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Mediterranean Diet

"If people lived and ate well, there would be no disease", Hippocrates, On Ancient Medicine.

2,500 years have passed since Hippocrates highlighted the close relationship between food and health. Today's medicine has turned its gaze in the Mediterranean and especially in Crete, the Peloponnese and other Greek regions: it has been found by international research, that mortality rates caused from cardiovascular diseases and cancers are smaller in these areas than in other areas of the world which were studied – simply because people follow(ed) traditional nutrition patterns.

What is the Mediterranean Diet?
"Mediterranean Diet" is a term originally coined by American physiologist and nutritionist Ancel Keys from the University of Minnesota and his colleagues from around the Mediterranean, to describe the model of nutrition which is followed by the people of Mediterranean countries that were included in the "Seven Countries Study" (see below). At the International Conference on Mediterranean Diet in 1993, in Cambridge, MA (USA) it was defined what would be considered healthy, traditional Mediterranean Diet, on the recommendation of a team of scientists of Harvard University (head Dr. Willett) - with the assistance of the Oldways Organization and the European Office of World Health Organization. Consequently, in 1995, the "Mediterranean Diet Pyramid" was proposed, modeled on the Food Pyramid that had been recently adopted by the U.S. Department of Agriculture.
From a purely nutritional standpoint, the traditional Mediterranean Diet was defined with the following characteristics:
  • Abundant vegetable fibers (fruits, vegetables, bread / cereals, potatoes, beans, nuts).
  • Products minimally processed
  • Dairy products (principally cheese and Greek yogurt) daily in small to moderate quantities
  • Fish and poultry in small to moderate quantities
  • Red meat in small quantities
  • Olive Oil daily, as the main source of fat (containing monounsaturated fatty acids)
The specific nutritional composition of the "Mediterranean Diet" leads on one hand to low concentration in saturated fat and cholesterol and on the other hand to high concentration in carbohydrate and fibers. The daily consumption of Olive Oil leads to high concentration of the Diet in monounsaturated fatty acids.

However, the term "Mediterranean Diet" is somewhat misleading, since in reality there is not a single but many "Mediterranean diets". The traditional diets of Mediterranean peoples were the result of significant developments that have occurred over approximately three millennia. About 20 countries and corresponding nationalities are described as "Mediterranean", with eating habits which vary due to religious, economic and cultural peculiarities.
In fact, the term "Mediterranean Diet", the way it is used today, essentially was used by scientists to describe the diet a) of Crete (initially), and then the rest (mainly southern part) of Greece, and b) the diets of other Mediterranean regions which share similar features, during the decades of 1950 and 1960, when the consequences of the Second World War had been overcome, but before the arrival of the culture of "fast food" (and the so called "Western Diet"). Because Olive Oil was the main source of fat in the diet throughout Southern Greece, particularly the Peloponnese and Crete, the term "Mediterranean Nutrition (or Diet)" essentially describes the dietary pattern that prevailed in Mediterranean areas where olive groves have being cultivated traditionally and extensively.

The Mediterranean Diet as a lifestyle: "Mediterranean Diet" as Cultural Heritage
In 2010, UNESCO included the Mediterranean Diet in the List of Intangible Cultural Heritage of Humanity, upon request made jointly by the countries Greece, Spain, Italy and Morocco. Through this it was recognized that ...

"the Mediterranean Diet consists of a set of skills, knowledge, practices and traditions that vary from field to table, including the crops, harvesting, fishing, conservation, processing, preparation and, especially, consumption of food. The Mediterranean Diet is characterized by a nutritional model that has remained constant through time and space, consisting mainly of olive oil, cereals, fresh or dried fruits and vegetables, a moderate amount of fish, dairy products and meat (in small quantities) and many herbs and spices, all accompanied by wine or infusions, always respecting the beliefs of each community.

However, the Mediterranean Diet (from the Greek "dieta" or "lifestyle") includes more than just food. It promotes social interaction, since shared meals are the cornerstone of social customs and celebrations. This has led to significant organization of knowledge, songs, stories and myths. The system is based on respect for the land and biodiversity, and ensures the conservation and development of traditional activities and crafts linked to fishing and farming in the Mediterranean communities of which Soria in Spain, Koroni in Greece, Cilento in Italy and Chefchaouen in Morocco are examples. Women play a particularly crucial role in the transmission of skills and knowledge of rituals, traditional expressions and celebrations, and the safeguarding of techniques".

Study of 7 Countries:
The correlation of the diet of the inhabitants of Crete and other Greek regions with Health, became widely known through the "Seven Countries Study". This study began shortly before 1960 by the American Ancel Keys and his colleagues, on the occasion of the impressively low rates of mortality and cardiovascular disease were observed in the Mediterranean area (he had even noticed that the Hospital of Naples, where he served during the Second World War II, had no patients with heart diseases!).
Indeed, according to the United Nations, no other region of the Mediterranean and the world had so low mortality rates as Crete and Corfu, both before and after the Second World War. In the "Study of 7 countries", a total of about 13,000 men participated, all at age 40-59 years, who were selected from 18 different locations in seven countries (Finland, the Netherlands, Japan, United States, Italy, Yugoslavia and Greece - with Crete and Corfu); the Study was aiming to investigate the obscure, until then, relationship between diet and cardiovascular diseases (and other diseases).

The comparisons between different populations, showed that the population of Crete (and even Corfu) had better health status and lower rates of mortality from coronary heart disease and cancer than other populations studied. After 20 years of monitoring, death rates from all causes remained smaller. After 25 years of monitoring, deaths from coronary heart disease, were impressively lower compared with deaths observed in populations of the United States and northern Europe, but even compared with deaths observed in other parts of southern Europe. Noteworthy, conclusions of the study was that 40 years after the study, half of the Cretans who participated were alive and energetic, while none of the Finnish participants had survived!

The lower incidence of coronary heart disease and cancer, but also the lower mortality from all causes, were attributed to the particular eating habits that characterized the region. The life expectancy of Greek participants was ultimately the same as the Japanese, but whose traditional diet includes too much fish and almost no fat. Instead, most Greeks over-consume fat, but in the form of extra virgin olive oil and, nevertheless, have a very high life expectancy. According to the TIME Magazine (2001), "... maybe it is a coincidence but the Greeks are by far the largest per capita consumers of olive oil in the world."

Why the Mediterranean Diet does any good ?
The postwar Greek diet has differences compared to other diets in the Mediterranean region at the same period. Specifically, the Seven Countries Study showed that in Greece the consumption of olive oil, legumes and fruits (and herbs especially in Crete) was higher compared with the consumption of these foods in the rest of the Mediterranean, while red meat, fish and cereals were consumed in smaller amounts.

From the beginning, the protective effect of the "Mediterranean Diet" to health, was attributed to its high content of monounsaturated fat (due to the daily use of olive oil), and low content of saturated fat (due to low consumption of red meat). We are now in a position to know that this dietary pattern has other important features; it is a diet that, when consumed in sufficient quantities, it provides all the necessary micronutrients (ie vitamins and minerals) and is rich in omega-3 fatty acids, fiber, antioxidants and various phytochemicals, which have significant effects on various body functions, affecting positively the overall health of the organization.

It should be noted that the very same countries on which the conclusions of the "Mediterranean Diet" were based, have not been over the years good examples for its adoption. Greece, and especially Crete, followed within the next years what we would call "Western Diet", both in lifestyle and in the use of "fast food" (junk) in particular. Abandoning the Mediterranean Diet resulted in obesity to soar, and especially childhood obesity to conquer one of the first places at European level!

"Strict observance of the traditional Mediterranean Diet promotes longevity": benefits after a long term Mediterranean Diet seems to increase with age!
Recent research published by Harvard University in June 2003:
The traditional Mediterranean Diet is characterized by loads of vegetables, legumes, fruits, nuts and cereals and regular use of olive oil (monounsaturated fat), moderate amounts of fish and dairy products (mostly cheese or yogurt), small amounts of red meat (low intake of saturated fat) and moderate alcohol consumption, usually in the form of wine consumed during meals. Researchers from the Harvard School of Public Health and the Medical School of Athens University, evaluated the dietary habits of the study participants from all regions of Greece and found that those who were intensely observing a "Mediterranean Diet" improved their longevity in relation to the participants who did not follow the Diet so closely. Using a 1-10 scale for measuring adherence to "Mediterranean Diet", it was observed that following the Diet was associated with a 25% reduction in overall mortality among participants! The study was supported by the European Commission program "Europe against Cancer", the Greek Ministry of Health and the Greek Ministry of Education.

The "Authentic Greece - Peloponnese" Team



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