Benefits of the Mediterranean Diet

Last Editorial Review: 7/30/2008

A delicious Mediterranean eating plan can help protect against heart disease, diabetes, cancer - even help with weight loss.

By Kathleen Zelman, MPH, RD/LD
WebMD Weight Loss Clinic - Feature

Reviewed by Louise Chang, MD

When we think of the Mediterranean diet, we picture Europeans leisurely dining on meals of fish, vegetables, fruits, olives, and crusty whole-grain bread dunked in olive oil, along with a glass of wine.

For thousands of years, residents of the Mediterranean coastal region have enjoyed this kind of delicious diet -- high in plant foods and monounsaturated fats (like olive oil) -- while getting plenty of regular physical activity. They don't think of their eating habits as a diet plan; it's simply their way of life. And it's a way of life that apparently leads to long, healthy lives virtually free of chronic disease.

For the past 50 years, scientists have studied the eating patterns characteristic of the Mediterranean diet -- and they continue to find additional health benefits. Recently, a large study published in journal BMJ showed that healthy people who followed a Mediterranean diet had a lower risk of developing type 2 diabetes.

Further, a recent study published in The New England Journal of Medicineshowed that a restricted-calorie Mediterranean diet (as well as a low-carb diet) could be even more effective for weight loss than a low-fat diet, while also offering other health benefits.

"Research continues to demonstrate that being physically active and eating a nutritious diet of primarily whole foods that are filling and satisfying can enable people to control weight, lower blood pressure [and] cholesterol levels, reduce risk of diabetes, heart disease [and] Alzheimer's disease, and basically protect against chronic diseases," says cardiologist Arthur Agatston, MD, creator of the South Beach Diet, based on the Mediterranean diet model.

What Makes the Mediterranean Diet So Healthy?

What is it about the Mediterranean diet that makes it so healthy?

A diet rich in fruits, vegetables, whole grains, nuts, beans, and seeds provides thousands of micronutrients, antioxidants, vitamins, and minerals that can help protect against cancer, heart disease, and Alzheimer's disease, among other conditions, experts say.

The multiple factors at work in the Mediterranean diet, Agatston explains, provide health benefits that "cannot be replaced by a supplement."

Monounsaturated fats, found in avocado, fish, canola and olive oils, contain omega-3 fatty acids, which are anti-inflammatory and fight disease at the cellular level. And olive oil, with its rich monounsaturated fat content, has gotten lots of attention. But according to a study published in The New England Journal of Medicine in 2003, it may not be the olive oil itself, but the interaction or synergy between all the foods that leads to the health benefits.

Studies show the Mediterranean diet's protective effect against obesity and type 2 diabetes is likely due to its high proportion of plant foods, fish, and olive oil, along with moderate consumption of alcohol.

"A Mediterranean diet is high in fiber, which slows down digestion, preventing wild swings in blood sugar; reduces insulin resistance (a precursor of type 2 diabetes); and improves insulin sensitivity to reduce obesity and type 2 diabetes," says Agatston.

Many studies have confirmed that a diet that is high in fat but low in saturated fat ultimately reduces the risks of heart disease, stroke, and cancer.

And it's important to note that the Mediterranean lifestyle is not just about food and wine; it also includes regular physical activity. Not only is the typical American diet much higher in calories and saturated fat, we are more sedentary. As a result, our rates of heart disease, obesity, and type 2 diabetes are among the highest in the world.

The good news is that studies have shown that it's never too late to adopt the Mediterranean lifestyle to increase longevity and reduce the risk of chronic disease. Research published in The Journal of the American Medical Association found that seniors who led a healthy lifestyle -- defined as not smoking, eating a Mediterranean-type diet, drinking alcohol in moderation, and engaging in 30 minutes of daily physical activity -- significantly increased their life expectancy.

How to Follow a Mediterranean Diet

Of course, we don't have to move to the Mediterranean to reap the benefits of this region's good health habits. How can we go about adopting into our lifestyles?

According to the American Heart Association, there is not one single "Mediterranean diet." Instead, there's a dietary pattern: Plenty of plant foods (perhaps as much as a pound a day), limited amounts of animal protein, and very little saturated fats.

The Mediterranean diet also emphasizes minimally processed, fresh, and preferably local foods. Typical meals include plenty of vegetables, fruits, legumes, nuts, seeds, olive oil, whole grains, pasta, and cereals, with lesser amounts of fish, poultry, eggs, and low-fat dairy, and even smaller amounts of meat. A glass of wine is almost always served with lunch and dinner.

If you visit the Mediterranean region, you may also notice that the locals tend to enjoy leisurely dining, taking pleasure in savoring their meals. And while they eat plenty of healthy fats and drink some alcohol, they generally aren't plagued with weight problems. That's because the quantity of food they consume is balanced with regular physical activity.

You can embrace the Mediterranean style of eating by making smart food choices. Select whole grains for your breads, cereals, and starches. Choose fish, low-fat dairy, poultry, nuts, and legumes to satisfy your protein needs (include some lean meat as well). Bulk up on vegetables. And, most important, reduce the amount of saturated fat in your diet and use olive or canola oil instead of butter.


Foods That Aren't as Healthy as You Think See Slideshow

That's not to say you can pour it on with abandon.

"Calories and portions still count, even when they are healthy," says Dawn Blatner, RD, a spokesperson for the American Dietetic Association. "These oils are good for the heart but hard on the waistlines because all oils contain 120 calories per tablespoon."

Blatner advises a double-handed pour method for oils -- "one hand on the bottle and one hand holding a measuring spoon. No freehand pouring, or you will end up with much more fat and calories than you need."

If you enjoy alcohol, women can include one serving a day and men can have two servings daily and still meet the recommendations of the American Heart Association and the U.S. dietary guidelines.

The bottom line is that research on the Mediterranean diet shows once again that good nutrition and physical activity are a prescription for a long and healthy life. There seems to be an infinite number of health reasons why we need to eat more fruits, vegetables, and whole grains -- and weight loss is just one of them.

Medically Reviewed July 30, 2008.

Dawn Jackson Blatner, RD, spokeswoman, American Dietetic Association.
Arthur Agatston, MD, cardiologist; author, The South Beach Diet Supercharged.
Trichopoulou, A. The New England Journal of Medicine, June 26, 2003; vol 348: pp 2599-2608.
Knoops, K. The Journal of the American Medical Association, Sept. 22, 2004; vol 292: pp 1433-1439.
Martinez-Gonzalez, M. BMJ, June 14, 2008; vol 336: pp 1348-1351.
Benetou, V. British Journal of Cancer, 2008; vol 99: pp 191-195.
Schroder, H. Journal of Nutritional Biochemistry, 2007; vol 18: pp 149-60.
WebMD Health News: "Diet Debate: 3 Plans Go Toe to Toe."

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