1. Eat abundant amounts of plant foods (fruits, vegetables, whole grains, beans, nuts and seeds).
2. Eat concentrated sugars only on rare occasions.
4. Use olive oil as your principal source of fat.
5. Eat dairy products (mainly cheese and yogurt) only occasionally
6. Eat red meat and poultry rarely and then in small amounts. Eat 4 eggs or less a week.
7. Eat fish frequently.
8. Drink wine in low to moderate amounts, generally with meals.
Illustration: diet pyramid: http://www.oldwayspt.org/mediterranean-diet-pyramid
Mediterranean Diet: Francesco Sofi et al Meta-analysis
Jacob Schor ND
October 20, 2010
Over the years we’ve followed the ongoing debate over what diet is the healthiest. Is it vegetarian, vegan, macrobiotic, Atkins, Zone, high carb, low carb or one of a seemingly endless list? We follow this debate closely as our patients frequently ask us for dietary advice during their visits. In the last few years, the scientists seem to have reached a consensus, at least temporarily. At this point in time, if we were able to choose any diet for our patients to emulate or follow, it should be what is called the Mediterranean diet. This is the classic diet eaten in the countries that border the Mediterranean Sea, Italy, Greece and Southern Spain up until the 1960s, before modernization and fast food set in.
A bit of History:
Probably the first, though unrecognized, promoter of the Mediterranean diet was Giacomo Castelvetro. Italian by birth, Castelvetro taught at Cambridge University in England. Appalled by English food and probably a bit homesick, he wrote a treatise praising the foods he missed titled, The Fruit, Herbs & Vegetables of Italy. He encouraged his English readers to plant salad greens and eat them regularly dressed with olive oil. Because he advocated for eating more vegetables, olive oil and other foods that have anticancer effect, some scientists now consider Castelvetro the Father of Nutritional Oncology. Though Castelvetro’s book was published in 1614, it is to be republished this year.
In our own era, Ancel Keys was among the first scientists to realize that a Mediterranean style diet is healthy. Keys was probably more famous for designing the K-rations eaten by soldiers during World War II. It’s a curious thought that the same man who brought us Spam also is also responsible for our appreciation of extra virgin olive oil.
Just after World War II, Keys organized what is known as the Seven Countries Study. This study examined the health of almost thirteen thousand middle-aged men in the United States, Japan, Italy, Greece, the Netherlands, Finland, and then-Yugoslavia comparing lifestyle and diet to cardiovascular disease risk and overall mortality. This study lasted for decades. The data clearly suggested that men who ate a diet of mostly fruits and vegetables, grains, beans, and fish were the healthiest. Men living in Crete had the healthiest hearts of any of the groups studied. Keys’ work led to the concept that Mediterranean style eating patterns were connected with good health. Since then the evidence supporting this Keys’ theory has steadily accumulated.
Research studies tell us that following a Mediterranean Diet reduces the risk of many chronic diseases including heart disease, high blood pressure, diabetes, depression, Alzheimer’s disease, Parkinson’s disease, rheumatoid arthritis, and asthma. It also reduces risk of certain cancers. Probably most important, the data tell us following this diet lengthens life span.
Sofi et al:
In November 2010, Francesco Sofi and colleagues from the University of Florence, Italy had a significant paper published on the long-term benefit of following this diet. It was a meta-analysis of data from many prior studies, and calculated the impact the Mediterranean diet has on major disease and mortality.
Actually this 2010 paper was an update on a prior paper Sofi had published in the September 2008 issue of the British Medical Journal. This first analysis looked at all the studies on the Mediterranean diet published from 1966 to June 2008. Data from twelve separate studies were combined for analysis. Doing this gave Sofi and colleagues a pool of data from 1, 574, 299 subjects. The November 2010 update added 7 more studies expanding the data pool to 2,190,627 subjects.
How closely a subject followed the Mediterranean diet pattern was measured through a simple point score. For each characteristic used to describe the Mediterranean diet in which the subject scored above the mean, or was above average, they received one point. For each characteristic that they were average or below they received a zero. For example, eating above average amounts of vegetables, earned a point or eating below average amounts of red meat earned a point. Subjects could earn from 0 points for absolutely poor adherence to the diet up to a high score of 9 points for excellent adherence.
Sofi’s analysis found that as little as a 2-point increase in scores produced statistically significant decreases in disease risk. For every 2-point increase in their adherence score, a subject had a 13% decrease in the risk for getting Alzheimer’s and Parkinson’s disease, a 6% decrease in risk of getting or dying of cancer, and a 9% decreased risk of dying of cardiovascular disease. Every 2-point increase in adherence was associated with an 8% decrease in risk of overall mortality, that is, dying from any cause. The closer one follows the diet, the more points and the greater the benefit.
As there is no comparable degree of scientific data supporting the other ‘diets’ that have been promoted over the years, it makes sense for people to shift their diets in the direction of a Mediterranean diet.