An update on the world’s most misunderstood eating style and why the contemporary version is making people overfat.

Most people have heard about the Mediterranean diet, and the medical literature contains thousands of research articles referencing it. The “Med diet” has been recommended as a remedy for metabolic syndrome, “weight” gain and obesity, and for preventing most chronic diseases.

There’s also a connection between the overfat epidemic and the modern version of the Med diet, which is really quite different from the original.

Healthy components of the original Med diet include higher consumption of olive oil, vegetables, fruits, legumes and nuts, and moderate red wine intake. Known for its higher fat content, especially when supplementing extra fat from olive oil and nuts like almonds and walnuts, the style of eating is associated with a reduction in cardiovascular risk by about 30 percent. It has also be shown to reduce carbohydrate intolerance.

However, over the course of decades of research, something bad happened — an obvious problem consistently missed by the media and most scientific discussions — the diet began to include processed junk foods. Associating these health benefits with today’s popularized and contrived “Med diet” is a myth.

Technically defined quite simply as a menu of the traditional foods that have been consumed for thousands of years in the areas that surround the Mediterranean Sea, this way of eating has been described by modern-day nutrition researchers as “the cultural heritage of all mankind.” This is the same geographical area where Western civilization began to flourish, creating art, commerce and culture. Agriculture was the foundation of society, and it’s thought that 80 percent of the population was involved in growing, producing or selling these healthy, natural foods.

Unfortunately, the media has misled people about this so-called “diet.” Some researchers have even made a food pyramid out of it. Not unexpectedly, hundreds of diet books and cook books have been written in many languages. The worst portrayal of the Med diet is that it’s a “diet” in the first place. It’s not. There are no rules, no serving sizes and no special recipes one must follow to eat this way. It’s a way of eating local, natural foods “specific to a certain climate and culture,” says Walter Willet, chairman of the Department of Nutrition at the Harvard School of Public Health. “By paying attention to healthy ingredients rather than specific recipes, anyone can adapt this plan to their own tastes.”

The result is better fat-burning, increased longevity, and improved health with much less chronic illness.

The area surrounding the Mediterranean Sea varies significantly in climate so that the food grown there can differ considerably as well, and even the seafood available in waters in different locations can vary. This provides a smorgasbord of healthy, natural foods rather than one eating style.

Another myth is that the Mediterranean people avoided eating animal foods. They ate meat — ranging from poultry and lamb, to wild animals. Likewise, they didn’t shun beef, it just was not part of the daily dietary regimen because cattle didn’t exist there in large numbers. However, raising other animals provided more than meat, including chickens (which also provided eggs), lamb (which also provided wool) and sheep (which also provided milk).

In addition, the whole grains consumed in the Mediterranean area were truly whole. Cereal, from the Greek word sitos, refers to any type of grain. For thousands of years, about 90 percent of the cereal grain grown and consumed in the Mediterranean region was whole, unprocessed barley. Most people today, especially in the Western world, have never seen or tasted whole grains despite what labels say on most packaged food items like breads and cereals. The commercial phrase “whole grain” is usually a gimmick to fool people into thinking they’re eating something healthy, when in fact the product is most often highly processed.

As a result, the varying climates, lifestyle, and physical environments in the Mediterranean area produced a diet in Greece that was different than the foods consumed in say, Spain and Italy, which varied from the foods consumed in Lebanon. Yet the people in each of these regions consumed a “Mediterranean diet.” In fact, the Greek root word of “diet” is diaita, which means to live one’s life.

Popularizing the “Diet”

In the West, descriptions of a Mediterranean diet began to appear in the 1950s after researchers studied the eating habits of those living on the Greek island of Crete. These people had better longevity, and suffered very low rates of heart disease and cancer, despite having a diet that was high in healthy fat. In this particular Mediterranean area, people would eat vegetables and fruits, legumes, cheese, nuts and yogurt, and whole grain barley on a daily basis. Each week, eggs, poultry, and fish were consumed, with lesser amounts of meat. Olive oil was used daily and liberally, and wine was regularly consumed in moderation. In addition, the Cretans led very active physical lives. Studies verified that they not only lived significantly longer than those who ate poorly and were less active, but their quality of life was higher through old age.

In 2003, Antonia Trichopoulou and colleagues, from the University of Athens Medical School, published a study that described the essence of the Greek Mediterranean diet. This included vegetables (excluding potatoes), legumes, fruits, nuts, seeds, whole grains, fish, and moderate alcohol consumption. Another study published in The New England Journal of Medicine the same year showed that a greater adherence to this traditional Mediterranean diet is associated with a significant reduction in total mortality.

The problem is, there never really was a Mediterranean diet. There are only Mediterranean-type ways of eating — foods consumed by those who live at or near the Mediterranean Sea in the more than 15 countries that surround it. Today, these countries include those in Europe to the north and west, including Greece, Italy, France and Spain; Asia and the Middle East to the east, including Turkey, Israel, Lebanon, and Syria; and Africa to the south, including Egypt, Tunisia and Libya.

The fact is, local foods were the only ones available until the last half century. Not only did people not have radio and TV to tell them which foods to buy, there were hardly any unhealthy foods to choose from. The overfat person was a rare individual, usually someone with an unusual metabolic disorder. Sadly, all this has changed.

The New Med Diet

Starting in the 1950s, the diets of the Mediterranean nations began to be replaced by high amounts of refined white wheat flour, sugar and unhealthy fat. The proliferation of fast-food restaurants, packaged foods, and convenience items are now the norm in the daily eating habits of most people, with the traditional fare of vegetables, fruits, nuts, and fish no longer the staple. The new Med diet has morphed into junk food. Meanwhile, the health benefits associated with the traditional diet began slipping away. Today’s new Med junk food diet has significantly contributed to the overfat epidemic — in both adults and children, with rising rates of heart disease, diabetes and cancer.

Angelos Vetsis, a computer engineer who lives in Athens, Greece, with his wife and two children, subscribes to my newsletter. In an email, he told me that he and his family eat in the traditional, healthy manner. “But the problem is that under the pressure of the media the majority of Greek people adopted the so-called ‘Western lifestyle,’ which among other habits means consuming unhealthy and processed foods.”

An example is in Greece, which, along with the U.S., has one of the highest levels of overweight adolescents aged 13 to 15 years in the world, with children in other age groups following similar trends.

The high level of screen time has also contributed to the significant reduction in physical activity. Despite hosting the 2004 Olympics, Greece has largely become a society of sedentary individuals. Ironically, many of the stadiums and arenas built for the Games are unused and already falling apart. Nor does it help matters that Greece has one of the highest per-capita smoking rates in Europe. Then there’s the issue of advertising and marketing. Television commercials ignore the traditional diet in favor of junk food — fast food restaurants, packaged sweets and other highly processed sugary snacks.

Cost Factor Fallacy

While some have tried to argue that eating healthy is too expensive, studies have found that promoting a healthy Mediterranean-type dietary pattern need not necessarily be associated with higher overall food costs.

In the September 2009 issue of the journal Public Health and Nutrition, Adam Drewnowski (from the University of Washington’s Center for Obesity Research) and Petra Eichelsdoerfer (from the Bastyr University Research Institute) wrote a paper entitled “The Mediterranean diet: Does it have to cost more?” They observed that, “the key to avoiding increased overall dietary costs lies in educating consumers about lower-cost foods while selectively purchasing limited amounts of higher cost ones.”

Those willing to take the one simple step to break the habit — avoiding these unhealthy foods — will find the traditional healthy Mediterranean diet still waiting for them. As Vetsis wrote to me from Athens, “There are grocery stores in every neighborhood where you can find a great variety of healthy foods — vegetables, legumes, fresh fish and meat, eggs, and of course, olive oil.”

We can all adopt healthier eating habits — just like our Mediterranean ancestors. This does not mean going to an Olive Garden Restaurant with its phony Old World Italian décor and then gorging on bread-stick appetizers and pasta. Instead, grab some fresh vegetables to make a great Greek salad, add a small amount of meat, a nice red wine, and you have a delicious meal which won’t take more than 15 minutes to prepare.

16 Comments

  • Andrew says:

    Great summary. In addition, people often fail to note that fasting and greater spacing of meals was often the norm. Neither of which we practice much today. Our snack-centric culture is further contributing to our over-fat woes.

    • Jonathan says:

      “Fasting and greater spacing of meals” might be a bit of an understatement. I think we should be skeptical of claims that certain populations are or were healthy because they ate certain foods. More likely they simply didn’t have very much to eat, period. The Mediterranean area is perhaps a good example. Judging from my personal experience and reading, most of the land surrounding the Med is dry and relatively unproductive. There are, of course, fish in the sea but it’s no secret that traditional fishing is unpredictable at best.

      • Jonathan:

        Latest accounts of the energy metabolism of the human body suggest that being healthy and unhealthy—which is correlated with but a different thing altogether than fat or weight status—is NOT a function of how much food you end up eating. While the amount of food you eat does impact your health, it has a much smaller effect size than the KINDS of food you eat. The article I linked to above suggests that (a) overeating and (b) a low activity level can be better understood as consequences of obesity, than as causes of it. Overeating and a low activity level entrench and exacerbate health problems, of course. And while overeating cannot occur in an energy-deprived environment, the same metabolic phenomena underlying obesity and the metabolic syndrome can and do occur in such an energy-deprived environment.

        Indeed, fasting is only beneficial and effective at promoting health when combined with a healthy and varied diet. We can say that when “fasting” is combined with a poor diet—when it is a consequence of having poor access to foods—it is not “fasting” in any sense of the word. It is much better described by the word “starvation.” What this means is that those cultures intentionally fasted as a way of life and as a way of producing health by enabling the body to reset many of its regulatory mechanisms. This simply does not happen when the reason you are not eating is because food is only available intermittently or is simply not there.

        If you look at the historical roots of fasting, you will find that almost all instances occur in subcultures that focus on abnegation as a reaction to the excess of elites (meaning that they came in response to people who indulged in too much food). This is the reason that fasting is so associated with spirituality, monks, priests, etc. Digging a little deeper, you will see that many of the reasons these people fasted were to purify the mind and body from the very excesses of the elites. (Those excesses brought with them gout, kidney failure, arthritis, etc.) And so fasting became a cultural tool to separate one’s mind and body from the excesses themselves and their psychological and health consequences.

  • Mark says:

    Perhaps a plug for the movie “The Big Fat Fix” is in order.
    http://www.thebigfatfix.com/
    https://vimeo.com/174105504

  • CKarch says:

    Great article. May I add that, as a person of Mediterranean descent, I find the concept of “The Mediterranean Diet” offensive. How about some cultural sensitivity? The Mediterranean is a geographic region with a vast number of ethnicities and cultures, within which can be found an endless variety of cuisines, let alone micro-variations within cuisines that occur sometimes only miles from each other. To see these foodways whitewashed into a bland soulless “diet,” misses the entire point of how food functions in that part of the world: as something that, besides mere nourishment, cements the social fabric and brings pleasure. What proponents have overlooked in their obsession with this “diet” is that the benefits of it most likely can’t be had without the socio-cultural aspect. I’m sorry, but the American eating their steamed broccoli and boneless, skinless chicken breast (with the allowed olive oil) alone in front of the TV is not going to live to be 120 like the “Mediterranean” person with strong social connections, who is physically active, has low stress, and sees eating as an enjoyable and necessary experience rather than some sort of prescription to be grimly endured (though, to be fair, that person is quickly becoming an obsolete stereotype, as American homogeneity erases cultural traditions around the world and causes, as the author points out, American-style health problems).
    Also, fun fact, many Mediterranean cultures ate lard regularly. For example, in Italy, olive oil only became widely used only after the railroads were nationalized in the 1860s. So the prevalence of olive oil is itself a result of industrialization. If you research the regional cooking of Italy you can see that southern Italian recipes include not only lard, but also up to 3 different kinds of meat (lamb, pork, chicken) in one dish. I assume those would be excluded from the “Mediterranean Diet,” as would any number of dishes that don’t meet some narrow criteria hatched in a laboratory.

    • CKarch:

      All good points! Very much agreed that the name “Mediterranean Diet” obscures many of the different culinary heritages of the region.

    • Dan says:

      I love your comment and as someone who lived nearly equal amount of time in the US and the Mediterranean, I couldn’t agree more. There’s a notion that Italians have been using olive oil since time immemorial but as you pointed out, it only became prevalent in the late 1800; and so for and so for. Also where I’m from, meals are eaten together rather than separately in front of the Tv but I would be careful to generalize. 2nd and 3rd generation of Americans of Italian, Greek and Jewish descent to name a few, still gather around the dinner table and break bread. But we should also be fair and compare small town residents to small villages abroad.

  • Great article! Thanks for the work you do.
    I truly agree its not about a “diet.” We as professionals have a job to educate our clients and peers
    to adopt a lifestyle and not let corporations decide our health. The current trend of things seems
    to revolve around the sugar industry. Product placement and modern marketing skills are our biggest enemy.
    We must be creative in our attempts to break the cycle. Attainability is a tool we can use to make information and practices available to
    the public. Onward! Take care my friends

  • Cathy says:

    Hello! Love reading this blog. First heard of Dr. Maffetone in the book “Natural Born Heroes”. Maybe this has already been done, but what about an expose on the so called Mexican diet?

    • “Mexican diet” encompasses lots of foods.

      I want to make sure you mean “beans + corn + hot peppers + squash”

      Lots of interesting implications to that diet. I’ll talk to Dr. Maffetone about discussing it.

  • Northern Europeen says:

    So you mean that food from northern Europe or East Asia is bad? Is seaweed, roots, berries bad? Is dairy bad, Is rice bad. Is reindeer meat worse than their kind of meats? Is canola oil or linseed oil bad? Is eating wild muschrooms bad?I am a pescetarian that doesn´t drink alcohol. I love to eat oats, bruna bönor, ärtsoppa utan fläsk, mackerel, Salmon, inlagd sill, wild plants, matjee herring, saurkraut, swedes, pepparrot, rödklöver, sojaflour, northern cheese, gräddfil, filmjölk, nettles, well I could make the list very long. The mediterranian peoples do not seem to have many bicycle paths, pollted air in the cities, very few places where you can Breathe healthy air, low ecological awareness. I will go on being a pescitarian and eat stuff I feel make make me healthy and I hate pasta, all this french and italian food, cous cous, Deep fried shit, greek food, lebanese food,etc. Yeah sure I like Almonds, lemons, oranges, bananas, avacados, sardines, olive oil, etc but I have never been impressed by Southern food habits. I also like the way east asians eat, or real indian food which is ovo lacto vegitarian, but why limit my food choises to what they eat at the mediterranian. About all this social shit it can be both negative and positive. I often prefer to be outdoors or at home Reading or doing my hobbies than sitting among people drinking alcohol and eating excessively. I meat and chat with people enough Daily.

  • Robert says:

    I wonder about the effects of sunshine on health and life expectancy.

    It´s true that the Med countries mostly do well on life expectancy. But Australia does too.

    (See WHO table for 2015: https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy)

    Australia is joint 4th with Spain! Yet their diet is very similar to the UK´s.. Lots of fast and junk food, fried food and sugar. They also have a bad overweight/obesity problem. How come they are generally near the top on life expectancy tables? New Zealand has a similar diet – but they are further down the table on life expectancy. About the same as the UK.. They also have less sunshine than Australia.

    Japan almost invariably comes top. Why don´t we talk more about their diet?

  • John says:

    This reinforces the simple truth that is avoided in the drive for scale and profit, and the apathy of short term consumer thinking… Backed up (?) by simple layman’s observations in Europe, China, Australia and Tanzania.
    Prepare a simple balanced meal from raw ingredients and you can eat as much as you like and get healthier. Eat from a packet and the pendulum swings very quickly.

  • Lucas says:

    I like the Mediterranean diet and it easy to follow, I am really healthy right now.

  • Thomas says:

    I really enjoy following this diet but the name is hard. The diet has seafood, meat and allot of salads.
    I think it is really really really healthy first I was obese and now I am very healthy.

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