The Mediterranean diet is a modern nutritional recommendation originally inspired by the traditional dietary patterns of Greece, Southern Italy, and Spain.[1] The principal aspects of this diet include proportionally high consumption of olive oil, legumes, unrefined cereals, fruits, and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yogurt), moderate wine consumption, and low consumption of non-fish meat and non-fish meat products.[2]
In 2013, UNESCO added the Mediterranean diet to the Representative List of the Intangible Cultural Heritage of Humanity of Italy, Spain, Portugal, Morocco, Greece, Cyprus, and Croatia.[3][4]
Despite its name, this diet is not typical of all Mediterranean cuisine. In Northern Italy, for instance, lard and butter are commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables.[6] In both North Africa and the Middle East, sheep's tail fat and rendered butter (samna) are the traditional staple fats, with some exceptions.[7] Indeed, one researcher concludes: "It appears that currently there is insufficient material to give a proper definition of what the Mediterranean diet is or was in terms of well defined chemical compounds or even in terms of foods.... The all embracing term 'Mediterranean diet' should not be used in scientific literature...."[8]
The most commonly understood version of the Mediterranean diet was presented, among others, by Dr Walter Willett of Harvard University's School of Public Health from the mid-1990s on.[9][10][11][12][13][14] Based on "food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s", this diet, in addition to "regular physical activity," emphasizes "abundant plant foods, fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts". Total fat in this diet is 25% to 35% of calories, with saturated fat at 8% or less of calories.[15]
Olive oil is part of the Mediterranean diet, although not of all Mediterranean cuisines: in Egypt, Malta, and Israel, olive oil consumption is negligible,[5] and in other areas, it is not predominant.[6][7] It contains a very high level of monounsaturated fats, most notably oleic acid, which epidemiological studies suggest may be linked to a reduction in coronary heart disease risk.[16] There is also evidence that the antioxidants in olive oil improve cholesterol regulation and LDL cholesterol reduction, and that it has other anti-inflammatory and anti-hypertensive effects.[17]
Although it was first publicized in 1975 by the American biologist Ancel Keys and chemist Margaret Keys (his wife and collaborator),[18] the Mediterranean diet failed to gain widespread recognition until the 1990s. Objective data showing that Mediterranean diet is healthy originated from results of epidemiological studies in Naples and Madrid [19] confirmed later by the Seven Countries Study, with first publication in 1970,[20] and a book-length report in 1980.[21]
The Mediterranean diet is based on what from the point of view of mainstream nutrition is considered a paradox: that although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found. A parallel phenomenon is known as the French Paradox.[22]
A diet rich in salads was promoted in England during the early Renaissance period by Giacomo Castelvetro in A Brief Account of the Fruits, Herbs, and Vegetables of Italy.[23]
A number of diets have received attention, but the strongest evidence for a beneficial health effect and decreased mortality after switching to a largely plant based diet comes from studies of Mediterranean diet, e.g. from the NIH-AARP Diet and Health Study.[24]
The Mediterranean diet often is cited as beneficial for being low in saturated fat and high in monounsaturated fat and dietary fiber. One of the main explanations is thought to be the health effects of olive oil included in the Mediterranean diet.
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Mediterranean diet - Wikipedia, the free encyclopedia
