The Mediterranean Diet

The Mediterranean Diet has certain types and amounts of food. If eaten for a number of years, it has been shown to reduce the risks of developing heart disease, cancer, high blood pressure (hypertension), type 2 diabetes, Parkinson's disease and Alzheimer's disease. Following the diet has also been linked with a reduced risk of early death and has proved a successful strategy for healthy weight reduction. You don't need any particular cooking skills to produce inexpensive, delicious, meals fitting the Mediterranean Diet.

What is the Mediterranean Diet?

The Mediterranean Diet is rich in vegetables, fruit, peas and beans (legumes) and grains. It also contains moderate amounts of chicken and fish.

There is little red meat and most fat is unsaturated and comes from olive oil and nuts. Having a small amount of red wine has been shown to increase the health benefits.

In combination with moderate exercise and not smoking, the Mediterranean Diet offers a scientifically researched, affordable, balanced, and health-promoting lifestyle choice.

Lifestyle and risk

The modern Western diet, living in cities, office working, daily stress and reliance on the car all appear to have contributed to a recipe for unhealthy living.

Heart disease is still the most common cause of death (and premature death) in the UK. It causes around 101,000 deaths each year. 1 in 5 men and 1 in 6 women die from heart disease. Among the more developed countries in Europe, only Ireland and Finland have higher rates than the UK.

Unhealthy lifestyle, diet and obesity have also been linked to type 2 diabetes, raised cholesterol and high blood pressure. These conditions can combine to make medical risks and problems more severe. Diet, lifestyle factors and obesity are also associated with an increased risk of certain cancers. Being substantially overweight can bring on or worsen osteoarthritis, sleep apnoea (a condition where your breathing stops for short spells during sleep), high blood pressure and gallbladder disease.

Why was the Mediterranean Diet investigated?

In 1980, Professor Ancel Keys published the results of his investigation into cardiovascular death rates in different countries. He found death rates were low in Greece (particularly Crete), southern Italy (also Japan) and relatively high in the USA and Finland.

He investigated the lifestyle of the long-lived Mediterranean people to see if we could learn from them and use the knowledge in higher-risk populations. After such factors as smoking, exercise, education and stress had been taken into account, it was found that diet had played an essential part in keeping these communities healthy. The dietary pattern was not new. In fact, it was a traditional mix of fresh seasonal and easily stored produce, that probably dated back to the early civilizations. It had incorporated new foods, such as tomatoes, peppers and potatoes.

They tried to establish which foods offered particular health benefits, producing all the research into 'superfoods'. It was found that both individual food components (such as vegetables, fruits, mono-unsaturated fats) and their combination into a long-term dietary pattern were important for health. This led to the identification and description of an 'ideal' Mediterranean diet which could be tested on Western populations.

Many long-term population studies, involving hundreds of thousands of people, have been carried out to assess the likely health benefits of switching to a Mediterranean diet.

The 'ideal' Mediterranean Diet

The 'ideal' (in terms of health-giving effects) Mediterranean Diet has, in relation to a typical Western diet:

  • High quantities of: a variety of vegetables, a variety of fruit, legumes (eg, beans), cereals and cereal products.
  • Moderate quantities of: fish, white meats, nuts, low-fat dairy produce, wine (men: 1-3 units per day, women: 1-2 units per day) with meals.
  • Low quantities of: red meat, eggs, sweets and sweet desserts.
  • A high mono-unsaturated fat (eg, olive oil) to saturated animal fat (eg, fatty red meat) ratio - at least 2:1.
  • Low amounts of added salt - in many cases, herbs can be used for flavouring in place of excess salt.

The Mediterranean Diet is a pattern of food proportions, rather than a set list of particular products, 'superfoods' or recipes. As such, there are many possibilities to be creative using locally sourced and affordable produce, according to your taste. You don't need to master Greek or Italian cookery - unless you want to. Just use the ingredient mix in any way you wish.

With fat being a major source of calories, restrictions can be placed on total amounts used in food preparation if setting targets for losing weight.

An example of the 'ideal' Mediterranean Diet food template (currently issued in Greece) is shown below:

This dietary pattern fits with both the World Health Organization's (WHO) 5-A-Day message and the recommendations of the UK Government's Change4life campaign.

7 ways to improve your diet

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  • Eat at least five portions, and ideally 7-9 portions, of a variety of fruit and vegetables per day.

  • The bulk of most meals should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.

  • Limit your intake of fatty food, such as fatty meats, cheeses, full-cream milk, fried food and butter. Use low-fat, monounsaturated or polyunsaturated spreads.

  • Include 2-3 portions of fish per week, at least one of which should be 'oily' (such as herring, mackerel, sardines, kippers, pilchards, salmon or fresh tuna).

  • If you eat meat, it is best to eat lean cuts, or poultry such as chicken.

  • If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive.

  • Try not to add salt to food and limit foods which are salty.

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5 -a- day

Eat at least five portions, and ideally 7-9 portions, of a variety of fruit and vegetables per day.

What are the measured benefits of the Mediterranean Diet?

Scientists have compared the risks of developing heart and other diseases in populations that did and didn't adopt the diet. People who had closely followed the Mediterranean Diet were found to have:

  • Increased longevity - that is, a reduced chance of death at any age - due mainly to reductions in the chance of developing, having a recurrence of, or dying from heart disease or cancer. The results have been confirmed in UK and USA populations and represent around a 20% reduced risk of death at any age.
  • Reduction in the chance of developing type 2 diabetes, high blood pressure, or raised blood cholesterol, each of which is associated with cardiac and vascular disease, as well as other serious complications. And each of which may require permanent medication once developed.
  • Reduction in the chance of becoming obese and that the Mediterranean Diet formed the basis for a balanced reduction in weight.
  • Reduction in the risk of developing Parkinson's disease and Alzheimer's disease.

Enjoy the Mediterranean lifestyle at home

It has become clear that there are very good scientific reasons why certain peoples of the Eastern Mediterranean lived longer, healthier lives than those in the West in the mid 20th century.

We can all benefit from this information. The Mediterranean Diet is a healthy template that fits with the WHO and UK recommendation to eat five portions of fruit and vegetables per day.

But, the Mediterranean Diet also maximises the intake of essential nutrients and health-promoting ingredients, whilst minimising quantities of ingredients associated with health risks. So that, overall, those who adopt the Mediterranean Diet are likely to have a much lower risk of developing life-threatening and chronic disease than those who don't.

Switching to a Mediterranean diet, taking moderate exercise and stopping smoking, are all choices that offer a greater chance of being able to enjoy an active long life. If you are interested in trying out the Mediterranean Diet at home, see the separate leaflet called How to Follow the Mediterranean Diet.