Scientists have intensely studied the eating patterns characteristic of the Mediterranean Diet for over 50 years.

The first study examined the health status of the people of Crete at the end of the 1940s. It reached the startling conclusion that even after the deprivations of World War II, the cardiovascular health of Crete residents exceeded that of US residents. Researchers attributed the differences to diet.

Shortly after World War II, Ancel Keys and colleagues (including Paul Dudley White, President Eisenhower's heart doctor) organized the remarkable Seven Countries Study to examine the hypothesis that Mediterranean-eating patterns contributed directly to improved health outcomes. This long-running study proved the diet-health hypothesis and spawned several related studies—all of which reached similar conclusions.

Out of this extensive work came an understanding that certain Mediterranean-eating patterns were remarkably connected with good health. From this understanding emerged the concept of a "Mediterranean Diet" that was found to promote lifelong good health.

In subsequent years the body of scientific evidence supporting the healthfulness of the traditional Mediterranean Diet continues to grow, and it is now referred to as the "Gold Standard" for healthy dietary patterns.

The following excerpts from medical and scientific journals show the enormous amount of evidence supporting the "Gold Standard" status of traditional Mediterranean eating patterns, which have been shown to:

Lengthen your life (1-6)

Defend you from chronic diseases (7-16)

Fight certain cancers (17-21)

Lower your risk for heart disease along with your blood pressure and
"bad" cholesterol levels (22-32)

Protect you from diabetes (33-35)

Aid your weight loss and management efforts (36-40)

Keep away depression (41)

Safeguard you from Alzheimer's disease (42-45)

Ward off Parkinson's disease (46)

Improve rheumatoid arthritis, and (47-48)

Help you breathe better (49-52)

Lead to healthier babies (53)

Lengthen your life

¹ Greater adherence to a Mediterranean diet is associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson's disease and Alzheimer's disease (13%). These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of major chronic diseases.

² These results provide strong evidence for a beneficial effect of higher conformity with the Mediterranean dietary pattern on risk of death from all causes, including deaths due to CVD and cancer, in a US population.

Mitrou PN, Kipnis V, Thiébaut ACM, et al. Mediterranean Dietary Pattern and Prediction of All-Cause Mortality in a US Population: Results From the NIH-AARP Diet and Health Study. Archives of Internal Medicine. 2007;167(22):2461-8.

³ The findings of the present study in a northern European population of young women indicate that closer adherence to a Mediterranean dietary pattern reduces mortality even among young persons.

Lagiou P, Trichopoulos D, Sandin S, et al. Mediterranean dietary pattern and mortality among young women: a cohort study in Sweden. British Journal of Nutrition. 2006;96(2):384-92.

⁴ In this large, population-based cohort study, we found that a higher degree of adherence to the traditional Mediterranean diet was associated with a reduction in total mortality (17%) ... with respect to both deaths due to coronary heart disease and deaths due to cancer.

Trichopoulou A, Costacou T, Bamia C, et al. Adherence to a Mediterranean diet and Survival in a Greek Population. The New England Journal of Medicine. 2003;348:2599-2608.

⁵ Trichopoulou et al. report the results of a population-based study involving 22,043 apparently healthy adults in Greece, in which adherence to a traditional Mediterranean diet was associated with significantly lower total mortality, mortality from coronary heart disease, and mortality from cancer.

Hu FB. The Mediterranean Diet and Mortality—Olive Oil and Beyond. New England Journal of Medicine. 2003;348(26):2595-96.

⁶ Adherence to the principles of the traditional Mediterranean diet is likely to be associated with lower overall mortality. Moreover, key features of this diet appear to be transplantable to other dietary cultures and cuisines, and may have a substantial beneficial impact on the general mortality of elderly people who have the Westernized dietary habits. We conclude that a diet that adheres to thee principles of the traditional Mediterranean diet is associated with longer survival.

Kouris-Blazos A. Are the Advantages of the Mediterranean Diet Transferable to Other Populations? A Cohort Study in Melbourne, Australia. British Journal of Nutrition. 1999;82:57-61.

⁷In a review of 146 cohort studies and 43 randomized control trials, a Mediterranean diet was associated with a significantly lower risk of coronary heart disease (CHD). Overall diet pattern is more important to emphasize than individual foods.

Mente A, de Koning L, Shannon HS, et al. A systematic review of the evidence supporting a casual link between dietary factors and coronary heart disease. Arch Intern Med. 2009; 169(7): 659-669

⁸ We compared the 1-year effect of 2 behavioral interventions to implement the Mediterranean Diet vs advice on a low-fat diet on Metabolic Syndrome status. A traditional Mediterranean Diet enriched with nuts could be a useful tool in the management of the Metabolic Syndrome.

Salas-SalvadóJ, Fernández-Ballart J, Ros E, et al. Effect of a Mediterranean Diet Supplemented With Nuts on Metabolic Syndrome Status: One-Year Results of the PREDIMED Randomized Trial. Archives of Internal Medicine. 2008;168(22):2449-58.

⁹... our findings emphasize the importance of the consumption of a dietary pattern "close" to the Mediterranean diet and the adoption of even light-to-moderate physical activity to reduce the prevalence of the metabolic syndrome at the population level.

Panagiotakos DB, Pitsavos C, Chrysohoou C, et al. Impact of Lifestyle Habits on the Prevalence of the Metabolic Syndrome Among Adults from the ATTICA Study. Journal of the American Heart. 2007;147(1):106-12.

¹⁰ These results provide strong evidence for a beneficial effect of higher conformity with the Mediterranean dietary pattern on a risk of death from all causes, including deaths due to CVD and cancer in a US population.

Mitrou PN, Kipnis V, Thiebaut ACM, et al. Mediterraenean Dietary Pattern and Prediction of All-Cause Mortality in a US Population: Results From the NIH-AARP Diet and Health Study. Archives of Internal Medicine. 176(22):2461-9;2007.

¹¹ During the past decades a large body of evidence has related adherence to a Mediterranean diet with reductions in all-cause mortality, the prevalence of metabolic disorders such as obesity and high blood pressure, and the incidence of coronary heart disease and various types of cancer.

Panagiotakos DB, Pitsavos C, Skoumas Y, et al. The Association Between Food Patterns and the Metabolic Syndrome Using Principle Components Analysis: The ATTICA Study. Journal of the American Dietetic Association. 2007;107:979-87.

¹² Adherence to a Mediterranean diet is associated with reduced odds of having hyper-cholesterolemia, hypertension, diabetes and obesity among elderly people.

Panagiotakos DB, Polystipioti A, Papairakleous N, et al. Long-term adoption of a Mediterranean diet is associated with a better health status in elderly people; a cross-sectional survey in Cyprus. Asia Pacific Journal of Clinical Nutrition. 2007;16(2):331-7.

¹³ Together with regular physical activity and not smoking, our analyses suggest that over 80% of coronary heart disease, 70% of stroke, and 90% of type 2 diabetes can be avoided by healthy food choices that are consistent with the traditional Mediterranean Diet.

Willett WC. The Mediterranean diet: science and practice. Public Health Nutrition. 2006;9(1A):105-10.

¹⁴ Patients who followed a Mediterranean-type diet had reduced combined all-cause mortality, nonfatal cancer, and myocardial infarction compared with those who followed an approximate American Heart Association Step 1 diet. The Mediterranean-type diet also showed a trend toward a decreased risk for cancer.

De Lorgeril M, Salen P, Martic JL, et al. Mediterranean dietary pattern in a randomized trial: Prolonged survival and possible reduced cancer rate. Archives of Internal Medicine. 1998;158:1181-7.

¹⁵ The Mediterranean diet or its elements have repeatedly been shown to provide remarkable protection against chronic diseases.

Gjonça A, Bobak M. Albanian Paradox, Another Example of Protective Effect of Mediterranean Lifestyle? Lancet. 1997;350:1815-7.

^{16 "}Efforts to combat nutrient deficiencies have centered on supplemental nutrient administration and addition of selected nutrients to the food chain in the form of food fortification. In addition to supplementation or forti-fication with specific nutrients, the consumption of certain dietary patterns (such as the Mediterranean diet) is associated with a reduced risk of chronic diseases, particularly cardiovascular diseases."

Caballero B. Fortification, supplementation, and nutrient balance. European Journal of Clinical Nutrition. 2003;57(1):S76-8.

¹⁷ Data presented from a review of 20,000 cases affecting 20 cancer sites and 18,000 controls show that risk for most epithelial cell cancers was decreased with increased fruit, vegetable, whole grain and fish intake. Olive oil and other monounsaturated and unsaturated fats were inversely related to cancer risk at several sites. A Mediterranean diet pattern appears to be favorable for reduced cancer risk.

La Vecchia C. Association between Mediterranean dietary patterns and cancer risk. [Review] Nutrition Reviews. 2009; 67(5):126-130.

¹⁸ In conclusion, in a general population-based prospective cohort investigation, we have found evidence that adherence to the traditional MD is associated with markedly and significantly reduced incidence of overall cancer, which is appreciably larger than predicted from examining individual MD components.

Benetou V, Trichopoulou A, Orfanos P, et al. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. British Journal of Cancer. 2008;99:191-5.

¹⁹ This provides therefore additional evidence that the combination of various food items reflecting the Mediterranean diet favorably affects the risk of several common cancers.

La Vecchia C, Bosetti C. Diet and cancer risk in Mediterranean countries: open issues. Journal of Public Health Nutrition: 2006;9(8A):1077-82.

²⁰ The Mediterranean diet is not a specific diet plan or diet program but a collection of eating habits that are traditionally followed by the people of the Mediterranean region. There are at least 16 countries bordering the Mediterranean Sea and food habits vary between these countries according to culture, ethnic background and religion. The Mediterranean diet, containing olive oil, fish, fruits and vegetables is associated with a low rate of cardiovascular and cancer diseases.

Zadak Z, Hyspler R, Ticha A, et al. Polyunsaturated fatty acids, phytosterols and cholesterol metabolism in the Mediterranean diet. [Review]
Acta Medica (Hradec Kralove). 2006;49(1):23-6.

^{21 ...} an optimal diet for the prevention of both coronary heart disease and cancer is likely to extensively overlap with the traditional Mediterranean diet. It is not yet clear which components in the Mediterranean diet are more important for its apparent health effects, but olive oil, plant foods and moderate wine consumption are likely candidates.

Trichopoulou A, Critselis E. Mediterranean diet and longevity. European Journal of Cancer Prevention. 2004;13(5):453-6.

²² Our results suggest that adhering to a Mediterranean-type diet could contribute to the prevention of age-related changes in blood pressure.

Ñúnez-Córdoba, JM, Valencia-Serrano F, Toledo E, et al. The Mediterranean Diet and Incidence of Hypertension: The Seguimiento Universidad de Navarra (SUN) Study. American Journal of Epidemiology. 2009;169 (3):339-46.

²³ Following a Mediterranean-style diet, rich in olive oil and fruit and vegetables, may improve vascular health and reduce the risk of hypertension.

²⁴ Consuming a Mediterranean-type diet rich in fruits, vegetables, and low-fat dairy products and reduced in sodium and saturated fat represents an ideal eating pattern. Weight loss and increased physical activity contribute to ideal lifestyle conditions.

Van Horn L, McCoin M, Kris-Etherton PM, et al. The Evidence for Dietary Prevention and Treatment of Cardiovascular Disease. Journal of the American Dietetics Association. 2008;108(2):287-331.

²⁵ Experimental and epidemiological studies indicate that eating patterns, such as the traditional Mediterranean or Okinawan diets, that incorporate these types of foods and beverages reduce inflammation and cardiovascular risk. This anti-inflammatory diet should be considered for the primary and secondary prevention of coronary artery disease and diabetes.

O'Keefe JH, Gheewala, NM, O'Keefe JO. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. Journal of the American College of Cardiology. 2008;51:249-55.

²⁶ Our results suggest that the more frequent consumption of foods from the Mediterranean pattern may reduce CVD [cardiovascular disease] and IHD [ischemic heart disease] risks and may be most beneficial for persons with diabetes.

Harriss LR, English DR, Powles J, et al. Dietary Patterns and cardiovascular mortality in the Melbourne Collaborative Cohort Study. American Journal of Clinical Nutrition. 2007;86:221-9.

²⁷ Individuals at high cardiovascular risk who improved their diet toward a traditional Mediterranean Diet (TMD) pattern showed significant reductions in cellular lipid levels and LDL oxidation. Results provide further evidence to recommend the TMD as a useful tool against further risk factors for coronary heart disease.

Montserrat F, Guxens M, Corella D, et al. Effect of a Traditional Mediterranean Diet on Lipoprotein Oxidation. Archives of Internal Medicine. 2007;167:1195-1203.

²⁸ Our results suggest that the healthy effects of the Mediterranean Diet observed in epidemiologic studies are exerted partly through plausible mechanisms: improved lipid profiles and reductions in blood pressure, insulin resistance, and systemic markers of inflammation...an increasing body of knowledge supports the Mediterranean diet as a useful tool in managing individuals who are at high risk for CHD (coronary heart disease).

Estruch R, Martinez-Gonzalez MA, Corella D, et al. Effects of A Mediterranean-Style Diet on Cardiovascular Risk Factors: A randomized trial. Annals of Internal Medicine. 2006;144:1-11.

²⁹ The SUN study and the accompanying case-control study support the benefits of a Mediterranean diet and olive oil against coronary heart disease and hypertension.

Martinez-Gonzalez MA. The SUN cohort study (Seguimiento University of Navarra). Journal of Public Health Nutrition. 2006;9(1A):127-31.

³⁰ The present study provides a pathophysiologic explanation to the growing scientific evidence for the beneficial effect of the Mediterranean diet on human health and, especially, atherosclerotic disease. We found that greater adherence to this traditional diet was independently associated with a reduction in the inflammation and coagulation indexes that are believed to have an important role in CVD. The World Health Organization reports that the three major components involved in preventing atherosclerotic disease are smoking, physical inactivity, and an unhealthy diet, as they are factors that can be changed. Our findings emphasize the need for actions from public health care professionals in order to prevent the development and progression of atherosclerotic diseases through the adoption of low animal fat diets, like the Mediterranean diet.

Chrysohoou C, Panagiotakos DB, Pitsavos C, et al. Adherence to the Mediterranean diet attenuates inflammation and coagulation process in healthy adults: the Attica study. Journal of the American College of Cardiology. 2004;44:152-8.

³¹ In the Lyon Heart Study, higher ALA [a type of healthy fat] consumption in the context of a Mediterranean diet dramatically reduced total and cardiovascular mortality as well as nonfatal MI. These trials strongly support the protective effects of omega-3 fatty acids, including both ALA and fish oil, in secondary prevention of CHD. Mediterranean diet enriched with ALA reduced death by more than 70%.

Hu FB, Willett WC. Optimal Diets for Prevention of Coronary Heart Disease. Journal of the American Medical Association. 2002;288:2569-78.

³² The traditional Mediterranean diet as outlined in this article is an ideal eating pattern for prevention of cardiovascular disease. We believe that current understanding and scientific evidence are adequate to recommend this diet widely as a practical, effective, and enjoyable strategy--the new "gold standard"--in heart disease prevention.

Curtis B, O'Keef J. Understanding the Mediterranean Diet: Could This Be the New "Gold Standard" for Heart Disease Prevention? Postgraduate Medicine. 2002;112(2):35-8.

Protect you from diabetes

⁴⁹ High adherence to traditional Mediterranean diet increased the likelihood of asthma to be under control in adults.

Barros R, Moreira A, Fonseca J, et al. Adherence to the Mediterranean diet and fresh fruit intake are associated with improved asthma control. Allergy. 2008; 63(7):917-23.

⁵⁰ Our results support a protective effect of a high level of adherence to the Mediterranean Diet during pregnancy against asthma-like symptoms and atopy in childhood.

Chatzi L, Torrent M, Romieu I, et al. Mediterranean Diet in pregnancy protective for wheeze and atopy in childhood. Thorax. 2008; 63:507-13.

⁵¹ In the large prospective cohort of US men, two distinct dietary patterns were identified using principal component analysis: the prudent [Mediterranean-style] pattern (loaded by a high consumption of fruits, vegetables, fish and whole grains) and the Western pattern (loaded by a high intake of refined grains, cured and red meats, desserts and sweets and French fries). During 12 years of follow-up, the risk of newly diagnosed chronic obstructive pulmonary disease (COPD) decreased as the prudent [Mediterranean-style] pattern score increased, whereas the risk of newly diagnosed COPD increased as the Western pattern score increase.

Varraso R, Fund T, et al. Prospective study of dietary patterns and chronic obstructive pulmonary disease among US men. Thorax. 2007;62(9):785-90.

⁵² We showed a general protective effect of a high level of adherence to the Mediterranean diet on allergic rhinitis, asthma and atopy.

Chatzi L, Apostolaki G, Bibakis I, et al. Protective effect of fruits, vegetables and the Mediterranean diet on asthma and allergies among children in Crete. Thorax. 2007;62(8):677-83.

Healthier babies

⁵³ The Mediterranean dietary pattern seems to be associated with reduction in the risk of offspring being affected by spina bifida.

Vujkovic M, Steegers EA, Looman CW, et al. The maternal Mediterranean dietary pattern is associated with a reduced risk of spina bifida in the offspring. BJOG: An International Journal of Obstetrics & Gynaecology. 2009:116(3):408-15.

For more excerpts from medical and scientific journals, contact Adriene Worthington at 617.896.4876 or via email: aworthington@oldwayspt.org.
     

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