Is The Mediterranean Diet Really Best?
When the ball dropped one month ago 2014 was born. As with other years, many of us set out to make this year one of promise and set out to better ourselves. The most popular resolution is weight loss and with obesity at epic and epidemic proportions, it's a great move.
When patients share with me their weight loss goals I provide encouragement, but I also challenge them to think about the long term - can they sustain their diet and exercise plans for years or just for a month or so? For many on fad diets the answer is the later. For those looking more for a healthy way of life than a quick drop in their weight, I point them east, across the Atlantic to an area known for its health and longevity - the Mediterranean.
A Way of Life
Change is difficult, but for many of us change is necessary, a diversion away from our Western tendencies of convenience eating and hours logged on the sofa. But at the same time this change needs to be doable and sustainable. Let's face it - we have come to a point where eating is an enjoyable, social experience. The notion of getting together with friends to share a concoction from a blender is ridiculous. Slimfast, Paleo Diet, Atkins Diet and so many other "programmed" subscriptions for eating all involve an element of discomfort. They put us into a new chapter that causes us to look forward to its end - the old way. The Mediterranean Diet is different - it's better framed as the Mediterranean way of life. Not only is this way of life relatively simple to adjust to, it's enjoyable and it confers lasting health benefits for prevention and treatment of the most common chronic diseases killing Americans.
The Mediterranean Diet at a Glance
The medical community with its incessant observations on trends, saw clearly that people in the Mediterranean regions were more healthy. They were less obese, they had less heart disease and diabetes. And, they were happier. Data arose showing that by eating like them and adding in more walking and activity, we could experience the same outcomes in our Western society. The Mediterranean Diet was born. But in this multi-billion dollar weight loss industry there really was nothing to sell except advice to "live like they do." There are plenty of resources outlining the Mediterranean Diet along with recipe ideas. Generally, the Mediterranean diet means:
- Lots of fruits and vegetables.
- Olive oil flows liberally for cooking, dipping and drizzling.
- While chicken and fish are consumed in moderation, red meat is an uncommon treat.
- Whole grains are used in lieu of highly processed, bleached grains.
- Milk products are consumed moderately.
- And finally, sweets, processed foods are consumed uncommonly.
While it sounds counter to the Western diet, anyone walking away from a well-made Mediterranean meal would be satisfied and delighted. The most difficult aspect is not the enjoyment factor but rather the convenience factor. It requires more time and preparation, something we Americans often find difficult to commit to our daily food intake.
With an emphasis on "healthy fats" in the Mediterranean Diet and light consumption of high-cholesterol meat products, cholesterol levels are optimized in the body. Lower cholesterol means lower incidence of heart disease and peripheral artery disease and this has played out in the Mediterranean population.
Science has also shown that Western populations converting to Mediterranean lifestyles improve cholesterol and reduce risk of clogging their arteries. The results of a large study looking at Mediterranean Diet vs. a simple low fat diet in a high risk population were recently published in the Journal of the American Medical Association. Interestingly, the Mediterranean subjects fared significantly better in the outcome of peripheral artery disease compared to the low fat group (1) Earlier studies have documented reduced risk of death by heart attack in populations consuming a Mediterranean Diet.
Diabetes Prevention and Treatment
Recent studies are documenting the benefits of warding off diabetes in high risk populations switching to the Mediterranean way of eating. A recent study out of Spain was recently published in The Annals of Internal Medicine. (2) It looked at a large group of people ages 55-80 at high risk for developing diabetes. These subjects were randomized into a Mediterranean or low fat diet and followed long-term. Outcomes were significant, showing a 30% reduction in the development of diabetes in the Mediterranean group which emphasized extra virgin olive oil. Further studies in persons with diabetes have shown that Mediterranean eating reduces the bodies resistance to insulin and improves blood sugar control. Recent studies have also shown benefits in kidney function with the Mediterranean Diet. This has important implications in diabetics at risk for kidney disease as well as persons with active kidney disease.
Due to a myriad of confounding issues, there is not a lot of good data on weight loss in the Mediterranean Diet. Common sense, however, should prevail that a move from a typical Western diet would yield a new way of eating optimizing glycemic index and nutrition while decreasing calories. And for those looking to supplement with exercise, energy and motivation necessary to get out and move will not be sacrificed by starving the body of carbohydrates.