No to the Adulterated Version of The Mediterranean Diet

May 3, 2014
By

Greek Santorini Salad

When I first started this site, one of the reasons I began writing here was to clarify the misconceptions and misunderstandings involving the Mediterranean diet. But first let me make a few things clear:

I did not “discover” the Mediterranean diet during a summer vacation to Italy and Greece.

I did not “discover” the Mediterranean diet in the pages of a magazine or on TV

I did not “discover” the Mediterranean diet in a classroom during my studies in Nutrition.

I was raised on the Mediterranean Diet.

From the moment I started eating solid food, my diet consisted mainly of the foods that make up the Mediterranean diet. My favorite dishes were okra cooked in olive oil and tomato, I often ate octopus and squid and fasted from animal products for weeks since the age of five.

I was born in the U.S. by Greek parents. My mother, A young law student at the time did not know how to cook when she started a family, but found American food bland and tasteless, so she learned to cook Greek food-the food her mother and grandmothers cooked, we ate mainly plant based dishes with plenty of olive oil… I was lucky, that even though I lived thousands of miles away from Greece, my mother managed to provide us with Greek food (as many Greeks at the time) and not let us adopt a westernized, processed diet out of convenience or the need to belong.

At that time, it was not known (except in the scientific community) that the Greek-Cretan diet circa 1960 was one of the healthiest in the world, my parents and most other Greeks were told that the diet of “rich” America was healthy and that the diet of poor nations such as Greece and Italy was nutritionally inferior. But science eventually showed us that the opposite was true.

Several years later I am studying to be a nutritionist. There we were taught that a low fat diet is the best diet. I do not recall the Mediterranean diet being taught or discussed, except by me during my final project which was on the Mediterranean diet. A few years later Mediterranean food, became trendy and stylish, everywhere you went there were little plates of olive oil accompanied with bread for dipping (by the way traditionally Greeks never serve olive oil in small plates for dipping).

Articles began showing up and I would read about the this famous Mediterranean diet with many descriptions and recipes that resembled very little to the food my mother but also my grandmothers cooked in Greece. I would read about this famous diet and little mention was made about Greece, let alone Crete and its relationship with this healthy eating pattern. There was and is plenty of misinformation about the diet. In discussions with colleagues, I would explain to them that this so-called Mediterranean diet was actually based on studies on the diet of Crete. But most of the time it seemed like my comments were pushed aside and that I was being patriotic and biased because I was Greek after all.

But this has nothing to do with patriotism. This has everything to do with the facts:

THE FACTS

The first ever study of the now known Mediterranean diet happened in Crete. In 1948 the Greek government invited the Rockefeller foundation to investigate how to raise the standard of living in post war Crete. The study was very thorough and I was discovered that the diet of the Cretans were nutritionally adequate compared to the U.S. nutrition standards. This came as surprise to the Cretans and the foreign investigators. The diet made up of wild greens, fruit, herbs, beans, olive oil and wine with very little meat, was up to par.

Then there was Ancel Keys, the U.S. physiologist and his observations that lead to the 7 countries study. He found that the typical dietary pattern of Crete in the 50’s and 60’s was associated with good health and the lowest rates of heart disease by far even though they consumed high amounts of fat, mainly in the form of olive oil. In 1961 the life expectancy of a Greek at the age of 45 was higher than any other country according to data from the Word Health Organization.

In 1993 The Mediterranean Diet Food pyramid was developed by a collaboration of researchers from Harvard and the World Health Organization along with Oldways a non-profit organization. In essence it was the introduction of the Mediterranean diet to the American public and the authors in their report define the Mediterranean diet and the pyramid based on the research from the diets of Crete, Greece and southern Italy.

DEFINITION OF THE MEDITERRANEAN DET

But what is the definition of the Mediterranean Diet? For the scientific community that was involved with this diet , it is known as a diet modeled after the dietary practices of Cretan men in the 50’s and 60’s.

However today the term is often used (intentionally or unintentionally) in the media and academia, generically to refer to the diet of areas in the Mediterranean region. We often read  that there is no ONE Mediterranean diet or that it is a combination of various diets across the Mediterranean.

More than 20 countries border the Mediterranean Sea with very different cultures that affect the diet. For example some countries do not use olive oil as their main source of fat, while others do not consume wine, others eat plenty of meat. Can a Mediterranean diet exist without these components?

So the term Mediterranean diet is a bit misleading. It is NOT a generic diet from the Mediterranean region.

Others say that no single set of criteria exists for what constitutes a traditional Mediterranean diet eating pattern. This also is not possible as you cannot study a diet without a set of criteria. How would you even measure adherence?

And this is another issue. Mediterranean diet adherence tests and scales have been developed in order to asses if someone is following a Mediterranean diet. However, they are not that detailed, which is often the case as you need a quick tool in research in order to assess large number of participants. These tools can assess a Mediterranean style eating pattern but not an actual Mediterranean diet.

UNESCO recently recognized the Mediterranean diet as an Intangible Cultural Heritage of Spain, Portugal, Morocco, Italy, Greece, Cyprus and Croatia. Can they say that absolutely all these countries had a Mediterranean diet? Perhaps their definition of what is a Mediterranean diet differs from the original scientific definition.

MEDITERRANEAN DIET IN THE MEDIA

Journalists, experts and everybody in between often describe the Mediterranean diet (their own version it seems) with all sorts of misconceptions. No it is not about drinking expensive wine with every meal, or eating expensive fish or drizzling flavored olive oil over your heirloom tomatoes, or adding feta to everything. It is a natural occurring eating pattern that existed in a specific area of the world that made use of the local products.

As a nutritionist, I am more than happy to see the Mediterranean diet gain widespread attention. It is a diet that is easy to follow, has the science to support it , and can be adapted by anyone. Yes, it is fair to recognize that there are several variations of this eating pattern around the Mediterranean and there are many common characteristics. However, this diet was modeled after very specific eating patterns, namely the diet of Greece, Crete and southern Italy in the 60’s. This was how it was defined back in the 90’s by the researchers that developed the Mediterranean diet pyramid. Today it is being re-defined and not in a good way. It is re-defined by individuals who do not really now what it is in the first place. It is re-defined to satisfy the needs and interests of people, countries and organizations, but sometimes it is being re-defined by plain ignorance.

But why is this important? It is important, because the media and some so called experts often present a watered down-westernized version of the Mediterranean diet and this is not fair to the public. Are they really following a Mediterranean diet? Or a diet that a journalist or health professional thinks is the Mediterranean diet? Think about it….Will they receive all the benefits of this famous diet by following an altered version? Probably not.

Photo by Elena Paravantes
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13 Responses to No to the Adulterated Version of The Mediterranean Diet

  1. Nickie Koustoubekis
    May 3, 2014 at 1:39 pm

    My husband and I follow a diet of fresh fish, chicken, once a month red meat, lots of fresh vegetables, salad, yogert, beans and whole grains and at least one glass of red wine per day. very little sweets but we do have them on occasion. My husband is very busy in his garden and I walk 1 hr per day. We have retired from America to Chios Greece. However, my experience with the diet of the locals of the Island is not a Mediterranean Diet as is ours. Most of their food is fried.

    • Elena Paravantes RD
      May 3, 2014 at 1:49 pm

      Thank you Nickie for your comment and congratulations on your diet! As I have mentioned in the past, many of Greeks today no longer follow their ancestors diet unfortunately. Regarding the fried foods, they were part of the original Mediterranean diet, in moderation and always fried in olive oil. In fact a recent Spanish study showed that when fried foods were consumed within a Mediterranean diet and fried in fresh olive oil they did not have a negative effect on heart health, here is the link to the study: http://www.olivetomato.com/like-fried-foods-no-problem-as-long-as-they-are-fried-in-olive-oil/

      • Alexia
        May 5, 2014 at 2:54 pm

        Elena, I think in the comment above you meant to say that foods fried in olive oil did NOT have a negative effect on heart health.

        • Elena Paravantes RD
          May 6, 2014 at 7:47 am

          Thanks Alexia for noticing that! Yes, that is what I meant. I have corrected it on the comment.

  2. Brenda
    May 3, 2014 at 2:25 pm

    Thank you, Elena, for your solid, evidence based articles, and advocacy for authentic Greek/Cretan cuisine. I have learned so much from your web site and excellent articles. I provide it as a reference for patients in my professional work as a hospital clinical RD. I honestly don’t know of another resource like yours, simply because you haved lived the Med Diet.
    Always looking forward to whatever you bring to us in the future.

    • Elena Paravantes RD
      May 3, 2014 at 7:59 pm

      Thank you so much Brenda! Especially coming from you as a clinician.

  3. May 4, 2014 at 5:56 pm

    I think that in general the Med diet is more healthy than say a USA diet! However, it is also sad to observe so many fat middle aged Meditteraneans now. What’s gone wrong? Too much access to processed foods, that’s what’s gone wrong! Peter. Taylor

  4. Kate
    May 28, 2014 at 12:51 am

    Elena, I would like to know what you eat for dinners with a family? If you don’t eat meat what other dishes do you add to replace meats? I struggle to make dinners. Thanks

    • Elena Paravantes RD
      May 28, 2014 at 6:12 am

      Hi Kate,

      Thanks for your question. Generally we do not try to replace meats, they just are a smaller part of the diet as the Mediterranean diet is,considering they consumed meat only once a week. So we always supplement our vegetable meal with cheese. For dinner which is our smaller meal we may have an egg and yogurt and again cheese. And we have beans (legumes). And we also supplement a dish with the fish I mentioned. And on the weekends we will have meat. Last week it was lamb and fish. Sometimes it is chicken. Also it is important to note that almost all foods with the exception of fruit and fat have some level of protein in them.

  5. May 29, 2014 at 11:52 am

    Since you are a nutritionist, I have a question; What oil is best to replace the olive oil with? I get sick from olive oil (for days!).

    • Elena Paravantes RD
      June 2, 2014 at 3:12 pm

      Hi Marjolein, Do you mean you get sick physically? If that is the case, I would have tests to see if this is an allergy or maybe something else. Generally there are some seed oils that are high in monounsaturated fats although they do not contain the antioxidants that olive oil has.

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