Established in 2009 by Oldways, a non-profit organization teaching people about various traditional diets, Med Diet Month actually celebrates the Mediterranean Lifestyle which involves more than just eating certain foods.
This plant-forward diet is fibre-rich, low in sodium and saturated fats, high in potassium and unsaturated fats.
This generally breaks down as follows:
- Every day: whole grains, fruits, vegetables, legumes, herbs, spices, nuts, seeds and healthy fats such as olive oil every day
- At least twice weekly: fish and seafood
- Moderate: dairy, eggs, and poultry
- Infrequent: red meat and sweets
In addition to the diet aspect of this component, the Mediterranean Lifestyle also encourages community and connection, regular movement, and life balance.
- Community and connection: where possible, eat with others and connect regularly with those who matter to you
- Movement: lots of walking, moving naturally through your day
- Life balance: laugh often, simply, do things for fun
At this time, the Mediterranean Diet remains the most researched dietary pattern. In fact, there have been over 3000 studies published in the last 3 years alone on topics as varied as cancer, osteoporosis, heart disease, cognition, diabetes, arthritis, acne, and ADHD.
Despite this interest, it’s important to know that nutrition research is a very tricky thing to do right. Not only is it unethical to force people to eat only certain things (obviously), but it is also impossible to achieve certain other desirable study components such as “blinding” since you can’t prevent people from knowing what they are actually eating. It is for these reasons, and more, that nutritional research often gets described as unreliable.
Although that’s partially true, researchers have been reframing how nutritional investigations should be done, and are finding ways to adjust for these issues which has led to some exciting new results.
The latest study looking at the Mediterranean diet and heart health specifically is hot-off-the-presses recent, released less than a week ago (of my writing this blog). Titled “Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and low-fat diet: a randomised controlled trial”1, this study (also known as the CORDIOPREV trial) looks at whether a Mediterranean diet rich in olive oil reduces risk of heart disease events more than a low-fat diet.
Approximately 1000 Spanish patients who had already been diagnosed with heart disease were separated into an olive oil group and a low-fat group and followed for 7 years, making it the longest study of its kind. After that time it was observed that the people in the olive oil group collectively had fewer major cardiovascular events than the low-fat group. Yay Med Diet with olive oil!
What’s particularly interesting is that the low-fat group was already eating a pretty decent Mediterranean-like diet with a good amount of fibre and less saturated fat. So the study actually showed that high-risk groups can benefit from even relatively modest changes to their diet.
How great is that?
Where do I start?
A commonly used tool to help people work on following more of a Mediterranean Diet-style of eating is the Medi Diet Score adapted from the PREDIMED trial2.
Each “Yes” answer gets 1 point.
Results from the PREDIMED trial suggests that if you can find a way to increase your total score by 2 points, you can reduce your risk of many chronic conditions.
- Do you use olive oil as main culinary fat?
- Do you consume more than 4 Tbsp of olive oil per day (including oil used for frying, salads, out of house meals, etc.)?
- Do you consume 2 or more servings of vegetables per day? (1 serving = 200g – consider side dishes as 1/2 serving)
- Do you consume 3 or more servings of fruit per day?
- Do you consume less than 1 serving of red meat, hamburger, or meat products (ham, sausage, etc.) per day? (1 serving = 100-150 g)
- Do you consume less than 1 serving of butter, margarine, or cream per day? (1 serving = 12 g)
- Do you drink less than 1 sweet/carbonated beverages per day?
- Do you drink 7 or more glasses of wine per week?*
- Do you consume 3 or more servings of legumes per week? (1 serving = 150 g)
- Do you consume more than 3 servings of fish or shellfish per week? (1 serving: 100-150 g fish, or 4-5 units or 200 g shellfish)
- Do you consume fewer than 3 servings of commercial sweets or pastries (not homemade), such as cakes, cookies, biscuits, or custard per week?
- Do you consume 3 or more servings of nuts (including peanuts) per week? (1 serving = 30 g
- Do you preferentially consume chicken, turkey or rabbit meat instead of veal, pork, hamburger or sausage?
- Do you consume vegetables, pasta, rice, or other dishes seasoned with sofrito (sauce made with tomato and onion, leek, or garlic, simmered with olive oil) at least twice per week?**
*growing research suggests that this factor has more to do with socializing during meals than with the wine itself so it is not recommended to start drinking if you are not already doing so
**sofrito is a Mediterranean-specific sauce in this context, please consider the addition of tomato and onion/garlic and/or leek in other contexts
Long story short
How we eat matters, but it isn’t everything. Even Mediterranean Diet proponents agree that the lifestyle factors contribute to its magic. That said, data continues to build supporting the above dietary recommendations, especially when combined as an overall dietary pattern.
1. Delgado-Lista, J. et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet 399, 1876–1885 (2022).
2. Estruch, R. et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. New Engl J Med 378, e34 (2018).