Only Rich, Well-Educated Benefit From Med Diet

A study has revealed that the Mediterranean diet is only beneficial to those who have access to high-quality foods.

Aug. 7, 2017
By Isabel Putinja

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A study by a group of Italian researchers pub­lished in the International Journal of Epidemiology has con­cluded that those who are well off or highly edu­cated are more likely to reap the health ben­e­fits of the Mediterranean diet.

We can­not keep say­ing that the Mediterranean diet is good for health if we are not able to guar­an­tee an equal access to it.- Giovanni de Gaetano

As part of the study, the researchers from IRCCS Istituto Neurologico Mediterraneo Neuromed, an Italian research insti­tute, tracked a group of 18,991 men and women over the age of 35 for a period of four years and four months.

The Mediterranean Diet Score (MDS) was used to assess the par­tic­i­pants’ com­pli­ance to the diet while data on their annual house­hold income and edu­ca­tional lev­els were col­lected as indi­ca­tors of their socio-eco­nomic sta­tus. Each of the study par­tic­i­pants was also mon­i­tored for total phys­i­cal activ­ity, tobacco use, body mass index, health his­tory, and inci­dence of car­dio­vas­cu­lar dis­ease, dia­betes and can­cer.

The researchers assessed the par­tic­i­pants’ food intake, tak­ing note of the foods they con­sumed as well as fac­tors deter­min­ing food qual­ity: for exam­ple, whether foods were organic or not, and if bread con­sumed was whole-grain or refined. At the same time, they exam­ined the cook­ing meth­ods used and specif­i­cally whether foods were pre­pared by boil­ing, stew­ing, fry­ing, roast­ing or grilling.

The results revealed that for every two-point increase in MDS, there was a 15 per­cent reduced risk of car­dio­vas­cu­lar dis­ease. However, this result was only evi­dent in those with a higher income or level of edu­ca­tion com­pared to par­tic­i­pants of lower socioe­co­nomic sta­tus.


According to the research analy­sis, this dif­fer­ence was attrib­uted to dif­fer­ent intakes of antiox­i­dants and polyphe­nols, fatty acids, micronu­tri­ents, dietary antiox­i­dant capac­ity, dietary diver­sity, organic veg­eta­bles and whole grain bread con­sump­tion.”

Marialaura Bonaccio, the lead author of the study told CNN that the higher-income group con­sumed more fish and a higher qual­ity diet that included organic and whole grain foods. She also pointed out that the qual­ity of prod­ucts like olive oil may make a dif­fer­ence.

Let’s give that two per­sons fol­low the same diet, that is equal amounts of veg­eta­bles, fruits, fish, olive oil etc. every day so that they report the same adher­ence score to the Mediterranean diet,” she told CNN. It might be that, beyond quan­tity, dif­fer­ences in qual­ity may exist. For exam­ple, in olive oil… our hypoth­e­sis is that dif­fer­ences in the price may yield dif­fer­ences in healthy com­po­nents and future health out­comes.”

Speaking to Science Daily, Giovanni de Gaetano, another mem­ber of the research team, high­lighted the impact of socioe­co­nomic sta­tus on healthy food choices that the study has brought to light:

Our results should pro­mote a seri­ous con­sid­er­a­tion of socioe­co­nomic sce­nario of health. Socioeconomic dis­par­i­ties in health are grow­ing also in access to healthy diets. During the very last years, we doc­u­mented a rapid shift­ing from the Mediterranean diet in the whole pop­u­la­tion, but it might also be that the weak­est cit­i­zens tend to buy Mediterranean’ food with lower nutri­tional value. We can­not be [keep say­ing] that the Mediterranean diet is good for health if we are not able to guar­an­tee an equal access to it.”

The Mediterranean diet is char­ac­ter­ized by a high con­sump­tion of fruits, veg­eta­bles, legumes, cere­als and nuts, a mod­er­ate intake of fish, and small quan­ti­ties of meat, poul­try and dairy prod­ucts. Also, monoun­sat­u­rated fats like olive oil are favored instead of sat­u­rated ones like but­ter and lard, and alco­hol con­sump­tion is lim­ited.

This was the first study to link the health ben­e­fits of the Mediterranean diet to socio-eco­nomic sta­tus.

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