Exploring the sense and nonsense of food and health

Olive Oil and Longevity: The Mediterranean Diet Pyramid

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About 15 olive-growing countries border the Mediterranean Sea, the largest inland sea.  These include Spain, France, Italy, Greece, Portugal, and the countries of North Africa.  Lifestyles in these countries vary, but there are diet patterns similar throughout the region.  Along with Oldways, the Harvard School of Public Health, and the European Office of the World Health Organization introduced the classic Mediterranean Diet in 1993 at a conference in Cambridge, MA.

According to the Oldways Website, “This pyramid represents the “gold standard” of eating patterns that promotes lifelong good health.  The pyramid was created using the most current nutrition research  based on the dietary traditions of Crete, Greece and southern Italy circa 1960 at a time when the rates of chronic disease among populations there were among the lowest in the world, and adult life expectancy was among the highest even though medical services were limited”

  • High consumption of olive oil
  • High consumption of legumes
  • High consumption of cereals, mostly unrefined
  • High consumption of fruits
  • High consumption of vegetables
  • Moderate consumption of dairy, mostly cheese and yogurt
  • Moderate consumption of poultry and fish
  • Low consumption of red meat (1 time a month)
  • Wine, in moderation – with meals (never alone)
  • Physical activity is also emphasized

The Lyon Heart Study, a randomized, controlled trial with free-living subjects tested the effectiveness of a Mediterranean-type diet on the rate of coronary events in people who’ve had a first heart attack.

A total of 302 experimental- and 303 control-group subjects were randomized into the study. All were patients who had survived a first heart attack. The two groups had a similar coronary risk factor profile (blood lipids and lipoproteins, systolic and diastolic blood pressure, body mass index and smoking status). Patients in the experimental group were asked to comply with a specific Mediterranean-type diet. Patients in the control group received no dietary advice from the researchers but were asked by their physicians to follow a low-fat diet.

After a minimum follow-up of one year for each patient, the study was stopped at that point because of significant beneficial effects noted in the Mediterranean diet group. The overall results suggested that a Mediterranean-style diet might help to reduce recurrent events in patients with heart disease.

Since then a meta-analysis including results of 50 studies on the Mediterranean diet, with an overall studied population of about half a million people showed that these diet patterns have been shown to be associated with:

  • Decreased mortality from all causes
  • Lower risk for heart disease, type 2 diabetes, obesity, and some types of cancer
  • Beneficial effect on lipid levels, glucose metabolism, blood pressure levels

The authors remarked that the “antioxidant and anti-inflammatory effects of the Mediterranean diet as a whole, as well as the effects of the individual components of the diet, and especially olive oil, fruits and vegetables, whole grains and fish, also confer to the beneficial role of this pattern”.

The Mediterranean Diet Now

The traditional diet of this region is slowly fading, especially in the urban areas.  They still use olive oil – but due to higher incomes and use of refrigeration throughout the area, the use of butter, margarine and polyunsaturated fats like corn oil are creeping into the diet in most areas.  Meat is gaining staple status.  Imported meats in Greece increased more than fourfold from 1975 to 1985 alone.

When you stroll along now in Greece, you’ll likely see dozens of restaurants serving American-style sandwiches such as grilled cheese and ham and in kiosks, you’ll notice potato chips and snacks for sale – products that were not even available there a decade or so ago.

Today you can still find restaurants serving up Mediterranean-inspired delicacies on almost every corner and Greek food products in almost every major grocery store.  Although the Mediterranean diet is rated as one of the best  diets for health and effectiveness, according to a recent article in U.S. News & World Report,  one can’t say the same of its birthplace. A recent United Nations Food and Agriculture Organization report shows that Greeks, Italians and other Mediterranean nations are consuming more calories, more saturated fat and anything but following their forefather’s diet.

Researchers attribute this change in eating habits not only to increased income but to diverse factors such as the rise in the number of supermarkets, working women having less time to cook, families eating out more often in fast-food restaurants, and of course, less exercise. Sadly today, a massive 75% of the population in Greece is obese or overweight – an ironic leader in the European Union. Sounds familiar?

Public health officials in Greece are working hard to promote and revitalize the traditional Mediterranean diet among the growing fast-food-and-butter-loving population.  The Mediterranean diet pyramid was officially adopted in Greece as “the way to eat” in 1994.

Dr. Antonio Trichopoulou, MD from the University of Athens and a Mediterranean researcher, fears the advent of a dramatic leap in heart disease statistics in the near future if the sedentary, high-fat lifestyle manifests itself into the population for good.

Dr. Trichopoulou calls olive oil (the extra-virgin kind) “olive fruit juice” .  Maybe it is the secret of the Mediterranean diet – olive oil is replete with vitamin E and other disease-fighting antioxidants that have yet to be discovered.   Research will continue to pursue the healthy aspects of the diet but it is thought that in addition to the diet, increased activity and the lifestyle of the Mediterranean region plays a role and should be preserved.

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