Mediterranean diet as a way of life: why is it important?

Few dietary patterns have been studied and praised as much as the well-known Mediterranean Diet.

Adherence to the basic rules by which it is governed seems to be the key to maintaining physical and mental well-being, as well as longevity!

What is the Mediterranean diet?

The Mediterranean diet is defined as the traditional diet created by the countries of the Mediterranean basin, such as Greece. [1][2]

In each country, depending on the culture, customs and traditions, there are some differences in the dietary pattern followed. [2]

Nevertheless, there are some key points that these regions share, points that highlight the value of the Mediterranean diet for health.

In particular, the daily consumption of fruits, vegetables, grains and olive oil, combined with the frequent consumption of fish and seafood, the moderate consumption of alcohol and the occasional consumption of red meat, seems to be a common characteristic of the people living in this area. [1][2]

Making a historical review, several decades ago the scientist Ancel Keys and his colleagues had carried out a very large research (seven countries study), in which they compared the eating habits of 7 nations. [2]

Then it became clear that the diet of the Greeks, and in particular the dietary pattern they followed in Crete, contributed significantly to the protection from diseases, especially cardiovascular diseases, and to longevity. [2]

From then on, the term Mediterranean Diet began to be used and a lot of research was and is dealing with its numerous benefits and the mechanisms by which it acts on the body.

Mediterranean food pyramid

Many have heard of the numerous benefits of the Mediterranean dietary pattern, but without knowing exactly what the Mediterranean Diet entails.

The main characteristics of the Mediterranean Diet and the foods that characterize it can be easily learned by observing and analyzing the Mediterranean pyramid or pyramid of the Mediterranean diet.

In this particular pyramid there are different levels, which indicate how often certain food groups should be consumed, and it is not limited to food alone, but also contains general lifestyle advice.

There are several variations of the Mediterranean pyramid, but the basic elements remain constant in each version.

Specifically, the daily consumption of grains (mainly whole grain), fruits, vegetables, legumes, seeds, herbs, spices and olive oil is recommended, with oil being the main source of additional fat in the diet. [3]

The frequent consumption (at least 2 times a week) of fish and seafood is also recommended, as well as the regular consumption (daily to weekly) of poultry, eggs and dairy products (milk, yogurt, cheese) in moderate quantities. [3]

Less often – on a monthly basis – it is recommended to consume red meat and processed meat products (sausages, etc.), while junk food, sweet and salty snacks should be consumed rarely, preferably at some social event (e.g. birthday). [3]

In the Mediterranean pyramid, the importance of sufficient water consumption is also emphasized, while the moderate consumption of wine – preferably red – with meals is allowed. [3]

Regular consumption of junk food, fried foods, refined grains and processed products is strictly avoided, as is frequent consumption of alcoholic and sugary beverages.

Why is the Mediterranean diet important?

As mentioned above, the Mediterranean Diet has been characterized by many scientists as one of the healthiest dietary patterns, while it is not limited to the part of the daily diet.

Revised depictions of the Mediterranean pyramid emphasize the importance of daily physical activity, adequate rest, leisure activities with friends and family, and sharing meals with others.

So we can easily understand how one could see the Mediterranean Diet as a way of life; a way of life that contributes to the prevention and treatment of many diseases and at the same time promotes the mental well-being and social life of the people who follow it.

Mediterranean diet and health benefits

Numerous studies have highlighted the health benefits of following the Mediterranean diet.

In particular, it has been shown that people who comply with the Mediterranean dietary pattern have significantly lower mortality rates in general, but also in particular with regard to the risk of death from cardiovascular disease. [1][3]

In addition, many studies have shown that the Mediterranean diet is associated with a lower risk of type II diabetes, cardiovascular disease, stroke, rheumatoid arthritis, Parkinson’s disease, depression, Alzheimer’s disease, and dementia. [1][3]

Adherence to the Mediterranean diet is strongly associated with obesity, both in adults and adolescents. A recent publication linked the ever-increasing prevalence of childhood obesity in Greece with the insufficient adherence to the Mediterranean dietary pattern by children today.

The reason why the Mediterranean diet affects and is associated with so many different clinical conditions is due to the foods it includes and mainly due to the frequency of their consumption.

The high composition of food in dietary fibers (soluble and insoluble), the low intake of refined products, the high consumption of polyunsaturated and monounsaturated fatty acids (from fish, olive oil and nuts) compared to saturated ones, antioxidants (polyphenols, flavonoids), as well and the multitude of vitamins and trace elements obtained from the various fruits, vegetables, spices and herbs, are some of the basic elements that highlight the value of the Mediterranean diet for human health.

It has been shown, in fact, that the benefit of the individual components above is enhanced in the context of a balanced diet, such as the Mediterranean, as they act synergistically to provide optimal results.

Weight loss

The Mediterranean Diet has been recognized by many as the most effective in preventing obesity-related diseases. [4]

In particular, a number of studies have proven that adherence to the Mediterranean Diet is associated with a lower risk of developing obesity, as well as maintaining a healthy body weight. [1][5]

In overweight people, it has been shown that the change from an unhealthy way of eating to following the Mediterranean Diet is associated with a reduction in body weight and waist circumference, especially when combined with regular exercise and a slightly hypocaloric diet. [5][3]

The above positive findings concern all age groups of both sexes, as well as women during pregnancy and lactation. [5]

Heart health

The beneficial effect of following the Mediterranean diet on heart health was among the first benefits to be established and widely studied.

Specifically, the Mediterranean diet appears to support cardiovascular function, reducing the risk of coronary heart disease, slowing down the progression of arteriosclerosis and significantly protecting against myocardial infarction. [1][3]

It seems that the foods and ingredients that characterize the Mediterranean diet maintain blood pressure and blood glucose at desired levels, while also contributing to maintaining an ideal lipid profile: high HDL cholesterol and low levels of LDL cholesterol and triglycerides. [1][3]

Diabetes

The Mediterranean diet appears to help maintain healthy blood glucose levels and reduce the risk of type 2 diabetes.

Specifically, it has been shown to improve glycemic control, reducing fasting glucose and insulin resistance. [1][3]

An important role in this beneficial effect is played by the regular consumption of foods with a high fiber content (whole grains, fruits, vegetables, legumes), as well as good fats that improve the glycemic and lipid profile.

Alzheimer’s disease

The Mediterranean Diet has repeatedly been shown to contribute to normal cognitive function and to the prevention of neurodegenerative diseases, such as Alzheimer’s disease. [1][3]

It also seems to help slow down the progression of the disease, if it has already occurred, while also protecting against conditions such as depression, in people with diagnosed neurodegenerative disorders (e.g. dementia). [1]

Gastrointestinal health

As is well known, eating habits are inextricably linked to the state of health and the functioning of the gastrointestinal tract. [6]

An unbalanced diet can lead to the appearance of malfunctions (e.g. constipation) and further complications, while following a healthy dietary pattern – such as the Mediterranean Diet – contributes to maintaining a healthy gastrointestinal tract and reduces the risk of related disorders (eg Irritable Bowel Syndrome). [6]

In addition, it has been shown that following the Mediterranean Diet contributes to maintaining a healthy intestinal microbiome, which positively affects the health of the entire body. [7]

Both probiotics and fiber found in many of the foods consumed daily in the Mediterranean diet play an important role in protecting the digestive tract.

Asthma

There appears to be a negative correlation between adherence to the Mediterranean Diet and the onset or recurrence of asthma. [1]

In addition to the strong protection provided by the adherence to the Mediterranean diet in terms of the cardiovascular system, diabetes mellitus, hypertension, obesity, respiratory and gastrointestinal function, inflammatory and neurodegenerative diseases, a great benefit also appears to be shown in mental health (protection from anxiety and depression), as well as academic performance, especially in children and adolescents. [1][3][8]

Mediterranean diet and children

The prevalence of overweight and obesity during childhood is a very important problem and affects both the physical and mental health of children.

Numerous studies have proven that following the Mediterranean diet contributes to the prevention and treatment of obesity, both in minors and in the adult population. [1][9]

Mediterranean Diet and childhood obesity are inversely related, while it seems that unhealthy dietary patterns (e.g. frequent consumption of junk food) reinforce the already big problem of obesity.

According to research published in 2020, it appears that adherence to the Mediterranean Diet is associated with maintaining a healthy body weight during childhood, as well as with better physical condition. [9]

It has been shown, in fact, that following the Mediterranean Diet during adolescence is significantly related to the subjective feeling of happiness. [10]

Specifically, according to research published in 2019, it seems that teenagers and children who follow the Mediterranean Diet have a better quality of life and are more often happy. [10]

It is also worth noting that following the Mediterranean dietary pattern during pregnancy reduces for the fetus the cardiometabolic risk and the possibility of developing obesity in later life. [11]

Ideas for Mediterranean plates

Many are looking for information about the Mediterranean diet, such as what foods and recipes characterize it, what portions and breakfast are like in it, while others are interested in finding a weekly Mediterranean diet plan to fully understand the characteristics of this dietary pattern.

As mentioned above, the Mediterranean diet is based on the frequency of consumption of specific food groups, as well as the seasonality of the products.

It is recommended, for example, to consume several portions of fruits and vegetables daily, preferably in season, while emphasis is also placed on food variety.

There are no specific rules as to how a recipe should be made or what each meal should contain. However, attention must be paid to food combinations in order to cover the body’s nutritional needs, as well as to the caloric content of each meal (caloric surplus/deficit).

Fruits and vegetables can be chosen as snacks during the day as they are relatively low in calories but rich in nutritional value.

In addition, fruit can be used as a dessert and replace various unhealthy choices (e.g. sweets), while vegetables – fresh or boiled – should accompany every main meal.

Some balanced Mediterranean dishes are:

• Beans with tomato sauce in the oven
• Fish with rice and mixed vegetables
• Wholemeal spaghetti with vegetable sauce (e.g. tomato-mushroom-peppers)
• Chicken with quinoa and boiled vegetables
• Colorful egg/chicken/tuna salads
• Mixed vegetables in the oven (e.g. aubergines and zucchini)
• Stuffed vegetables (peppers/tomatoes/zucchini) with rice and seafood
• Omelet with asparagus and/or other vegetables
• Baked chickpea meatballs
• Grilled vegetable skewers with fish or chicken
• Legume and vegetable salad with olive oil and herbs (e.g. black-eyed beans with onion-tomato-cucumber).

When it comes to breakfast or the hours of the day when one is away from home, there are several healthy options for all tastes and for every season of the year.

Some such options that one can easily either make themselves or buy from somewhere are as follows:

• Yogurt with honey and nuts
• Yogurt with fruit and whole grains
• Wholemeal bread with cream cheese, chicken and tomato
• Wholemeal bread with tomato and avocado/olives
• Wholemeal bread with salmon, cream cheese, lettuce and cucumber.

Sources

1. Mediterranean diet and health outcomes: a systematic meta-review
2. The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription
3. Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review
4. Obesity and the Mediterranean Diet: A Review of Evidence of the Role and Sustainability of the Mediterranean Diet
5. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort
6. Good adherence to mediterranean diet can prevent gastrointestinal symptoms: A survey from Southern Italy
7. Shifts on Gut Microbiota Associated to Mediterranean Diet Adherence and Specific Dietary Intakes on General Adult Population
8. Adherence to the Mediterranean diet and academic performance in youth: the UP&DOWN study
9. Weight Status, Adherence to the Mediterranean Diet, and Physical Fitness in Spanish Children and Adolescents: The Active Health Study
10. Higher Adherence to the Mediterranean Diet is Related to More Subjective Happiness in Adolescents: The Role of Health-Related Quality of Life
11. Adherence to the Mediterranean diet during pregnancy and offspring adiposity and cardiometabolic traits in childhood