Mediterranean diet

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The Mediterranean diet is a modern[1] nutritional model inspired by the traditional dietary patterns of some of the countries of the Mediterranean Basin, particularly Greece and Southern Italy.

Common to the diets of these regions are a high consumption of fruit and vegetables, bread, wheat and other cereals, olive oil, fish, and red wine. The diet is often cited as beneficial for being low in saturated fat and high in monounsaturated fat and dietary fiber.

Although it was first publicized in 1945 by the American doctor Ancel Keys stationed in Salerno, Italy, the Mediterranean diet failed to gain widespread recognition until the 1990s. It is based on what from the point of view of mainstream nutrition is considered a paradox: that although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found.

One of the main explanations is thought to be the large amount of olive oil used in the Mediterranean diet. Unlike the high amount of animal fats typical to the American diet, olive oil is high in monounsaturated fat and lowers cholesterol levels in the blood. It is also known to lower blood sugar levels and blood pressure. In addition, the consumption of red wine is considered a possible factor, as it contains flavonoids with powerful antioxidant properties.

Dietary factors may be only part of the reason for the health benefits enjoyed by these cultures. Genetics, lifestyle, and environment may also be involved.

Concerns remain whether the diet provides adequate amounts of all nutrients, particularly calcium and iron. Nonetheless, green vegetables, a good source of calcium and iron, are used in the Mediterranean diet as well as goat cheese, a good source of calcium.

Health benefits

Regarding weight loss, the DIRECT randomized controlled trial found[2]:

  • "Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions"

Regarding reduction in mortality and MACE, the PREDIMED randomized controlled trial found[3]:

  • "Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. "

More recent systematic reviews have found:


  1. Alberto Capatti et al., Italian Cuisine: A Cultural History, p. 106.; Silvano Serventi and Francoise Sabban, Pasta, p. 162.
  2. Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I; et al. (2008). "Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet". N Engl J Med. 359 (3): 229–41. doi:10.1056/NEJMoa0708681. PMID 18635428. Review in: Evid Based Med. 2008 Dec;13(6):176
  3. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F; et al. (2013). "Primary prevention of cardiovascular disease with a Mediterranean diet". N Engl J Med. 368 (14): 1279–90. doi:10.1056/NEJMoa1200303. PMID 23432189. Review in: Ann Intern Med. 2013 Jun 18;158(12):JC3 Review in: Evid Based Med. 2014 Feb;19(1):10 Review in: J Fam Pract. 2013 Dec;62(12):745-8
  4. Bloomfield HE, Koeller E, Greer N, MacDonald R, Kane R, Wilt TJ (2016). "Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake: A Systematic Review and Meta-analysis". Ann Intern Med. 165 (7): 491–500. doi:10.7326/M16-0361. PMID 27428849.
  • Martin Bruegel, "Alimentary identities, nutritional advice, and the uses of history" [1]
  • Bruno Simini, "Serge Renaud: from French paradox to Cretan miracle" The Lancet 355:9197:48 (1 January 2000) at Science Direct (subscription)

See also

External links

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