Mediterranean diet

TheMediterranean dietis a concept first invented in 1975 by the American biologistAncel Keysand chemist Margaret Keys. The diet took inspiration from the eating habits andtraditional foodtypical of Crete, much of the rest of Greece, and southern Italy, and formulated in the early 1960s.It is distinct fromMediterranean cuisine, which covers the actual cuisines of the Mediterranean countries, and from theAtlantic dietof northwestern Spain and Portugal. While inspired by a specific time and place, the "Mediterranean diet" was later refined based on the results of multiple scientific studies.
This approach emphasizes aplant-based diet, focusing onunprocessed cereals,legumes,vegetables, andfruits.It also includes moderate consumption offish, dairy products (mostlycheeseandyogurt), and a low amount ofred meat.Olive oilhas been studied as a potential health factor for reducingall-cause mortalityand the risk ofchronic diseases.
The Mediterranean diet is associated with a reduction in all-cause mortality inobservational studies.A 2017 review provided evidence that the Mediterranean diet lowers the risk ofheart diseaseand early death.The Mediterranean diet may help with weight loss inobese people.The Mediterranean diet is one of threehealthy dietsrecommended in the 2015–2020Dietary Guidelines for Americans, along with theDASH dietandvegetarian diet.
A 2017 review found evidence that practice of a Mediterranean diet could lead to reduced risk ofcardiovascular diseases, overallcancerincidence,neurodegenerative diseases,diabetes, andearly death.A 2018 review showed that practice of the Mediterranean diet may improve overall health status, such as reduced risk of non-infectious diseases, reduced totalcosts of living, and reduced costs for nationalhealthcare.A 2016 review found similar weight loss as other diets.A 2019Cochrane reviewfound that there is still uncertainty regarding the effects of Mediterranean‐style diet advice on cardiovascular disease occurrence and risk factors in people both with and without existing cardiovascular disease.
The US 2015–2020 national guidelines devised a "Healthy Mediterranean-Style Eating Pattern", assessed against and mirroring the Mediterranean diet patterns and its positive health outcomes. It was designed from the "Healthy U.S.-Style Eating Pattern", but it contains more fruits and seafood, and less dairy.In the 2020s, research on the Mediterranean diet indicates that a Mediterranean diet may contribute to health.
The Mediterranean diet is included among dietary patterns that may reduce the risk of cardiovascular diseases.A 2013Cochrane reviewfound limited evidence that a Mediterranean diet favorably affects cardiovascularrisk factors.A 2013 meta-analysis compared Mediterranean,vegan, vegetarian, low-glycemic index, low-carbohydrate,high-fiber, andhigh-protein dietswith control diets. The research concluded that Mediterranean,low-carbohydrate,low-glycemic index, andhigh-protein dietsare effective in improving markers of risk for cardiovascular disease and diabetes, while there was limited evidence for an effect of vegetarian diets on glycemic control and lipid levels unrelated to weight loss.However, more cautious reviews arose in early 2016, raising concerns about the quality of previoussystematic reviewsexamining the impact of a Mediterranean diet on cardiovascular risk factors.These reviews insisted upon the need for further standardized research,stating that the evidence for possible prevention of cardiovascular disease by the diet was "limited and highly variable".Reviews in 2016-17 reached similar conclusions about the ability of a Mediterranean diet to improve cardiovascular risk factors, such as lowering the risk forhypertensionand other cardiovascular diseases.A Mediterranean diet is recommended as a means of loweringApolipoprotein B.
The Mediterranean diet is low insaturated fatwith high amounts ofmonounsaturated fatanddietary fiber. One possible factor is thepotential health effects of olive oilin the Mediterranean diet. Olive oil contains monounsaturated fats, most notablyoleic acid, which is under clinical research for its potential health benefits.TheEuropean Food Safety AuthorityPanel on Dietetic Products, Nutrition and Allergies approved health claims on olive oil, for protection by itspolyphenolsagainst oxidation of blood lipidsand for the contribution to the maintenance of normal bloodLDL-cholesterollevels by replacing saturated fats in the diet with oleic acid(Commission Regulation (EU) 432/2012 of 16 May 2012).A 2014 meta-analysis concluded that an elevated consumption of olive oil is associated with reduced risk of all-cause mortality, cardiovascular events and stroke, while monounsaturated fatty acids of mixed animal and plant origin showed no significant effects.TheAmerican Heart Associationdiscussed the Mediterranean diet as a healthy dietary pattern that may reduce the risk ofcardiovascular diseases.
A 2023 review found evidence for a reduction of mortality and cardiovascular disease risk in women on a Mediterranean-type diet.A 2024 review highlighted that bioactive compounds found in Mediterranean diet components (such as olive, grape, garlic, rosemary, and saffron) exhibit properties that may contribute to cardiovascular health.
In 2014, two meta-analyses found that the Mediterranean diet was associated with a decreased risk oftype 2 diabetes,findings similar to those of a 2017 review.The American Diabetes Association and a 2019 review indicated that the Mediterranean diet is a healthy dietary pattern that may reduce the risk of diabetes.
Ameta-analysisin 2008 found that strictly following the Mediterranean diet was correlated with a decreased risk of dying from cancer by 6%.Another 2014 review found that adherence to the Mediterranean diet was associated with a decreased risk of death from cancer.A 2017 review found a decreased rate of cancer, although evidence was weak.An updated review in 2021 found that the Mediterranean diet is associated with a 13% lower risk of cancer mortality in the general population.
Overweight adults who adopt Mediterranean diets may lose weight by consuming fewer calories.A 2019 review found that the Mediterranean diet may help obese people lower the quantity and improve the nutritional quality of food intake, with an overall effect of possibly losing body weight.
A 2016 systematic review found a relation between greater adherence to a Mediterranean diet and better cognitive performance; it is unclear if the relationship is causal.
According to a 2013 systematic review, greater adherence to a Mediterranean diet is correlated with a lower risk ofAlzheimer's diseaseand slower cognitive decline.Another 2013 systematic review reached similar conclusions, and also found a negative association with the risk of progressing frommild cognitive impairmentto Alzheimer's, but acknowledged that only a small number of studies had been done on the topic.
There is a correlation between adherence to the Mediterranean diet and a lower risk of depression.  Studies on which these correlations are made areobservationaland do not prove cause and effect.
As the Mediterranean diet usually includes products containinggluten, such as pasta and bread, increasing use of the diet may have contributed to the growing rate ofgluten-related disorders.
There are variations of the "Mediterranean diets" in different countries and among the individual populations of the Mediterranean basin, due to ethnic, cultural, economic and religious diversities.The "Mediterranean diet" as defined by dietitians generally includes the following components,which are not typical of diets in theMediterranean Basin:
These proportions are sometimes represented in theMediterranean Diet Pyramid. In a diet with roughly this composition, the fat content accounts for 25% to 35% of the total intake ofcalories, while the amount of saturated fat is, at most, 8% of the calorie content.
Somecuisines of the Mediterranean regionare not fully consistent with Mediterranean diet guidelines. For instance, olive oil is not the staple fat in the cuisines of all countries which border the Mediterranean: innorthernandcentralItaly,lardandbutterare commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables;in bothNorth Africaand theMiddle East, sheep'stail fatand rendered butter (samna) are traditional staple fats.
Consuming a Mediterranean diet or plant-based diet may contribute to improvingenvironmentalandagricultural sustainability, possibly due to lower use of dairy products,ruminant meat, andultra-processed foods.The environmental impact and amount of energy needed to feed livestock exceeds its nutritional value.In a 2014 lifecycle analysis ofgreenhouse gas emissions, researchers found that a Mediterranean-like diet may reduce food production emissions below those of an omnivorous diet for 2050, with aper capitareduction of 30%.
The concept of Mediterranean diet was first publicized in 1975 by the American biologistAncel Keysand chemist Margaret Keys (a husband and wife team),but failed to gain widespread recognition until the 1990s.
Objective data showing that the Mediterranean diet is healthy originated from results ofepidemiological studiesinCalabria,NaplesandMadrid, confirmed later by theSeven Countries Studyfirst published in 1970,and a book-length report in 1980.
The most commonly understood version of the Mediterranean diet was presented by, among others,Walter Willettand colleagues of theHarvard UniversitySchool of Public Healthsince the mid-1990s.The Mediterranean diet is based on a paradox: although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates ofcardiovascular diseasethan in countries such as theUnited Stateswhere similar levels of fat consumption are found. A parallel phenomenon is known as theFrench paradox.By 2011, the Mediterranean diet was included by some authors as afad dietpromoted for losing weight.
Since about 2016, theAmerican Heart AssociationandAmerican Diabetes Associationhave recommended the Mediterranean diet as a healthy dietary pattern that may reduce the risk ofcardiovascular diseasesandtype 2 diabetes, respectively.TheUnited Kingdom'sNational Health Servicealso recommends a Mediterranean diet to reduce cardiovascular disease risk.
In 2018, theEuropean Journal of Public Healthquestioned the value of the traditional Mediterranean diet due to homogenization of dietary choices and food products in the global economy.Despite this,clinical researchactivity remained high, with favorable outcomes reported for various disease conditions, such asmetabolic syndrome.
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