risk factors, such as lowering cholesterol level and blood pressure.[7] A 2013 Cochrane review found limited evidence that a Mediterranean diet favorably affects cardiovascular risk factors.[8]

A meta-analysis in 2013 compared Mediterranean, vegan, vegetarian, low-glycemic index, low-carbohydrate, high-fiber, and high-protein diets with control diets. The research concluded that Mediterranean, low-carbohydrate, low-glycemic index, and high-protein diets are effective in improving markers of risk for cardiovascular disease and diabetes.[9]

The Mediterranean diet often is cited as beneficial for being low in saturated fat and high in monounsaturated fat and dietary fiber. One of the main explanations is thought to be the health effects of olive oil included in the Mediterranean diet. A 2014 meta-analysis concluded that an elevated consumption of olive oil is associated with reduced risk of all-cause mortality, cardiovascular events and stroke, while monounsaturated fatty acids of mixed animal and plant origin showed no significant effects.[10] Olive oil contains monounsaturated fats, most notably oleic acid, which is under clinical research for its potential health benefits.[11] Whereas there is preliminary evidence that regular consumption of olive oil may lower risk of all-cause mortality and several chronic diseases,[10][11] the only approved health claim for olive oil is for protection by its polyphenols against oxidation of blood lipids.[12]

Diabetes

In 2014, two meta-analyses found that the Mediterranean diet was associated with a decreased risk of type 2 diabetes.[13][14]

Cancer

A meta-analysis in 2008 found that strictly following the Mediterranean diet reduced the risk of dying from cancer by 6%.[4]

Another 2014 systematic review and meta-analysis found that adherence to the Mediterranean diet was associated with a decreased risk of cancer mortality.[15]

Cognitive ability

According to a 2013 systematic review, greater adherence to a Mediterranean diet is associated with a lower risk of Alzheimer's disease and slower cognitive decline.[16] Another 2013 systematic review reached similar conclusions, and also found a negative association with the risk of progressing from mild cognitive impairment to Alzheimer's, but acknowledged that only a small number of studies had been done on the topic.[17] The decreased risk has been estimated at 13%.[4] It may also decrease other neurological disorders such as Parkinson's disease.[4]

Gluten

As the Mediterranean diet usually includes products containing gluten like pasta and bread, increasing use of the diet may have contributed to the growing rate of gluten-related disorders.[18][19]

Dietary components

Although there are many different “Mediterranean diets” among different countries and populations of the Mediterranean basin, because of ethnical, cultural, economical and religious diversities, the distinct Mediterranean diets generally include the same key components, in addition to regular physical activity:[20][21][22]

  • High intakes of extra virgin olive oil (as the principal source of fat), vegetables (including leafy green vegetables), fresh fruits (consumed as desserts or snacks), cereals (mostly wholegrains), nuts and legumes.
  • Moderate intakes of fish (especially marine blue species), seafood, poultry, dairy products (principally cheese and yogurt) and red wine (with the exception of Muslim populations).
  • Low intakes of eggs, red meat, processed meat and sweets.

Total fat in this diet is 25% to 35% of calories, with saturated fat at 8% or less of calories.[22]

In Northern Italy lard and butter are commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables.[23] In both North Africa and the Middle East, sheep's tail fat and rendered butter (samna) are traditional staple fats.[24]

In 2013, UNESCO added the Mediterranean diet to the Representative List of the Intangible Cultural Heritage of Humanity of Italy (promoter), Morocco, Spain, Portugal, Greece, Cyprus, and Croatia.[25][26]

History

The concept of a Mediterranean diet was developed to reflect "food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s".[22] Although it was first publicized in 1975 by the American biologist Ancel Keys and chemist Margaret Keys (his wife and collaborator),[27] the Mediterranean diet failed to gain widespread recognition until the 1990s. Objective data showing that Mediterranean diet is healthful originated from results of epidemiological studies in Naples and Madrid [28] confirmed later by the Seven Countries Study, with first publication in 1970,[29] and a book-length report in 1980.[30] The most commonly understood version of the Mediterranean diet was presented, among others, by Walter Willett of Harvard University's School of Public Health from the mid-1990s on.[31][32][33][34][35]

The Mediterranean diet is based on what from the point of view of mainstream nutrition is considered a paradox: although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found. A parallel phenomenon is known as the French Paradox.[36]

A diet rich in salads was promoted in England during the early Renaissance period by Giacomo Castelvetro in A Brief Account of the Fruits, Herbs, and Vegetables of Italy.[37]

Portugal

When Ancel Keys and his team of researchers studied and characterized the Mediterranean diet and compared it with the eating habits of the US and the most developed countries during that period, some identified it as the "Diet of the Poor". According to the famed Portuguese gastronomist Maria de Lourdes Modesto who met with Keys, Portugal was included in their observations and studies, and Keys considered Portugal had the most pure "Mediterranean" diet.[dubious – discuss] However, Salazar, the dictator of Portugal, did not want the name of Portugal included in the diet of the poor.[38]

Still today the name of the diet is not consensual among Portuguese gastronomists. After the Mediterranean diet became well-known, some studies evaluated the health benefits of the so-called "Atlantic diet", which is similar to Keys' "Mediterranean" diet, but with more fish, seafood, and fresh greens. Virgílio Gomes, a Portuguese professor and researcher on food history and gastronomy says, Portuguese cuisine is really an "Atlantic cuisine".[38] The Southern European Atlantic Diet is the traditional diet of Northern Portugal and Galicia (Spain), and has been associated with a lower risk of non-fatal acute myocardial infarction.[39]

See also

References

  1. ↑ Alberto Capatti et al., Italian Cuisine: A Cultural History, p. 106.; Silvano Serventi and Francoise Sabban, Pasta, p. 162.
  2. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  3. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Lua error in package.lua at line 80: module 'strict' not found.
  5. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  6. ↑ Cardiovascular disease risk factors: epidemiology and risk assessment. Dahlöf B. Am J Cardiol. 2010 Jan 4;105(1 Suppl):3A-9A. PMID 20102968
  7. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  8. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  9. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  10. ↑ 10.0 10.1 Lua error in package.lua at line 80: module 'strict' not found.
  11. ↑ 11.0 11.1 Lua error in package.lua at line 80: module 'strict' not found.
  12. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  13. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  14. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  15. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  16. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  17. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  18. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  19. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  20. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  21. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  22. ↑ 22.0 22.1 22.2 Lua error in package.lua at line 80: module 'strict' not found.
  23. ↑ Massimo Alberini, Giorgio Mistretta, Guida all'Italia gastronomica, Touring Club Italiano, 1984
  24. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  25. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  26. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  27. ↑ Ancel Keys, Margaret Keys, How to eat well and stay well the Mediterranean way, Doubleday, 1975
  28. ↑ * António José Marques da Silva, La diète méditerranéenne. Discours et pratiques alimentaires en Méditerranée (vol. 2), L'Harmattan, Paris, 2015 ISBN 978-2-343-06151-1, pp. 52-54
  29. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  30. ↑ Ancel Keys (ed), Seven Countries: A multivariate analysis of death and coronary heart disease, 1980. ISBN 0-674-80237-3.
  31. ↑ Lua error in package.lua at line 80: module 'strict' not found.Archived by Webcite
  32. ↑ "Health implications of Mediterranean diets in light of contemporary knowledge. 1. Plant foods and dairy products." Kushi LH, Lenart EB, Willett WC Am J Clin Nutr 1995 Jun;61(6 Suppl):1407S-1415S. PMID 7754996
  33. ↑ "Health implications of Mediterranean diets in light of contemporary knowledge. 2. Meat, wine, fats, and oils." Kushi LH, Lenart EB, Willett WC" Am J Clin Nutr 1995 Jun;61(6 Suppl):1416S-1427S. PMID 7754997
  34. ↑ "The Mediterranean diet: science and practice". Willett WC. Public Health Nutr. 2006 Feb;9(1A):105-10. PMID 16512956
  35. ↑ Walter C. Willett, Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating, Free Press. 2005. ISBN 0-7432-6642-0
  36. ↑ Bruno Simini (1 January 2000) "Serge Renaud: from French paradox to Cretan miracle" The Lancet 355:9197:48 doi:10.1016/S0140-6736(05)71990-5
  37. ↑ Castelvetro. G., The Fruits, Herbs, and Vegetables of Italy, London, Viking, 1989, translated from the original published in 1614.
  38. ↑ 38.0 38.1 Lua error in package.lua at line 80: module 'strict' not found.
  39. ↑ Lua error in package.lua at line 80: module 'strict' not found.

External links

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