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Mediterranean Diet Affirmed by New Analysis
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Mediterranean-style diets based on veggies, fish, and olive oil tied to reductions in risk of dementia, cancer, and heart disease

by Craig Weatherby

The so-called “Mediterranean diet” is disappearing fast in the countries that surround this subtropical sea.

For more on this decline in the region's traditional diets, see “Mediterranean Region's Diets Differ from Ideal.

In any case, the so-called Mediterranean diet is more accurately called the “Aegean” diet.

The characteristic diets of people living on Greek coasts and islands represent the ideal that nutrition researchers now call the “Mediterranean” diet and advocate as a worthy goal.

In fact, it was in Greece's coastal Aegean regions more than any other Mediterranean lands that the famed Seven Countries studyconducted during the early 1960sfirst documented the amazingly low rates of heart disease now associated with the term “Mediterranean diet.”

The advantages of the Mediterranean dietand the specific physiological benefits of its key componentshave since been affirmed and detailed in many studies (search for related articles on our newsletter archive page using the key word “mediterranean”).

Fatty Mediterranean myths

Until recently, researchers thought that the observed heart-health benefits of the Mediterranean diet stemmed from its relatively low amounts of saturated fat and cholesterol, but that hypothesis has been refuted convincingly by subsequent studies.

In fact, the major role that fats play in America’s principal public health problemsheart disease, diabetes, cancer, and dementia— relates to grossly imbalanced intake of the two classes of essential unsaturated fats: omega-6 and omega-3.

Americans consume far too many omega-6 fats, simply because these fats abound in standard, grain-fed meats and poultry and in our most commonly used vegetable oils (corn, safflower, sunflower, cottonseed, soy, and canola) and the packaged and restaurant foods made with these  oils.

Fish are the richest sources of omega-3s by far, followed by omega-3-fortified eggs, flax seed, and leafy greens such as chard, kale, cress, and spinach. Needless to say, the average American does not eat any of these foods in abundance, compared with foods high in omega-6 fats.

The problem is that omega-6 fats tend to promote inflammation— which underlies all of the major public health problems cited aboveand overconsumption of omega-6s blocks absorption of omega-3s, which tend to ease inflammation.

The ideal Mediterranean diet lives on Crete

Artemis Simopoulos, M.D., who formerly chaired the Nutrition Committee of the National Institutes of Health, outlined the contours of the diet in Greece’s rural coastal regions and islands before 1960:

“…more so than other Mediterranean countries… the dietary pattern of Greeks consists of a high intake of fruits, vegetables (particularly wild plants), nuts and cereals mostly in the form of sourdough bread rather than pasta; more olive oil and olives; less milk but more [fresh, watery] cheese; more fish; less meat; and moderate amounts of wine...” (Simopoulos AP 2001).

This pattern was followed most closely on the Aegean coast and islands (like Crete), where fish virtually replace meat and poultry.

This diet features the key dietary factors for reducing disease risk: ample fiber and antioxidants, scant refined foods or sugar, and a roughly equal balance of omega-6 and omega-3 fatty acids.

This pattern presents a stark contrast to the starchy, produce-poor American diet, with its consequently low levels of fiber and antioxidants and extreme overload of omega-6 fats versus omega-3 fats.

Last month, researchers led by Francesco Sofi, Ph.D., from Italy’s University of Florence, reviewed data from 12 epidemiological studies, in which international teams recorded and compared the diets and health status of 1.5 million people, over periods ranging from three to 18 years (Sofi F et al. 2008).

Participants’ adherence to the Greek-Mediterranean diet was determined through scores that ranked their degree of conformity to the traditional Mediterranean dietary pattern.

Diets based on vegetables, fruits, beans, grains, fish, and olive oilwith moderate red wine during mealswere ranked closest in adherence to the Mediterranean ideal.

Diets based on relatively “un-Mediterranean” foodssuch as red and cured meats, white flour, sugars, processed foods, and milkwere ranked furthest from adherence to the Mediterranean ideal.

The adherence scores varied from a minimum of zero pointsindicating low adherence to the Mediterranean dietup to a maximum of 9 points, reflecting high adherence.

Findings affirm diets featuring fish, produce, and olive oil

The Florence University team’s analysis linked greater adherence to a Mediterranean diet with a significant improvement in health status.

The key measures were reductions in risks of death and major diseases:

  • Death from any cause – 9% lower risk
  • Cardiovascular death – 9% lower risk
  • Cancer death – 6% lower risk
  • Parkinson's disease risk – 13% lower risk
  • Alzheimer's disease – 13% lower risk

In typically understated scientific style, the Florence University team came to a positive conclusion:

“These results seem to be clinically relevant for public health, in particular for encouraging a Mediterranean-like dietary pattern for primary prevention of major chronic diseases” (Sofi F et al. 2008).

To which we can only add, “no kidding!”


  • Benetou V, Trichopoulou A, Orfanos P, Naska A, Lagiou P, Boffetta P, Trichopoulos D; Greek EPIC cohort. Conformity to traditional Mediterranean diet and cancer incidence: the Greek EPIC cohort. Br J Cancer. 2008 Jul 8;99(1):191-5.
  • Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev. 2006 Feb;64(2 Pt 2):S27-47. Review.
  • Simopoulos AP. The Mediterranean diets: What is so special about the diet of Greece? The scientific evidence. J Nutr. 2001 Nov;131(11 Suppl):3065S-73S. Review
  • Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344. doi: 10.1136/bmj.a1344. Review.
  • Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, Trichopoulos D. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995 Jun;61(6 Suppl):1402S-1406S. Review.

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