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The Mediterranean Diet: Longer Life, Better Health

"What Foods Are Healthy?"

What is the mediterranean diet?

Modern civilization came into being centuries ago in the area around the Mediterranean Sea. A hallmark of this civilization, begun with the Ancient Greeks and Romans, was a culinary culture that has lasted throughout history up to the present day. Even with its ancient roots, recent decades have seen this healthy food diet become increasingly popular around the world.

Based primarily on the diets of Greece, southern Italy, Portugal, Cyprus, Spain, and Turkey, aspects of the MD have made their way into diets everywhere. One example of the Mediterranean diet's staying power is olive oil, found today in kitchens around the world.

Olive oil is the result of the dietary habits of the Ancient Greeks, designed centuries ago as a way to preserve olives. It was also their main source of dietary fat as they believed animal fat was unhealthy and eaten only by barbarians.

Why has the Mediterranean diet (MD) had such a lasting impact worldwide? Perhaps because it is associated with health benefits such as increased longevity, protection from age-related cognitive decline, and reduced rates of cancer and heart disease.

Since observing lower rates of heart disease among people in the Mediterranean region in the 1950s, scientists have been researching the possible health benefits of the Mediterranean diet.

A study sponsored by the World Health Organization, examining the dietary habits of people from seven countries over the span of three decades, found that men living on the Greek island of Crete had death rates from heart disease that were exceptionally low when compared to people in other areas.

Numerous studies have been conducted in years since, and Dr. Perez-Lopez and his team from the University of Zaragoza, Spain, recently examined the existing scientific literature on the health benefits of the Mediterranean diet. Their findings? Following a traditional Mediterranean diet is associated with living a longer life[1]

Increased Longevity

The association between the MD and longevity has been well-studied, and the results have found that people who follow the traditional MD have an increased lifespan and decreased mortality. Adherence to the MD in nine different European countries was studied in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, and examination of the data found that a 60-year-old man who closely follows the MD can expect to live a year longer than a 60-year-old man who does not adhere to the Mediterranean diet [2].

Information from the EPIC study also found that those people who adhered most closely to the MD benefited from a significant reduction in risk of death during the following five years [3]. Similar benefits of the MD have been shown outside the European continent as well. A 1995 survey conducted by the US National Institutes of Health AARP, including information from 566,000 AARP members, found that those who reported a diet most closely resembling the MD were 20% less likely to die during the decade the survey information was collected [4].

Reduced Cardiovascular Risk

The EPIC study also examined the association between adherence to the MD and cardiovascular risk. In elderly people who had experienced a heart attack in the past, adherence to the Mediterranean diet was associated with an overall mortality rate that was an impressive 18% lower [5]. Another study, looking at 11,323 Italian people, also found that adhering to the MD was associated with decreased mortality after a myocardial infarction [6].

Study participants were instructed to increase their intake of fish, fruit, vegetables, and olive oil – all components of the traditional MD. The quartile of participants who adhered least well to the diet was compared to the quartile that adhered best, and a significant difference in risk of early mortality was discovered.

Protection Against Cancer

Several components of the Mediterranean diet appear to aid in the prevention of several types of cancer. These components include lycopene, contained in tomatoes, and fish, both of which have been shown to have protective properties against cancer [7, 8]. Other components of the MD that may play a role in reducing risk of cancer are vegetables, fruit, and olive oil. A large study, containing 10,582 male and 15,041 female participants, found a correlation between following the traditional MD and cancer incidence.

Participants' adherence to the MD, assessed on a scale of 0 to 9, was compared to incidences of cancer during a following median time of 7.9 years. The study found that a two-point increase on the MD adherence scale was associated with a 12% decrease in incidences of cancer. In addition, increasing consumption of unsaturated fats like olive oil was also associated with a decreased cancer risk – 9% lower [9].

Healthy Body Weight

Overweight and obesity are associated with a number of health problems, making the maintenance of a healthy body weight essential to living a long, healthy life. Industrialized countries across the world are facing an obesity epidemic, with a distressing 30-50% of the general population considered obese. One potential ally in the fight against obesity is the MD, which research has shown to be helpful in encouraging a healthy body weight.

A survey conducted in Spain found that respondents who most closely followed the MD had less chance of obesity and a lower Body Mass Index [10]. Another Spanish study, composed of over 27,000 men and women, found that strictly adhering to the MD was associated with a lower risk of weight gain [11].

Conclusion

With the many and significant health benefits to be gained by following the Mediterranean diet, its worldwide popularity is unsurprising. The adoption of the MD as a whole – rather than simply picking and choosing certain parts – appears to encourage health and longevity by decreasing cardiovascular and cancer risk and helping maintain a healthy body weight, in addition to other benefits too numerous to be discussed here.

Although it originated near the Mediterranean Sea, today the Mediterranean diet can be followed by individuals anywhere in the world who are interested in improving their health and increasing their lifespan.

References

1. Effects of the Mediterranean diet on longevity and age-related morbid conditions. Faustino R. Pérez-López, Peter Chedraui, Javier Haya, José L. Cuadros. Maturitas 2009; 64: 67–79.

2. Modiﬁed Mediterranean diet and survival: EPIC-elderly prospective cohort study. Trichopoulou A, Orfanos P, Norat T, et al. BMJ2005; 330: 991.

3. Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition). Bamia C,Trichopoulos D,Ferrari P, et al. Public Health Nutr 2007; 10: 590–8.

4. Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH- AARP Diet and Health Study. Mitrou PN, Kipnis V, Thiébaut AC, et al. Arch Intern Med 2007; 167: 2461–8.

5. Modiﬁed Mediterranean diet and survival after myocardial infarction: the EPIC-Elderly study. Trichopoulou A, Bamia C, Norat T, et al. Eur J Epidemiol 2007; 22: 871–81.

6. Mediterranean diet and all-causes mortality after myocardial infarction: results from the GISSI-Prevenzione trial. Barzi F, Woodward M, Marﬁsi RM, et al. Eur J Clin Nutr 2003; 57: 604–11.

7. Lycopene from heat-induced cis-isomer-rich tomato sauce is more bioavailable than from all-trans-rich tomato sauce in human subjects. Unlu NZ, Bohn T, Francis DM, Nagaraja HN, Clinton SK, Schwartz SJ. Br J Nutr 2007; 98: 140–6.

8. Concomitant supplementation of lycopene and eicosapentaenoic acid inhibits the proliferation of human colon cancer cells. Tang FY, Cho HJ, Pai MH, Chen YH. J Nutr Biochem 2009; 20: 426–34.
9. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Benetou V, Trichopoulou A, Orfanos P, et al. Br J Cancer 2008; 99: 191–5.

10. Adherence to the traditional Mediterranean diet is inversely associated with body mass index and obesity in a Spanish population. Schröder H, Marrugat J, Vila J, Covas MI, Elosua R. J Nutr 2004; 134: 3355–61.

11. Adherence to a Mediterranean diet is associated with reduced 3-year incidence of obesity. Mendez MA, Popkin BM, Jakszyn P, et al. J Nutr 2006; 136:2934–8.

About the Author

Matthew Papaconstantinou, a postdoctoral fellow and medical researcher at Washington University School of Medicine in St Louis, MO, was born and raised in Greece and witnessed firsthand the benefits of a Mediterranean diet. He is happy to have the opportunity to share relevant scientific information about the diet common in Greece and other Mediterranean countries. Mathew enjoys providing information on a variety of topics – from reviews of the best online diet plans to gastric vertical band revision. He also offers a Medifast discount.

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