In the 1950s, researchers from around the world began a large and ambitious study.
For decades, they analyzed the
diet and lifestyle
of thousands of middle-aged men living in the United States, Europe and Japan, and then studied how those characteristics affected their risk of cardiovascular disease.
The Seven Countries Study, as it later became known, found associations between saturated fat, cholesterol levels, and coronary heart disease.
But the researchers also got another remarkable result: People living in and around the Mediterranean -- in countries like Italy, Greece and Croatia -- had
lower rates of cardiovascular disease
than participants living elsewhere.
His diet, rich in fruits, vegetables, legumes, whole grains, nuts, seeds, lean protein, and healthy fats, seemed to have a protective effect.
Since then, the Mediterranean diet has become the
foundation of a heart-healthy diet
, with well-studied health benefits such as lowering blood pressure and cholesterol and lowering the risk of type 2 diabetes.
"It's one of the few diets
backed by studies
," said Sean Heffron, a preventive cardiologist at NYU Langone Health.
"It's not a diet that someone came up with to make money. It's something that millions of people have developed over time because it really tastes good.
And it just happens to be healthy
."
Here are some of the most frequently asked questions about the Mediterranean diet, answered by experts.
Multiple studies found benefits in adherence to the Mediterranean diet.
Photo Shutterstock.
What exactly does the Mediterranean diet consist of?
The Mediterranean diet isn't so much a strict eating plan as it is a lifestyle, explains Julia Zumpano, a registered dietitian specializing in preventive cardiology at Ohio's Cleveland Clinic.
People who follow the Mediterranean diet tend to
"eat foods that your grandparents would recognize
," Heffron added: whole foods, unprocessed and with few or no additives.
The diet gives priority to whole grains, fruits, vegetables, legumes, nuts, herbs, spices and olive oil.
Fish rich in omega-3 fatty acids, such as salmon, sardines, and tuna, are the preferred source of animal protein.
Other lean animal proteins, such as chicken or turkey, are consumed to a lesser extent.
And foods high in saturated fat, such as red meat and butter, are
rarely
eaten .
Eggs and dairy products like yogurt and cheese can also be part of the Mediterranean diet, but
in moderation
.
And moderate alcohol consumption, such as a glass of wine with dinner, is allowed.
According to Heffron, breakfast might consist of smashed avocado on whole-wheat toast with fresh fruit and low-fat Greek yogurt.
For lunch or dinner, a
vegetable and grain dish cooked in olive oil
and seasoned with herbs: roasted root vegetables, leafy greens, a side of hummus, and small portions of pasta or whole wheat bread, with a lean protein such as fish grilled.
"It's very easy to follow, very sustainable and very realistic," Zumpano said.
What are the health benefits of the Mediterranean diet?
Several rigorous studies have concluded that the Mediterranean diet contributes to better health, and in particular better heart health, in a number of ways.
In a study published in 2018, researchers evaluated almost 26,000 women and found that those who had followed the Mediterranean diet most faithfully for up to 12 years had around a
25% lower risk
of developing cardiovascular disease.
This was mainly due to changes in blood sugar, inflammation and body mass index, the researchers reported.
Other studies, conducted on men and women, have reached similar conclusions.
Research has also found that diet can protect against oxidative stress, which can cause DNA damage that contributes to chronic conditions such as neurological disease and cancer.
And some studies indicate that it may help reduce the risk of type 2 diabetes.
According to Dr. Anum Sohail Minhas, an associate professor of medicine at Johns Hopkins Medicine, diet can also be highly beneficial to health during pregnancy.
In a recent study of nearly 7,800 women published in December, researchers found that women who followed the Mediterranean diet more conscientiously around the time of conception and during early pregnancy had a 21% lower risk of complications such as preeclampsia, gestational diabetes or preterm labor.
"There definitely
seems to be a protective effect
," Minhas said.
By itself, however, the Mediterranean diet
is not a panacea
, Heffron noted: It won't eliminate the chances of cardiovascular disease, nor will it cure it.
It's important to pay attention to other principles of good heart health, such as
exercising regularly
, getting enough sleep, and not smoking.
In the Mediterranean diet, animal protein is provided mainly by fish and shellfish.
Photo Shutterstock.
Does the Mediterranean diet help to lose weight?
According to Zumpano, this diet can help you lose weight, but you have to pay attention to calories.
"Nutrient-dense foods
are not necessarily low-calorie
," Heffron said, noting that the diet includes foods like olive oil and nuts, which are heart-healthy but high in calories and can lead to increased blood sugar. weight if consumed in large quantity.
But if you switch from a diet high in calories, saturated fat, and added sugars, for example, to one that
prioritizes vegetables, fruits, and lean protein
, you can lose some weight.
However, the Mediterranean diet
does not pretend to be a
trick to lose weight quickly
Rather it should lead to a
long-term change
in eating behavior.
In a study of more than 30,000 people living in Italy, for example, researchers found that those who followed the Mediterranean diet most closely for about 12 years were
less likely to become overweight or obese
than those who followed the diet less carefully.
A smaller study, published in 2020, included 565 adults who had intentionally lost 10% or more of their body weight in the previous year.
This revealed that those who reported faithfully following the Mediterranean diet were twice as likely to maintain weight loss than those who did not faithfully follow the diet.
How long do you have to follow the Mediterranean diet to get benefits?
If you're just starting out on the Mediterranean diet, there's limited evidence that you may notice some cognitive improvements—such as in
attention, alertness, and satisfaction
, according to a review of studies published in 2021—in the first 10 days or so .
However, Zumpano said that to get sustained long-term benefits in terms of heart health, you need to follow the diet ideally
throughout your life
.
That said, he added, the diet allows for some flexibility;
Eating a cake or steak now and then will not negate its overall benefits.
Are there any downsides to trying the Mediterranean diet?
The diet typically provides a
balanced combination of nutrients
and adequate protein, so there are usually no significant risks associated with following it, Heffron said.
But since the diet recommends
minimizing or avoiding red meat
, you want to make sure you're consuming enough iron.
Good sources of iron include nuts, tofu, legumes, and dark green leafy vegetables, such as spinach and broccoli.
Foods rich in vitamin C, such as citrus fruits, chili peppers, strawberries, and tomatoes, can also help the body absorb iron.
And since the diet minimizes dairy, you may want to talk to your doctor about whether you need to take calcium supplements.
However, for the average person, the benefits of the Mediterranean diet far outweigh the potential drawbacks, Minhas said.
"These are things that
we can all try to incorporate into our lives
."
© The New York Times
Translation: Elisa Carnelli
***
Do you want to read more about the Mediterranean diet?
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***
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