40 Years of the Mediterranean Diet: What's Next for the World's Healthiest Eating Plan

After centuries of culinary tradition, the Mediterranean diet was formally defined in 1980. On its fortieth anniversary, experts reveal the health benefits that have allowed the diet to endure and look ahead to its future.

May. 4, 2020
By Costas Vasilopoulos

In 1958, a phys­i­ol­o­gist from the University of Minnesota School of Public Health observed that inci­dents of coro­nary heart dis­ease were more com­mon in mid­dle-aged Americans than their European coun­ter­parts liv­ing in Mediterranean coun­tries.

Ancel Keys pos­tu­lated that a cor­re­la­tion existed between peo­ple’s risk for heart dis­ease and their eat­ing habits and lifestyle.

You can make extra vir­gin olive oil part of a (Mediterranean) dietary pat­tern to improve your health acutely and reduce your risk of severe coro­n­avirus infec­tion.- David Katz, Yale University

This obser­va­tion led Keys to launch his sem­i­nal study, with par­tic­i­pants from seven coun­tries around the world – the United States, Italy, Greece, Yugoslavia, the Netherlands, Japan and Finland – to ver­ify the hypoth­e­sis.

Consequent research showed a large dis­crep­ancy in the inci­dence and mor­tal­ity of heart dis­ease among the mon­i­tored pop­u­la­tions.

See more: Olive Oil Health Benefits

Participants from Italy and Greece, espe­cially Crete, who had sim­i­lar eat­ing habits, had the low­est heart dis­ease rates among other par­tic­i­pants. The same was true for their Japanese coun­ter­parts, whose diet was also plant-based, but lacked the unsat­u­rated fat that Mediterranean pop­u­la­tions were receiv­ing mainly from olive oil.

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Participants from Finland and the United States, on the other hand, had the high­est rates of heart dis­ease due to their high intake of sat­u­rated ani­mal fat, the research con­cluded.

The Seven Countries Study demon­strated that low rates of heart dis­ease can occur both with a low and a high intake of fat, depend­ing on its nature and the dietary habits of the par­tic­i­pants.

This rev­e­la­tion led to the for­mal def­i­n­i­tion of the Mediterranean diet in 1980 after the first results of the study were pub­lished by Harvard University.

On the for­ti­eth anniver­sary of the pub­li­ca­tions of these results, experts from var­i­ous fields spoke with Olive Oil Times about the char­ac­ter­is­tics of the diet and its future.

Markos Klonizakis, a clin­i­cal phys­i­ol­o­gist at Sheffield Hallam University, in England, said one of the ben­e­fits of the Mediterranean diet is that there are many vari­a­tions, mak­ing it adapt­able across cul­tures.

My team tried to apply a MedDiet closer to the Greek type, con­tain­ing fruits, veg­eta­bles, legumes, fish, olive oil and more,” Klonizakis said. Our research has repeat­edly shown that the MedDiet can act defen­sively, pro­vid­ing short-term and longer-term ben­e­fits, either on its own or in con­junc­tion with mild exer­cise.”

Recently, we found that a Mediterranean-style eat­ing pat­tern can quickly lessen the impact of Type 2 dia­betes on microves­sels, but more time is needed to ease the impact of aging on peo­ple,” he added.

Klonizakis argued that the eat­ing pref­er­ences of peo­ple can be shaped by many fac­tors and the cur­rent pan­demic may be one of them.

Unhealthy food is eas­ier to pre­pare. Maybe the coro­n­avirus pan­demic is a chance for us to start eat­ing bet­ter,” he said. Of course, eat­ing pat­terns are also a mat­ter of trend, for exam­ple, the vegan regime has many adher­ents even though its ben­e­fits are not widely estab­lished, but nutri­tional tra­di­tion usu­ally endures through time.”

In 1980, Time mag­a­zine fea­tured the results of the Seven Countries Study and paid trib­ute to Keys on the cover.

David Katz, a doc­tor from Yale University and the founder of the True Health Initiative agrees. He told Olive Oil Times that part of the rea­son the Mediterranean diet is able to endure and remain pop­u­lar is due to its cul­tural impor­tance. It is not just a pass­ing fad.

It has been mak­ing and keep­ing peo­ple healthy for gen­er­a­tions,” he said.

Katz added that sup­ple­ment­ing the MedDiet with extra vir­gin olive oil makes it more plea­sur­able and enhances its health ben­e­fits. Following a healthy diet helps to improve the immune sys­tem.

You can make extra vir­gin olive oil part of a dietary pat­tern to improve your health acutely and reduce your risk of severe coro­n­avirus infec­tion,” he said.

Mary Yannakoulia, an asso­ciate pro­fes­sor of nutri­tion and eat­ing behav­ior at Harokopio University of Athens, named some of the traits of the Mediterranean diet demon­strated by numer­ous sci­en­tific stud­ies.

Many stud­ies have shown that higher adher­ence to the MedDiet, leads to lower risk for coro­nary dis­ease, can­cer, demen­tia and Alzheimer’s,” she told Olive Oil Times. In my opin­ion, the MedDiet is a healthy dietary pat­tern that can be used in Greece to pro­mote the cit­i­zens’ health, and even pre­vent var­i­ous dis­eases, given the avail­abil­ity of the sta­ple Mediterranean food and its direct con­nec­tion with the tra­di­tion and the cul­ture of our coun­try.”

In 2013, the MedDiet was named as a UNESCO Intangible Cultural Heritage of Humanity for both its health ben­e­fits and its cul­tural impor­tance to the Mediterranean region.

In spite of all this, Yannakoulia remains skep­ti­cal about the long-term adher­ence of con­sumers in Greece to the MedDiet.

It is a ques­tion of how much we have moved away from the MedDiet,” she said. No easy answer exists, con­sid­er­ing that eat­ing habits change over time, as do soci­eties.”

Basic ele­ments of the MedDiet con­tinue to exist in the dietary pat­terns of peo­ple in Greece, such as the every­day use of olive oil and the fre­quent con­sump­tion of fruits, veg­gies, legumes and grains,” she added. On the other hand, many peo­ple in Greece nowa­days have started to con­sume more meat and processed food.”

However, on the other side of the Atlantic, Lizzy Freier believes the Mediterranean diet will con­tinue to gain pop­u­lar­ity with younger con­sumers. Freier works at Technomic, a food­ser­vice research and con­sult­ing com­pany in Chicago, and said that the diet is linked to many cur­rent healthy eat­ing trends.

These health trends include the growth of veg­etable-for­ward diets and a focus on unprocessed foods — both of which are core attrib­utes of Mediterranean fare,” she told Olive Oil Times. Emphasizing health ben­e­fits of Mediterranean items espe­cially appeal to younger con­sumers who are con­sci­en­tious, are increas­ingly chang­ing their diets to limit ani­mal prod­ucts and are look­ing to include more nat­ural foods.”

There aren’t any strict rules, instead it’s based on a set of guide­lines such as includ­ing more fruits, veg­eta­bles, whole grains, legumes, beans and nuts.- Brynn McDowell, dieti­cian and blog­ger

Freier cited some mar­ket research sta­tis­tics to back up her obser­va­tion and said that 42 per­cent of con­sumers have tried and liked Mediterranean cui­sine. An addi­tional 37 per­cent have not yet tried a Mediterranean eat­ing plan, but would like to do so.

As health and diets evolve and con­sump­tion of eth­nic food con­tin­ues to expand, the Mediterranean diet is poised to grow as a pop­u­lar cui­sine that appeals to din­ers with fla­vor­ful, healthy dishes,” Freier said.

Brynn McDowell, an American dieti­cian and blog­ger, agrees that the Mediterranean diet is likely to con­tinue grow­ing in pop­u­lar­ity in the U.S. She said the flex­i­bil­ity of the diet plays a big part in mak­ing it an easy eat­ing plan to fol­low.

There aren’t any strict rules, instead it’s based on a set of guide­lines such as includ­ing more fruits, veg­eta­bles, whole grains, legumes, beans and nuts,” she told Olive Oil Times. Emphasis is placed on what you should add to your diet for health. While some foods, such as red meat and sug­ary desserts and pas­tries, are rec­om­mended to be enjoyed in mod­er­a­tion, they aren’t for­bid­den. This makes the Mediterranean diet eas­ily cus­tomiz­able to your lifestyle.”

McDowell sees this flex­i­bil­ity as a way to pre­vent con­sumers from get­ting frus­trated by the lim­i­ta­tions of the diet, which is one of the key rea­sons why peo­ple find more strict diets harder to fol­low.

I feel like peo­ple are start­ing to get frus­trated with the newest fad or restric­tive diet and instead, get­ting back to falling in love with good food and healthy, fresh ingre­di­ents again, which is what the Mediterranean diet is all about,” she said. It’s my opin­ion that the Mediterranean diet is here and pop­u­lar for the long haul.”

The Mediterranean diet has been selected as the best diet of 2020 by the U.S. News and World Report. It was the third con­sec­u­tive year that the eat­ing plan was selected as the top diet.





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