Last week leading Mediterranean Diet researchers from Greece and Spain, among them Antonia Trichopoulou and Miguel Ángel Martínez-González, both authors of hundreds of studies and reviews, authored an article pointing out what the Mediterranean Diet is NOT. This was based on an extensive review of articles, studies and reviews. They note that some prevalent myths and misconceptions on the Mediterranean Diet require clarification, since one of the main challenges of its application in the US come from these misconceptions.
Here are some important misconceptions they noted:
1. The traditional Mediterranean Diet is not a purely vegetarian diet.
The Mediterranean diet is primarily, but not exclusively, a plant-based diet that allows for a low consumption of meat and meat products, fermented dairy, and a moderate consumption of fish.
2. Pattern of alcohol consumption more important.
The main concern regarding alcoholic beverages is not just the amount of alcohol consumption, but the pattern of consumption, which is different in the American population. For adults, a traditional Mediterranean Diet may include moderate alcohol consumption, always during meals, preferably wine, with low or no liquor consumption. Binge drinking and preference for beer instead of wine are not part of the traditional Mediterranean Diet.
A “low fat” Mediterranean Diet is not a traditional Mediterranean Diet. The usual amount of fat in the diet is 30–45%
3. Avocado is not Mediterranean.
There are many reasons to think that the consumption of avocado is healthy, however this food is a fruit originating from South America and not a traditional Mediterranean food.
4. Misclassified “Mediterranean” Foods.
Other foods misclassified as part of a Mediterranean Diet eating pattern include quinoa, margarine, tofu.
5. The “Japo-Mediterranean” diet is not Mediterranean.
A “Japo-Mediterranean” diet comprised of olive oil, wine, fish, beans, nuts and seeds, soy, vegetables, fruits, bread, rice, seaweed, dairy products, and mushrooms, is not a traditional Mediterranean Diet because soy is not a traditional Mediterranean food.
6. The “Indo-Mediterranean diet” is not Mediterranean.
An “Indo-Mediterranean diet”which is rich in whole grains, fruits, vegetables, walnuts, mustard, oil, and almonds is not a Mediterranean Diet either.
7. A proper Mediterranean Diet requires the use of olive oil as the main cooking fat.
Using other unsaturated fat cooking oils other than olive oil, such as flaxseed, peanut, corn, or sunflower oils, with similar or higher content in saturated fat than olive oil, do not pertain to the traditional Mediterranean Diet. Although alternative liquid oils (sunflower, canola, soya, or other seeds) that are rich in polyunsaturated lipids are better than lard or butter, they are uncharacteristic of the traditional Mediterranean Diet.
8. A “low fat” Mediterranean Diet is not a traditional Mediterranean Diet.
The usual amount of fat in the Mediterranean Diet is 30–45%, but the important factor is not the amount, but the type of fat: olive oil, nuts, and fatty fish should be the main sources of fat, especially extra-virgin olive oil, which may represent 15% or more of the total caloric intake.
There are also issues with the definition not only among consumers, but also researchers as is noted in the review: “Some systematic reviews on the Mediterranean Diet misleadingly defined the diet as any diet that meets at least two of nine traditional Mediterranean Diet characteristics (high consumption of olive oil, legumes, cereals, fruits and vegetables, moderate to high consumption of fish, low consumption of meat and meat products, and moderate consumption of dairy products, mostly as cheese and yogurt, and wine). This definition based on at least two of these characteristics completely lacks specificity, and therefore it may prove useless.” Other misleading definitions of the Mediterranean Diet are based on macronutrient intake and may indirectly suggest that the Mediterranean Diet is defined solely by an unrestricted fat content.
So there you have it, the article also provides a handy guide on practical ideas for changing from a Westernized Diet to a Mediterranean diet.
For more information on the misconceptions of the Mediterranean diet check out these posts:
Hello Elena,
Thanks for your website. It has a sort of unique name that I can always remember when I want to check to see your new posts!
Many people I run into (in the US) these days are very happy to have their love of butter and some other saturated fat-infused foods getting positive press which allows them to eat these foods without guilt. I try to follow a traditional mediterranean diet pretty closely e.g. lots of olive oil, walnuts, greens and other vegetables, minimal meat etc. and I hear more people say “why bother?”
Can you perhaps provide some links (or maybe a blog post at some point) of the best current research that supports a mediterranean-type diet over say low (simple) carb/high protein and saturated fat diets? I know you have written on similar topics in the past but it would be interesting to read an updated summary. I’m interested in the various types of evidence from lifespan in different cultures (historical or current) all the way to randomized experiments…
Thanks, Chris
Thank you for your insights Chris. Yes, saying that saturated fats are fine makes for a good story, however there is a long way to go in terms of research that supports this. Fortunately, the Mediterranean diet is probably the most researched eating pattern and it is not low fat. I will be posting soon with comparisons. In the meantime here is an article that provides clarification: https://www.hsph.harvard.edu/magazine/magazine_article/is-butter-really-back/
Great, thanks for the link and looking forward to your future post.
I know this is from an external article, but a lot of these rules seem too pedantic to be helpful to someone just trying to be healthier. Why not indulge in avocado, seaweed or quinoa from time to time? It’s not unhealthy to do so, and after all Cretans in the 1950s didn’t avoid “new world” foods like bell peppers, squash, potatoes, tomatoes, etc. out of notions of purity. The items above correcting misconceptions regarding eating patterns and proportions of food types were more helpful to me as an average, non-UNESCO-affiliated person.
Thank you for your input Catherine. I believe from the researchers point of view, it is not about being a purist but to define a specific eating pattern correctly in order to make the appropriate studies and results. This does not mean someone should not eat avocados etc. the issue that I often see and experience is that the term “Mediterranean diet” is used to describe diets that are not in fact Mediterranean. And the problem with that is will those other versions of the diet offer the same benefits?