iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
GET UPDATES FROM Georgianna Donadio, MSc, Ph.D., D.C.
 

The Mediterranean Diet: It's Not Just About Food

Posted: 05/12/11 09:27 AM ET

In Annia Ciezaldo's April 1st article in the "New York Times Magazine," she asks, "Does the Mediterranean Diet even exist?" She suggests that since half of Spain, Portugal and Italy's populations are overweight -- with Lebanon rapidly following suit -- then, contrary to popular belief, the Mediterranean people now have the worst diets in Europe.

She states that the Greeks "are the fattest: about 75 percent of the Greek population is overweight." From Ciezaldo's perspective, the Mediterranean Diet research, which spanned over 50 years, was in fact -- flawed.

Research on the health benefits of the Mediterranean Diet has been well-documented and includes the Harvard School of Public Health and many esteemed medical researchers. Among them are Ancel Keys and Paul Dudley White, who later became Dwight D. Eisenhower's cardiologist.

Shortly after World War II, Keys and his colleagues set out to examine whether or not the Mediterranean dietary and lifestyle patterns were directly connected to improved health outcomes identified in Crete, Greece and southern Italy during the 1960s. These outcomes recorded the lowest rates of chronic disease in the world, and the life expectancy of adults in these regions was among the highest. This was particularly remarkable given the limited amount of medical care and services that were available to this population and the poverty these regions experienced.

Keys then began the long running Seven Countries Study and monitored the lifestyle and dietary habits of 12,700 middle-aged men in the U.S., Finland, the Netherlands, and then Yugoslavia, Italy, Japan and Greece.When the data was examined, the people who were the healthiest ate a diet where fruits and vegetables, grains, beans and fish were the basis of daily meals and valued vigorous physical activity and high social interaction. At the top of the list were the residents of Crete.

Scientists have intensely studied the eating and lifestyle patterns characteristic of the Mediterranean Diet for more than half a century. And with dozens of research studies, the evidence is that this way of eating and living results in an across-the-board reduction of chronic disease and increased longevity.

This evidence confirmed that certain Mediterranean lifestyles and dietary patterns were connected with good health. As a result, in the 1990s, Old Ways, an internationally respected nonprofit organization, joined in partnership with the Harvard School of Public Health to provide global education and information on this important disease-preventing evidence.

What the article has apparently overlooked is that the Mediterranean Diet is not just about what people eat. It is about the values, habits, relationships, quality of how food is grown and the quantity of how food consumed by these particular groups -- not just how or what they eat. A point that is often missed by the media is that health is not isolated to one's diet. The whole health of an individual is about the physical, emotional, nutritional, environmental and even spiritual components that create our overall state of health. Our dietary choices and habits can be seen as a metaphor of what the overall or whole picture of that individual's health is expressing. We eat how we think, feel, work and behave, all of which are influenced by our environment, values, age, financial and education levels and even by our gender.

Beyond just nutritional health, the Mediterranean Diet promotes a way of living that includes the following components, which could explain the positive health benefits.

Intense physical activity that includes work and all its forms of movement; farming, building, planting, gardening, dancing, sports, house work, child care or any activity that provides a non-sedentary daily routine.

Consuming many types and varieties of food in moderation as a form of nourishment -- both physically and socially, as well as sharing with others.

  • Meals are a part of the social and family fabric and are not taken alone.
  • Time spent eating is relaxing, nourishing and pleasurable.
  • Foods choices often include fruits, vegetables, whole grain bread and other cereals, potatoes, beans, nuts and seeds.
  • Olive oil is an important monounsaturated fat source in the diet.
  • Dairy products, fish and poultry are consumed in low to modest amounts, and little red meat is eaten.
  • Eggs are consumed zero to four times a week.
  • Wine, a component of social family sharing and bonding, is a dietary staple this is consumed in low to moderate amounts.

Is it any surprise that Europeans, who now have McDonalds, Kentucky Fried Chicken, electronic messaging that is replacing relationships and high credit card debt (none of which were there when the Seven Countries Study began), are becoming as obese and unhealthy as Americans are?

What is missing from many "nutrition books of the week" is the organic, common sense understanding that the food we eat is just part of a multi-faceted set of choices we make in how we choose to live and behave. Many of these choices are based on our personal and collective social values.

I was recently asked, in a conversation with an advisor to the U.S. Surgeon General, what I thought was the solution to health care cost reduction. I stated and firmly believe that until we as a nation return to the values we embraced and lived by up until the mid-1980s, a time when the "The Lifestyles of The Rich and Famous" became the national obsession, we will remain a nation of countless individuals who feel in many ways marginalized from contributing our skills and talents -- who are hungry to be seen, heard and valued.

This lack of belonging leads to poor nutrition and behavior choices, which serve in our efforts to self-sooth and self-medicate, as the world we inhabit continues on its trajectory of financial and societal misdirection. Yes, the Mediterranean Diet does exist, but the values that make it a healthy way of life are rapidly fading.

 
 
 
In Annia Ciezaldo's April 1st article in the "New York Times Magazine," she asks, "Does the Mediterranean Diet even exist?" She suggests that since half of Spain, Portugal and Italy's populations are ...
In Annia Ciezaldo's April 1st article in the "New York Times Magazine," she asks, "Does the Mediterranean Diet even exist?" She suggests that since half of Spain, Portugal and Italy's populations are ...
 
 
  • Comments
  • 156
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
Page: 1 2 3 4 5  Next ›  Last »  (5 total)
photo
HUFFPOST SUPER USER
Jennifer Hagan
Expat Mother of two living in France.
03:05 AM on 05/17/2011
What about France? You left France off in the study. I'm curious to understand why because there is also France which has the slimmest people in Europe. However the diet here is very Med. Though you have the rate of obesity rising here as it is in other countries, you just don't typically see fat people here.
01:18 PM on 06/03/2011
Hello Jennifer,
Beautiful pictures of you children! France was not included in the Seven Countries Study, although for sure there would be many similarities. Thank you for your comment and thanks to all who have commented on this blog!
All the best,
Georgianna
shuffleoff
...but not to buffalo!
01:57 PM on 05/16/2011
Thank you Dr. Donadio!!! You nailed it. This is why my parents, both Italian and hard workers, not necessarily exercising as we think of it today, but always moving and active, have lived well into their 80's. I grew up with lots of family and friends, a healhy dinner on the table every night at 5:30...we rarely ate out. Grandma's dinners every Sunday...a jug of red wine at the table...and everyone was happy, joyful and appreciative of what we had and of each other. I don't remember people being depressed...our family enjoyed life to the fullest and we were not financially rich, but our relationships were. People didn't live beyond their means. As it is going, I have more health issues now than my parents did at my age. I don't eat properly most of the time, am always in a hurry, yet never seem to get anywhere. I don't move as much as I used to. The TV and internet seem to take much of my time! The elders except for my parents are gone now and my cousins have moved in different directions. Family just doesn't have the same meaning. You have brought back memories for me and have inspired me to remember my roots...and yes, things did change after the 1970's. Again, thank you so much for writing this and defining The Mediterranean 'Diet' and all that that implies.
01:54 PM on 05/16/2011
Georgianna, while I'm not an authority on why people suffer from obesity I do believe that I can
shed some light on the import of your article and that is that the so-called "Mediterranean Diet"
is not just about food.

I am of Greek descent. I was raised to acquire a taste for what today is known as the "Medi-
terranean Diet". But there is more to that diet than meets the eye. My comments are strictly
anecdotal, as I do not have professional expertise in this area. But I do have life experience
that I believe is relevant to this discussion.

In 2007 my daughter and I visited our relatives in Greece. These folks are members of our fam-
ily who I never knew until we went there. One thing I noticed is how sociable the Greeks are.
They tend to do things together. There seems to be less of a barrier between your house and
the street where you live, than there is here. A Greek home is always open to neighbors. And
while Greeks are ever anxious to partake in food, it is very much a social event. Nobody eats
alone. Greeks are also avid outdoor enthuiasts and engage life in a physical way. It's not just
about the food but it's a way of life. Since humans are basically social creatures, we shouldn't
be surprised by how much an active social lifestyle may contribute to our well being.

~ James Ampela (nee, James Ampelakiotis)
HUFFPOST SUPER USER
Bruisersmom
01:45 PM on 05/16/2011
I saw a device on sale to calm down your dog. You wrapped it around him. Then, I saw a story on people who put melatonin in their children's brownies to make them sleepy. My thought was take the dog and the kids to the park. Run out their energy. The dog will be too tired to be crazy, and the kids will be tired and go to sleep.

I grew up in the eighties when when VCRs and video game players were coming into American homes. My mom didn't let me sit and vegetate in front of them. We had to go outside and play or do sports. So many problems with pets and with kids could be taken care of if they shut off all of the electronic devices and went outside to play.
01:42 PM on 05/16/2011
I can only speak from personal experience but I want to comment on the first paragraph. I live in the Mediterranean - I am based southern Italy and commute to central Italy all the time, not to mention regular trips throughout the north. I rarely see overweight people, lots of folks ride bikes and eat fresh, healthy food. I'm not sure where Ciezaldo got her information or where she was hanging out. But every time I go back to the U.S. to visit I am astonished by how overweight so many people are, and whenever I come back to Italy I notice how much more slender people are.

It's easy to gain weight ANYWHERE, whether you're in the Mediterranean or America, the idea is to eat small and move more.
This user has chosen to opt out of the Badges program
01:39 PM on 05/16/2011
No question the American Century has exported to the world many toxic presents and unhealthy american habits, and still continues to do so. As a whole, like the toddler who'd eat his own kaka, the world hasn't been smart enough to see through the American trojan horse. Americans, of course, see the proliferation of McDonald's, Baskin Robbins and Pizza Hut as evidence of "they wanna be like us".
[I got news for you, America - it's really easy to be stupid, no training or guidance necessary].

What puzzles me is that the Europeans should be normally very mindful of and resistant to the creeping Big Brother corporate takeover of life on planet Earth, part of which is to make a majority of people fat, stupid and lazy, as successfully implemented in the US since the early 1980s. But they appear to have lost some of their mental edge in that respect.
12:36 PM on 05/16/2011
With all due respect Dr. Donadio, you are mistaken. The Med Diet was a direct result of the economy. Poor people ate less and worked very hard hence their low BMI. Much like China, which has changed dramatically over the last 10 years. Agricultural economies allow for the mass consumption of grains, pasta, and bread. Which is why Lebanese, Italians, Spaniards are getting fat. The French maintained their tradition of high fat diets and are still the some of the thinest people on the Mediterranean. Believe me, there wasn't any olive oil used in cooking until 15 years ago. Before that it was butter, butter, and duck fat. And yet the French had the lowest levels of cardiovascular events in Europe.
HUFFPOST SUPER USER
balamo
05:27 PM on 05/15/2011
almost all greeks were slender back in the 1950's and 60's - one quick look at films of the period makes that clear. people at real food then-with a very low intake of sugar and complex fats.

today- most young city dwellers have adopted the 'american' model of cuisine - fast food, take out (there is even a new word in greek -deliverάs-for the person who brings take out to your door). children are bulging out of their clothes - and each year only gets worse. globalization's gift to the rest of the world i guess...
shuffleoff
...but not to buffalo!
01:59 PM on 05/16/2011
Yes balamo! Sugar and complex fats. I remember growing up, our dessert was often fruit! And we didn't snack much between meals...
03:32 PM on 05/16/2011
We still do eat real food in my part of the Mediterranean. I live two blocks from a daily outdoor market that is always crowded and fresh food with no fake ingredients is normal here (southern Italy). Our fish is freshly caught and we are an olive oil producing region so our fat comes from that. Add to that the pressure of always having a "bella presenza" and looking a certain way (not something I necessarily advocate), and I'd say that our young adult and adult population is pretty fit.

There are certainly packaged foods on the market here, I cannot argue with that. But for the most part I still see people eating simple, real food. Nothing complex or gourmet but as I said, simple, real and fresh.

But...there is a but...

The sad thing is that although Italy has one of the more slim adult populations in the developed world, we also have a high childhood obesity occurrence, which suggests that we'd better start worrying. :-(

The positive thing is that most cities here have initiatives to get people riding bikes more often. There are even bike sharing programs that cost practically nothing. Hopefully that will help somewhat.
photo
Jack Daniels Esq
Hold the ice
07:45 AM on 05/15/2011
What happened to good ol' fashioned discipline ....??!!
03:39 AM on 05/15/2011
I agree with what this article has to say, but feel that there are two things missing that contribute to good health and longevity. The first is living relatively stress free or knowing how to manage stress. The second is a helthy and active sex life which add to our overall ease with our own bodies. It's difficult to be healthy when one has a poor self image and is not in touch with one's own body.
02:56 PM on 05/16/2011
I appreciate your position, but the article was more about how our obese culture has spread via such venues as fast food joints and bad behavioral choices. A healthy sex life comes with being physically fit and that comes by major choices in what we eat and how much we exercise. Stress is inescabable, but is no reason to select a greasy burger and fries, over grilled chicken and veggies. Exercise is a great stress reliever also, but things like TV and technology have become a staple, rather than making better choices for ourselves because it is easier to do nothing, than to do something.

I stopped eating fast food over two years ago and joined a gym. Believe me, I had no particular self-esteem myself and was a homebody. I just said to myself, "enough is enough". Since then, I have lost 40 pounds, I'm at my ideal weight and have more sex than you could have convinced me of before. It all goes together as a package. It starts with determination, but then it's what you eat, how much and how hard you exercise. If you do those two things, your stress will go down and your sex life will improve on it's own.
04:21 PM on 05/17/2011
Right on!
12:49 AM on 05/15/2011
I also think people incorrectly correlate weight to health, this is why current thinking is a problem. Weight does not eqaul health! The weight on the participants in not mentioned but their level of health is. These old style values are also often missing. We have made weight = health and only consider food and activity. This shows there is so much more!
HUFFPOST SUPER USER
silviarimembriancor
09:46 AM on 05/14/2011
take mac donald out of italy and there won't be anymore fat people.. dear american friends,could you please take back your restaurants..? :(
HUFFPOST SUPER USER
vettura
07:36 AM on 05/15/2011
Silvia. The only way to get rid of Mcdonald's in Italy is not to patronize. I'm reminded of an article in the New York Times a few years ago where a Mc donald's in Altamura (Bari) Was forced to close because an enterprising local opened an "Italian" fast food restaurant right next door to it. He sold focaccia, gelato, panini and many local favorites.
HUFFPOST SUPER USER
Bruisersmom
01:47 PM on 05/16/2011
We don't want them. I look around my little burg on the edge of LA and it has too many fast food and chain restaurants in it.
06:59 AM on 05/14/2011
Simple, check the "work ethic" level of each country and I bet there is a common thread showing the more Liberal non-working, the fatter they get. Mmmmmm Sounds like anouther country I know of going down the tubes, hard work has it's own reward, in more than one way.
photo
hattrick752
Regulate Wall St; Stop socializing losses
10:40 PM on 05/15/2011
By that standard, the south should have the healthiest people and the 'librul' coasts should be full of obese people just waddling around like penguins. Wonder why it is the opposite!
05:38 AM on 05/16/2011
In the U.S., demographic studies of obesity show that the American South contains the largest concentration of obesity. The slimmest tend to be in the coastal areas, also known as the most liberal part of the country. Next time, instead of spouting off a preconceived bias, do a little research first.
HUFFPOST SUPER USER
joran111
God and science DO coexist!
05:40 AM on 05/14/2011
"we as a nation return to the values we embraced and lived by up until the mid-1980s" Thanks, President Reagan, for this too!
photo
HUFFPOST SUPER USER
Tom Hendricks
see wikipedia
12:50 AM on 05/14/2011
Disagree somewhat here. Weight problems may not be either genetics or lifestyle. Some new ideas suggest a pattern of food in and waste out is set up in childhood during the weaning period or when first solids are eaten. This eating pattern governed by the ENS, or enteric nervous system, is almost impossible to change.
There is a new hypothesis that suggests that each infant sets up a digestion pattern that may play a key part in every aspect of his life (including both overweight and underweight problems).
He develops, over the first year of his life a pattern of a) breaking down food into usable nutrients - from mouth to stomach, b) absorbing those nutrients - in small intestine, and c) excreting out waste - from large intestine.
Therefore each child sets a 3 part pattern in infancy of how he will digest food, use food, and excrete out waste. This seems to subconsciously program a lot of unconscious behavior from then on.
This pattern is in the ENS, or Enteric Nervous System or digestion brain. It is unconscious motivation, and it is very difficult to change.
These three patterns may be mostly set up through breast feeding and weaning.
Generally problems with breast feeding will lead to overweight problems, and problems with weaning will lead to underweight problems.