Can the Mediterranean Diet Save Your Life?

There always seems to be a “diet du jour” out there. In the ’70s and ’80s, it was Atkins; in the ’90s and early 2000s, it was South Beach. Today, people are embracing variations of the Paleo or Caveman diet, the Whole30 program, and dietary approaches that depend on protein shakes and vitamin supplements.

While some of these diets can, in fact, produce desired results, they can be hard to maintain unless you adopt a new lifestyle to support the change in the long-term.

Of all the diets and nutritional patterns studied to date, there is an effective lifestyle change that has been scientifically proven to produce major long-term health benefits: The Mediterranean diet. In fact, the Mediterranean diet has strong evidence showing that it can reduce your risk of:

The science behind the Mediterranean diet rises above the rest. Calling it a “diet” doesn’t accurately reflect what it is. It is a way of eating: a series of nutritional choices and a philosophy for eating. And it works.

The Mediterranean Diet

The Mediterranean diet is meant to mimic what has been eaten by people living along the Mediterranean Sea throughout history, specifically Greece, Crete, southern France, and parts of Italy. There is a strong emphasis on:

Vegetables
Fruit
Minimally processed whole grains
Fish
Chicken
Moderate wine consumption with dinner (Read here about the benefits and drawbacks of alcohol consumption.)

In addition, the Mediterranean diet contains an abundance of olive oil and nuts, while avoiding:

Soda
Bakery goods (containing refined flour and sugar)
Sweets
Red and processed meats
Butter

Initial Findings

The breakthrough Mediterranean diet study came in 1999 with the Lyon Heart Study. This study demonstrated that in a high-risk population—all subjects had already suffered a heart attack—those randomly assigned to a Mediterranean diet had a 70 percent relative risk reduction in:

Heart attacks
Cardiac deaths
Overall deaths

This was true after two years and four years of follow up. Impressively, all of these results occurred without any significant change in participants’ LDL cholesterol levels, which are often assessed when evaluating the risk of future heart disease.

While there were significant concerns about this study (for instance dietary compliance information was available for less than half of the participants), it was still a statistically valid trial and provided strong evidence in favor of this style of eating, paving the way for future studies.

PREDIMED Study

Four years after the Lyon Heart Study was published, the official Spanish agency for scientific research, Instituto de Salud Carlos III, funded the PREDIMED (Prevención con Dieta Mediterránea) study. In this study, subjects without pre-existing heart disease (a much lower-risk group than those who participated in the Lyon Heart study) were randomly assigned to one of three possible diets:

Mediterranean diet with added extra-virgin olive oil (1 liter per week)
Mediterranean diet with extra mixed nuts (30g per day)
Control low-fat diet that was low in bakery goods and processed foods

Both Mediterranean diet intervention groups had a three percent reduced risk of cardiovascular disease over five years.

Other key findings from this study include:

People found it easier to comply with the Mediterranean diet than they thought, and so the low drop-out rate contributed to the outcome. The drop-out rate in the low-fat control group was 11 percent compared to 4.9 percent in the Mediterranean diet.
As in the Lyon Heart study, the benefits occurred without any significant reduction in LDL cholesterol. This is more evidence that LDL reduction is not the primary target for health. Rather, reducing cardiovascular risk with healthy lifestyles should be the ultimate goal.
Other analyses have shown that both Mediterranean diet groups had a reduced risk of diabetes and cholesterol oxidation (less oxidation makes it less likely that it will lead to dangerous plaque formation)

Observational Studies

The Lyon Heart and PREDIMED studies were randomized, controlled trials, and therefore represent the highest quality of evidence. There is also observational data showing that a greater adherence to a Mediterranean diet may promote healthy aging and also reduce the risk of:

Go Beyond the “Type” of Food

It is important to note that the above-mentioned studies did not focus on a single nutrient or a single food type. Instead, they investigated a cultural style of eating that went beyond just the categories of food they ate or did not eat.

It also included appropriate portion sizes, the freshness and quality of the ingredients, and the social environment and mindset of the individuals as they ate.

Based on this research, the logical conclusion is to follow a Mediterranean-style diet based on real foods with the following characteristics:

Eat lots of fresh vegetables, fruit, nuts, olive oil, fish, avocados, and whole grains
Avoid sweets, baked goods, processed meats, and processed foods
Focus on higher quality ingredients and emphasize high-quality fat
Eat appropriate portion sizes
Be vigilant to avoid added sugars

It is empowering to know that a nutritional intervention such as this can lower your risk of cardiovascular disease, possibly even better than medications.

So in the end, will the Mediterranean diet save your life? According to the science, it just might.

*Editor’s Note: The information in this article is intended for your educational use only; does not necessarily reflect the opinions of the Chopra Center's Mind-Body Medical Group; and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.

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