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What’s The Mediterranean Diet, Really?

So, I went to the one place that I knew best to answer this question. I picked up a copy of Mediterranean Diet For Dummies. It’s written by Rachel Berman MD — dietician and head of Family and Wellness brands at Dotdash Meredith such as Verywell Fit — and it seemed like the best place to start.

Here’s what she said:

“The Mediterranean diet is a way of life — one where you eat lots of fresh food and slow down. More technically, the Mediterranean diet is a modern set of guidelines inspired by traditional diet patterns of southern Italy, the Greek island of Crete, and other parts of Greece”

But that didn’t explain much for me.

Most healthy diets include “lots of fresh food” like fruits and vegetables, and avoid ultra-processed foods like McDonald’s french fries and sugary cereal.

But Rachel gave a more specific answer after a few pages:

“The Mediterranean Food Guide Pyramid is based on the dietary traditions of the Greek island of Crete, other parts of Greece, and southern Italy around 1960, when chronic diseases such as heart disease and cancer were low.”

Okay now we’re getting somewhere.

But what’s this Mediterranean Food Guide Pyramid?

Well, in 1993, Oldways (a nonprofit organization) created the Mediterranean Diet Pyramid – in partnership with the Harvard School of Public Health and the WHO – as a healthier alternative to the USDA’s original food pyramid.

So, most content you’ll read or watch about the Mediterranean diet is based on this food pyramid.

But that begs a question:

Which “diet” is this food pyramid based on?

We know this food pyramid is inspired by the “diet patterns of southern Italy, the Greek island of Crete, and other parts of Greece.” But what about the other countries in the mediterranean? Are their diets not considered the Mediterranean diet?

The Mediterranean Sea is surrounded by the coastlines of 21 countries — Algeria, Croatia, Cyprus, Egypt, France, Greece, Italy, Libya, Malta, Montenegro, and Spain to name just a few.Most of the region has a similar warm climate which gives them crops like olives, figs, and grapes.

But most of these regions developed their own cuisine using the similar food that grows there.

So, why is it that only food from southern Italy and Greece are considered mediterranean?

The answer to this question comes from the introduction of the Mediterranean diet to the US by Dr. Ancel Keys. You see, with rising heart attacks in the 1940s, Dr. Ancel Keys started his research on the cause of heart attacks.

This research is what is now known as the Seven Countries Study in which he found that serum cholesterol, blood pressure, diabetes and smoking are universal risk factors for coronary heart disease.

And that’s also when he started recommending the Mediterranean Diet based on how people ate in the 50s and 60s in Greece and Italy to help control these risk factors.

So, why Greece and Italy?

This is what I found in Dr Keys’ book How to Eat Well and Stay Well the Mediterranean Way published in 1975:

In many respects of culture, including diet, Greece, Italy, southern France, and the Mediterranean coastal region of Spain are in sharp contrast with the countries of North Africa. And therefore in these pages "Mediterranean," referring to people and cookery, must have a special definition. To assure cultural and culinary harmony, most of the native cookery of Africa must be ignored or given only token recognition with recipes for a few specialties such as couscous. Turkey and Lebanon are more Mediterranean in our sense but the cookery of those countries does not quite fit; too often the appeal is to a different palate. Israeli cookery, still in evolution as a blend of various kitchens dominated by the traditions of the former ghettos of Bast Europe, is even farther from what we think of as Mediterranean.

[…] As a matter of fact, it would be more appropriate to put a Greek label on our restricted definition of the Mediterranean, for the basic culture came from classical Greece.

So, Dr Ancel Keys arbitrarily decided to go with Greece and Italy.

He thought the American palate would prefer Greek and Italian cuisine over African or Middle Eastern cuisine.

And that’s the simple reason

.He could’ve also recommended Japanese cuisine as well — because his research showed that the Japanese also had very low levels of CVD — but he didn’t recommend it for the same reason: taste.

Living In The Blue Zone Of Sardinia

During our year-long stay in Sardinia, Italy — pursuing Italian citizenship through our ancestry (a story for another day) — my wife Daniela and I had the incredible opportunity to immerse ourselves in the Mediterranean lifestyle.

As the founders of LyfeFuel, we were eager to get a firsthand experience of life in one of the world's Blue Zones, known for the remarkable longevity of its residents. We wanted to learn if the mainstream media narrative of the Mediterranean diet matched the authentic day-to-day lives, culture, and food choices of this special region.

But it didn't go as we expected it to.

We discovered a profound contrast between the Sardinian approach to life versus the diet-obsessed culture we're accustomed to in the United States.

In Sardinia, we quickly realized that the Mediterranean diet was much more than a set of dietary rules. It was a holistic way of life that encompassed not only what people ate but also how they sourced their food, prepared their meals, and engaged with their community. We were struck by the absence of the meticulous food tracking and calorie counting that has become so prevalent in American diet culture. Instead of obsessing over portion sizes and macronutrient ratios, the Sardinians focused on the quality and freshness of their ingredients, taking pride in sourcing their food from local farmers, fishermen, and artisans.

One of the most memorable aspects of our time in Sardinia was the way mealtimes brought people together.

Each gathering was a social occasion filled with laughter, conversation, and a deep appreciation for the food on the table. The relaxed, convivial atmosphere stood in stark contrast to the often solitary and guilt-ridden eating habits we had witnessed back home. It was clear that the Sardinians valued the social and cultural significance of meals just as much as the nutritional content of their food.

We were also captivated by the thriving agriturismo, or farm-to-table, concept that permeated the island.

These agricultural havens seamlessly blended the joy of bringing people together with the principles of zero-kilometer production. We had the pleasure of visiting several agriturismi, where we witnessed firsthand the incredible connection between the land, the food, and the people. The owners and staff took great pride in growing, harvesting, and preparing their own ingredients, often sourced from fields and gardens just steps away from the dining table. This commitment to local, sustainable production not only ensured the freshest and most flavorful meals but also fostered a deep sense of community and shared purpose among those who gathered to break bread together.

Through our immersive experience, Daniela and I came to understand that the Mediterranean diet was a way of life deeply rooted in tradition, community, and a profound respect for the natural world. By embracing these principles and incorporating them into our own lives, we discovered a newfound appreciation for the power of real, wholesome food and the joy of sharing it with others.

Our time in Sardinia transformed our perspective on what it means to live a healthy, fulfilling life, and we are excited to share these insights with others through our work at LyfeFuel.

Now that we finally know where the Mediterranean Diet came from and what it actually looks like on the ground...

Let’s look at why you might want to follow it.

Health Benefits Of The Mediterranean Diet

1. Better Sleep

A 2022 literature review looked at previous research to assess the effect of a Mediterranean diet on the number of hours people slept per night — and the quality of those Zzz’s. The findings suggest that the more someone adheres to a Mediterranean diet, the more likely they are to get longer and better sleep.

The Mediterranean diet is low in processed foods and refined carbohydrates and high in fruits, vegetables, whole grains, and lean meats like fish. Omega-3 fatty acids, which have been demonstrated to improve sleep, are also abundant in the Mediterranean diet.

Walnuts, flax seeds, and fatty fish like salmon and mackerel are rich in omega-3 fatty acids.These fatty acids can aid in regulating the body’s melatonin production, a hormone that is essential for controlling sleep.

2. Reduced Inflammation

In November of 2022, a published review of previous research indicated that adhering to the Mediterranean diet could have anti-inflammatory benefits that could protect against diseases like heart disease and COVID-19.

The study suggests that a diet high in plant-based foods, whole grains, and healthy fats may help reduce inflammation in the body. The researchers found that participants who followed a diet rich in these foods had lower levels of inflammatory markers in their blood.However, more research is needed on the Mediterranean diet’s relationship to inflammation.

Possible reasons for the anti-inflammatory effects of this type of diet include the presence of antioxidants and other anti-inflammatory compounds in plant-based foods, the promotion of a healthy gut microbiome, and the reduction of unhealthy fats and added sugars that can contribute to inflammation.

3. Increased Lifespan

A 36-year study of more than 75,000 women and more than 44,000 men, published in January 2023, listed the Mediterranean diet as one of four diets consistently associated with a reduced risk of all-cause or cause-specific death. Causes of death the authors mentioned included cardiovascular disease, cancer, and respiratory disease.

The Mediterranean diet is high in fruits, vegetables, legumes, whole grains, and nuts, which are all rich in antioxidants, vitamins, minerals, and fiber. These foods have been linked to reduced inflammation, improved immune function, and a lower risk of chronic diseases.Healthy fats, such as the ones found in olive oil and nuts, are rich in omega-3 fatty acids and mono-saturated fats.

They have been shown to improve heart health, lower cholesterol, and reduce inflammation.

Though the diet doesn’t take anything off the table, it does call for reducing the consumption of specific foods.The Mediterranean diet is low in red meat and saturated fats, which have been linked to an increased risk of heart disease, cancer, and other chronic diseases.

4. Lower Risk Of Heart Disease

A systematic review and meta-analysis of 16 studies indicated that women who followed a Mediterranean diet more closely were associated with a lower risk of cardiovascular disease.

Women with higher adherence to the diet were less likely to die of heart disease or develop coronary heart disease. Stroke incidence in women was also lower in this population, but researchers said it was not statistically significant.

By limiting saturated and trans fats, the diet decreases LDL — or bad — cholesterol, which causes plaque buildup in the arteries, or atherosclerosis, and can lead to heart attacks and strokes. By encouraging healthy unsaturated fats, it combats inflammation and promotes brain health.

5. Reduced Dementia Risk

A study published in March of 2023 followed more than 60,000 participants for an average of 9.1 years to evaluate the link between diet and dementia risk. The research indicated that people who followed the Mediterranean diet more closely had lower dementia risks.

The research suggests that consuming a diet rich in fruits, vegetables, whole grains, and fish, and low in red meat and saturated fats can help protect the brain from cognitive decline.

Again, the research didn’t dive into the reasons this diet may help reduce dementia risk.

Possible reasons why a Mediterranean diet could promote brain health include reducing inflammation, oxidative stress, and insulin resistance, as well as improving cardiovascular and metabolic health.

6. Lower Prostate Cancer Odds

A 2022 study examined 116 plasma samples of Caucasian men with late-onset prostate cancer and 132 matched controls. They analyzed them for micronutrients. Individuals in the prostate cancer group were found to have significantly lower blood levels of lycopene, lutein, α-carotene, and β-carotene than those in the control group.

These nutrients are found in foods in the Mediterranean diet. For example, watermelon and tomatoes have lycopene, and selenium is a mineral in plant-based foods like nuts and grains.The study clearly indicates that those men with higher concentrations of micronutrients such as selenium and beta carotene had a lower risk of cancer than men that did not have good levels of micronutrients. What it was unable to determine, however, was if these higher micronutrient levels were related to a healthier diet.

As with the other studies, the nutrients likely provide protective benefits.

It is thought that [these nutrients] may help reduce inflammation and oxidative damage in the body, which is associated with an increased risk of cancer. They may also help to regulate hormones, which are also thought to be involved in the development of prostate cancer.

7. May Benefit Vision As You Age

It is a common cause of vision loss in people over the age of 50 and can lead to a decrease in sharpness of vision, difficulty recognizing faces and colors, and a decrease in the ability to see in low-light conditions. Treatment options can include dietary changes, nutritional supplements, and in some cases, medications, or surgery.In light of recent research, adherence to a Mediterranean diet may be recommended.

A 2022 systematic review of 20 studies indicated that adherence to a Mediterranean diet contributes to a lower risk of progressing from early to late age-related macular degeneration.

The study found that people with higher consumptions of b-carotene, lutein, zeaxanthin, copper, folate, magnesium, vitamin A, niacin, vitamin B6, vitamin C, and omega-3 fatty acids were associated with a lower risk of progression of macular degeneration.

Though the Mediterranean diet doesn’t call for complete abstention from alcohol, it does advise lowering intake — another potential benefit.

8. Boost Mental Health

The Mediterranean diet may have more than just physical benefits. A small, 12-week 2022 study of 72 men ages 18 to 25 with moderate to severe depression compared the Mediterranean diet to befriending therapy, a modality that involves introducing a patient to at least one other person in hopes of providing them with more social support. The participants who followed the Mediterranean diet reported better quality of life than the group that received befriending therapy.

The reasons for these results might include:

Fresh fruits and vegetables have vitamins, minerals, and fiber, which boost brain functioning
Fiber regulates blood pressure, which may aid in reducing anxiety and depression
Omega-3 fatty acids may boost mood and lower inflammation
Improved gut health, which can affect mood

Conclusion

In conclusion, the Mediterranean diet is a powerful tool for promoting health and longevity, but its benefits extend far beyond the mere consumption of nutritious foods. Through our first hand experience living in Sardinia, Daniela and I discovered that the true essence of this lifestyle lies in the interconnected web of factors that shape the way people eat, live, and thrive.

From the emphasis on local, sustainable food production to the cherished social rituals surrounding mealtimes, the Mediterranean approach to life is a holistic one that nurtures both body and soul.

By embracing these principles and incorporating them into our daily lives, we can unlock the secrets to a longer, happier, and healthier existence. This is the foundation upon which we have built our Transformation Program at LyfeFuel – a comprehensive approach to wellbeing that goes beyond diet alone, empowering individuals to transform their health and vitality from the inside out.

By understanding and adopting the authentic Mediterranean lifestyle, we can all take steps towards a more vibrant, fulfilling future.