A new study showed that too many or too little carbohydrates can lead to higher mortality rates. Researchers from Brigham & Women’s Hospital, Harvard University and the University of Minnesota studied 15428 adults, investigating the association between the percentage of calories from carbohydrates and all-cause mortality.
Higher mortality rates (higher risk of death) was found in people who consumed less that 40% of their calories from carbohydrates or more than 70%.
They then further examined this association, by combining this data with data for carbohydrate intake reported from seven multinational prospective studies in a meta-analysis. They also assessed whether the substitution of animal or plant sources of fat and protein for carbohydrate affected mortality.
Higher mortality rates was found in people who consumed less that 40% of their calories from carbohydrates or more than 70%. In addition, those who replaced carbohydrates with animal based proteins and fats had a higher mortality rate than those who replaced carbohydrates with plant sources such as vegetables, legumes and plant fats such as olive oil or avocado.
The authors note that there are several possible explanations for the main findings, one of them being that low carbohydrate diets usually result in lower intake of vegetables, fruits, and grains and increased intakes of protein from animal sources which has been associated with higher mortality. Long-term effects of a low carbohydrate diet with typically low plant and increased animal protein and fat consumption have been hypothesized to stimulate inflammation, biological aging, and oxidative stress. In other words a moderately low carbohydrate diet which is rich in plant foods as opposed to an “Atkins” style diet rich in meats and animal fats can be the ideal diet. And guess what that diet is? The original Mediterranean Diet.
As I’ve note in a past post the traditional Greek diet which served as the prototype of the “Mediterranean Diet” is not a high carbohydrate diet. Dr. Antonia Trichopoulou a top Mediterranean researcher analyzed (and published) the macronutrient profile of a traditional Greek diet and found that it is around 40% fat, 40% carbohydrates and 20% protein. In addition, it is extremely rich in plant foods with small amounts of meat and the fat mainly comes from the generous use of extra virgin olive oil. The Greek version of the Mediterranean Diet combines all these factors: moderate carbohydrate levels, plant-based, and moderate fat levels making it highly palatable.
So, contrary to what you may think the Mediterranean diet is, it is not a high carbohydrate diet. But… you need to know how to follow a real Mediterranean Diet and not the so-called Mediterranean Diet presented in the media or various westernized guidelines in order to achieve optimal consumption of carbohydrates.
Check out some of my guidelines here:
Carbohydrates on The Real Mediterranean Diet
1. Balance your plate by filling it with about 75% vegetables the rest with carbs and protein.
2. Look for real whole-grain bread. Genuine whole-grain bread is made up of whole wheat flour, yeast, water and salt.
3. Add legumes at least twice a week for protein (ideally three), they consist of “good” carbohydrates while combining protein.
4. Do not consume a meal consisting of carbohydrates only, such as spaghetti. Pasta should be side dish not a main dish.
5. Prefer the whole fruit and not the fruit juice
6. For snacks choose nuts or cheese, not crackers or cereal bars.
7. For breakfast avoid a carb heavy meal, instead choose eggs with vegetables or yogurt with nuts.
Photo by Elena Paravantes © All Rights Reserved
This blog entry doesn’t seem to accurately reflect the results of the study that it is citing.
The macronutrients (by calories) found in the study are 12% protein, 40.3% fats, 41.4% carbohydrates, 2.4% fibre and 4% ethanol.
However this blog post states that there is 20% protein, 40% carbohydrates and 40% fats.
It seems that the author has rounded down the the values from both carbohydrates and fats and completely omitted the values from dietary fibre and ethanol and added all of these values to protein.
The actual study indicates 74.5 grams average daily protein intake while 20% of the 2473 daily calories in the study would imply a daily protein intake of about 124 grams.
This is quite a significant discrepancy as the latter value falls comfortably within the recommended 1.2-1.6 grams of protein per kilogram of bodyweight necessary to maintain muscle mass while the former value does not for the vast majority of people.
Very interesting article. I find it strange however that you recommend a low carb breakfast when traditional Mediterranean breakfasts almost always include some bread.
Hi Robin, I recommend a breakfast that is not carb-heavy for example just a bowl of cereal or just a slice of bread with honey. Generally the Mediterranean diet is characterized by a small breakfast with a more substantial mid-morning snack such as a vegetable pie.
Glad I found your article. My sister in law is from Crete. I have seen her struggle with cholesterol. A Greek friend , age 65 is struggling with carbs and diabetes. I’m forwarding your article.
Now I’m going to find out how to order your Mediterranean diet book.
I am female, 65, thyroidectomy 10 years ago. My health struggles and I’m constantly sick and fatigued. I wish to start living again. My only son moved to Florida. I want to be well enough to move snd not be afraid of being ill from the 300 issues of hypothyroidism.
Thank you, Kimithy Hassel living in Northern Cal.
Thank you Kimithy! Thank you for sharing, I hope you are able to feel better.
Can you tell me what a serving size of Greek yogurt would be? And also, Greek cream cheese? I have your graphic that shows 2 servings of dairy daily. 1 cup of milk (which I find odd, I didn’t think milk really was consumed on a MD), 1 ounce of cheese. But Greek yogurt isn’t really cheese, lol.
I’m trying to follow this diet as strictly as I can! 🙂
Thanks!
Hi Lynn, One serving Greek yogurt is 1 cup the same as regular yogurt.Yes, yogurt and cheese is your main dairy, but milk can occasionally be consumed.
Dear Elena,
First of all, thank you for your most inspiring website and the way you share your recipes and knowledge with the world. Living in the Netherlands I’ve been eating the Mediterranean way for almost 5 years now. I’m a lot healthier, happier, lost all of my excess weight and I’m bursting with energy almost 365 days a year. Moreover, since eating this way I don’t even crave for junk food or other unhealthy (factory made, and often highly processed) foods. So it seems like our bodies are telling us that fresh (seasonal) vegetables accompanied by occasional fish, meat, cheese and some dairy, is just what it likes/wants to get solely.
On the side of eating beans 1-2 times a week. I prefer to trade them for other vegetables in a completely vegetarian meal with less carbohydrates. Likewise, I trade almost all of my rice, potato, bread/rusk and pasta in a recipe for additional vegetables.
In my opinion, and supported by reading several studies (e.g. by professor Dariush Mozaffarian, Hanno Pijl, Walter Willett a.o.), combining the Mediterranean lifestyle and Mediterranean diet with moderate low carb eating is the healthiest way of living.
What is your opinion regarding this.
Thank you for your kind words! Regarding the carbohydrates, the traditional Mediterranean diet, is in itself a moderate carbohydrate diet as noted above at 40% as it is based mainly on vegetables and olive oil.
Hi Elena,
I have certain food intolerances (such as with dairy), and have to make adjustments for what I can eat, so I just had a question about the Traditional Greek Diet macro amounts mentioned here – nothing crazy important, but was curious if you had a guess at how much of the carbohydrate amount would be coming from fruit vs vegetables vs non fruit/veggie carbs, such as grains, as well as how much of the protein percentage would come from meat vs legume/beans vs dairy?
Thank you so much for all the information you’ve shared on here! I come back often to catch up on your fantastic recipes, and every one of them is just as tasty as they look in the pictures 🙂
Hi Christy, Thanks! Most protein is from plant sources and cheese or yogurt. The carbohydrate based on what is typically consumed I would say is 50/50 from veggies-fruit/bread
I don’t have a problem with the Mediterranean Diet as it seems to be a good, healthy diet. But I do have a problem with some of these studies. The respondents in the survey are being asked to state what they have eaten over the course of an extended period of time. Most people are terrible at remembering exactly what and how much of it they eat and they tend to underestimate their portion size and forget some of the things they have eaten due to shame or other reasons. Were the survey questions multiple-choice type where respondents could only select from the pre-defined list? People tend to guess when answering questions like this and the question’s wording biases their responses. The study’s conclusions are being drawn from unverified data so to me, I question the validity of the study and the soundness of the conclusions.
The full published study is available to the public here:
https://www.thelancet.com/action/showPdf?pii=S2468-2667%2818%2930135-X
The link is also above in my post.
I think it was Michael Pollan who said “Eat food. Not much. Mostly plants”- your recommended way of eating reminds me of this, actually. I find this way of eating to be one of, if not the most appealing and ‘doable’ eating plans out there (personally speaking). It’s still a shame many cultures around the world see meat as the main part of the meal and a staple rather than having it a few times a week. Also, there still seems to be a misconception that eating lots of meat is good for you and there’s some kind of shame in just eating pulses and vegetables. Going back to the carbs, it’s very easy for me to overeat the refined type but I still enjoy eating the wholewheat varieties (whilst trying not to eat too much!).
I don’t always practise what I preach though: I was ‘naughty’ this morning and chose a croissant and roll breakfast when I should’ve gone for the scrambled egg option which no doubt would’ve been healthier and more filling ☺
So true Eva! Unfortunately the meat industry is very involved in the development of nutrition guides in many countries which also plays a role in seeing meat as a daily necessary food.
I also have a hard time ignoring a good, authentic croissant…
What would you recommend for an athlete or bodybuilder wanting to switch to the Mediterranean diet but also wanting to increase protein intake to around that 30% mark?
You can increase protein through fish and shellfish as well as nut butters and beans.