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The Mediterranean Diet Myth

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.