Listen on Apple Podcasts | Listen on Spotify | Listen on YouTube
In the early 1960s, a scientist named Ancel Keys was puzzling over a question:
Why were rich, middle-aged businessmen in Minnesota more likely to die of heart disease than poor villagers in Italy?
Up to this point, most scientists considered heart disease to be part and parcel of the aging process—a result of your decaying DNA rather than your diet or exercise habits.
But then there were these remote villages in Southern Italy that had the highest rates of centenarians in the world and some of the lowest rates of heart disease, despite being populated with people genetically similar to American men.
Data like this convinced Keys that heart disease might be preventable, and was bolstered by other findings.
For instance, Keys discovered that in food-starved regions of post-war Europe, cardiovascular disease dropped along with the food supply, implying a connection between the two seemingly unrelated circumstances.
As the evidence mounted, Keys became more convinced that diet was a key factor in the risk of heart disease, and to test his hypothesis, he conducted an enormous study—one that would become his magnum opus.
The short story is that the Mediterranean diet is popular among scientists, doctors, and the average dieter for a reason: it’s a perfectly healthy way to eat.
That said, it’s not for everyone and not the only way to eat well.
Let’s find out why.
Time Stamps:
7:28 – What is the Mediterranean diet?
12:08 – Why is the Mediterranean diet popular?
12:50 – Can the Mediterranean diet prevent heart disease?
26:22 – Can you get the health benefits associated with the Mediterranean diet while still eating red meat, dairy, and poultry?
29:15 – Can the Mediterranean diet prevent type 2 diabetes?
34:32 – Does the Mediterranean diet help you lose weight?
38:59 – Can the Mediterranean diet help you live longer?
Mentioned on The Show:
What did you think of this episode? Have anything else to share? Let me know in the comments below!
+ Scientific References
- Hughes, T. F., Andel, R., Small, B. J., Borenstein, A. R., Mortimer, J. A., Wolk, A., Johansson, B., Fratiglioni, L., Pedersen, N. L., & Gatz, M. (2010). Midlife fruit and vegetable consumption and risk of dementia in later life in swedish twins. American Journal of Geriatric Psychiatry, 18(5), 413–420. https://doi.org/10.1097/JGP.0b013e3181c65250
- Chen, G. C., Lv, D. B., Pang, Z., Dong, J. Y., & Liu, Q. F. (2013). Dietary fiber intake and stroke risk: A meta-analysis of prospective cohort studies. European Journal of Clinical Nutrition, 67(1), 96–100. https://doi.org/10.1038/ejcn.2012.158
- Key, T. J. (2011). Fruit and vegetables and cancer risk. In British Journal of Cancer (Vol. 104, Issue 1, pp. 6–11). Nature Publishing Group. https://doi.org/10.1038/sj.bjc.6606032
- Lourida, I., Soni, M., Thompson-Coon, J., Purandare, N., Lang, I. A., Ukoumunne, O. C., & Llewellyn, D. J. (2013). Mediterranean diet, cognitive function, and dementia: A systematic review. Epidemiology, 24(4), 479–489. https://doi.org/10.1097/EDE.0b013e3182944410
- Sofi, F., Cesari, F., Abbate, R., Gensini, G. F., & Casini, A. (2008). Adherence to Mediterranean diet and health status: Meta-analysis. BMJ, 337(7671), 673–675. https://doi.org/10.1136/bmj.a1344
- Dinu, M., Pagliai, G., Casini, A., & Sofi, F. (2018). Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials. In European Journal of Clinical Nutrition (Vol. 72, Issue 1, pp. 30–43). Nature Publishing Group. https://doi.org/10.1038/ejcn.2017.58
- Brown, J. C., Harhay, M. O., & Harhay, M. N. (2016). Sarcopenia and mortality among a population-based sample of community-dwelling older adults. Journal of Cachexia, Sarcopenia and Muscle, 7(3), 290–298. https://doi.org/10.1002/jcsm.12073
- Metter, E. J., Talbot, L. A., Schrager, M., & Conwit, R. (2002). Skeletal muscle strength as a predictor of all-cause mortality in healthy men. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 57(10), B359–B365. https://doi.org/10.1093/gerona/57.10.B359
- Krieger, J. W., Sitren, H. S., Daniels, M. J., & Langkamp-Henken, B. (2006). Effects of variation in protein and carbohydrate intake on body mass and composition during energy restriction: A meta-regression. American Journal of Clinical Nutrition, 83(2), 260–274. https://doi.org/10.1093/ajcn/83.2.260
- Phillips, S. M., & van Loon, L. J. C. (2011). Dietary protein for athletes: From requirements to optimum adaptation. Journal of Sports Sciences, 29(SUPPL. 1). https://doi.org/10.1080/02640414.2011.619204
- Paddon-Jones, D., Westman, E., Mattes, R. D., Wolfe, R. R., Astrup, A., & Westerterp-Plantenga, M. (2008). Protein, weight management, and satiety. American Journal of Clinical Nutrition, 87(5). https://doi.org/10.1093/ajcn/87.5.1558s
- Westerterp, K. R. (2004). Diet induced thermogenesis. In Nutrition and Metabolism (Vol. 1, Issue 1). Nutr Metab (Lond). https://doi.org/10.1186/1743-7075-1-5
- Helms, E. R., Aragon, A. A., & Fitschen, P. J. (2014). Evidence-based recommendations for natural bodybuilding contest preparation: Nutrition and supplementation. In Journal of the International Society of Sports Nutrition (Vol. 11, Issue 1, pp. 1–20). BioMed Central Ltd. https://doi.org/10.1186/1550-2783-11-20
- Evans, E. M., Mojtahedi, M. C., Thorpe, M. P., Valentine, R. J., Kris-Etherton, P. M., & Layman, D. K. (2012). Effects of protein intake and gender on body composition changes: A randomized clinical weight loss trial. Nutrition and Metabolism, 9(1). https://doi.org/10.1186/1743-7075-9-55
- Astrup, A., Raben, A., & Geiker, N. (2015). The role of higher protein diets in weight control and obesity-related comorbidities. In International Journal of Obesity (Vol. 39, Issue 5, pp. 721–726). Nature Publishing Group. https://doi.org/10.1038/ijo.2014.216
- Campos-Nonato, I., Hernandez, L., & Barquera, S. (2017). Effect of a High-Protein Diet versus Standard-Protein Diet on Weight Loss and Biomarkers of Metabolic Syndrome: A Randomized Clinical Trial. Obesity Facts, 10(3), 238–251. https://doi.org/10.1159/000471485
- Helms, E. R., Zinn, C., Rowlands, D. S., Naidoo, R., & Cronin, J. (2015). High-protein, low-fat, short-term diet results in less stress and fatigue than moderate-protein, moderate-fat diet during weight loss in male weightlifters: A pilot study. International Journal of Sport Nutrition and Exercise Metabolism, 25(2), 163–170. https://doi.org/10.1123/ijsnem.2014-0056
- Helms, E. R., Aragon, A. A., & Fitschen, P. J. (2014). Evidence-based recommendations for natural bodybuilding contest preparation: Nutrition and supplementation. In Journal of the International Society of Sports Nutrition (Vol. 11, Issue 1, pp. 1–20). BioMed Central Ltd. https://doi.org/10.1186/1550-2783-11-20
- Esposito, K., Marfella, R., Ciotola, M., Di Palo, C., Giugliano, F., Giugliano, G., D’Armiento, M., D’Andrea, F., & Giugliano, D. (2004). Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: A randomized trial. Journal of the American Medical Association, 292(12), 1440–1446. https://doi.org/10.1001/jama.292.12.1440
- Cioffi, I., Ibrugger, S., Bache, J., Thomassen, M. T., Contaldo, F., Pasanisi, F., & Kristensen, M. (2016). Effects on satiation, satiety and food intake of wholegrain and refined grain pasta. Appetite, 107, 152–158. https://doi.org/10.1016/j.appet.2016.08.002
- Knudsen, S. H., Karstoft, K., Pedersen, B. K., Van Hall, G., & Solomon, T. P. J. (2014). The immediate effects of a single bout of aerobic exercise on oral glucose tolerance across the glucose tolerance continuum. Physiological Reports, 2(8), 12114. https://doi.org/10.14814/phy2.12114
- Clamp, L. D., Hume, D. J., Lambert, E. V., & Kroff, J. (2017). Enhanced insulin sensitivity in successful, long-term weight loss maintainers compared with matched controls with no weight loss history. Nutrition & Diabetes, 7(6), e282. https://doi.org/10.1038/nutd.2017.31
- Borghouts, L. B., & Keizer, H. A. (2000). Exercise and insulin sensitivity: A review. In International Journal of Sports Medicine (Vol. 21, Issue 1, pp. 1–12). Int J Sports Med. https://doi.org/10.1055/s-2000-8847
- Georgoulis, M., Kontogianni, M. D., & Yiannakouris, N. (2014). Mediterranean diet and diabetes: Prevention and treatment. Nutrients, 6(4), 1406–1423. https://doi.org/10.3390/nu6041406
- Christensen, A. S., Viggers, L., Hasselström, K., & Gregersen, S. (2013). Effect of fruit restriction on glycemic control in patients with type 2 diabetes--a randomized trial. Nutrition Journal, 12. https://doi.org/10.1186/1475-2891-12-29
- Dinu, M., Pagliai, G., Casini, A., & Sofi, F. (2018). Mediterranean diet and multiple health outcomes: An umbrella review of meta-analyses of observational studies and randomised trials. In European Journal of Clinical Nutrition (Vol. 72, Issue 1, pp. 30–43). Nature Publishing Group. https://doi.org/10.1038/ejcn.2017.58
- Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., Golan, R., Fraser, D., Bolotin, A., Vardi, H., Tangi-Rozental, O., Zuk-Ramot, R., Sarusi, B., Brickner, D., Schwartz, Z., Sheiner, E., Marko, R., Katorza, E., Thiery, J., … Stampfer, M. J. (2008). Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. New England Journal of Medicine, 359(3), 229–241. https://doi.org/10.1056/nejmoa0708681
- Ajala, O., English, P., & Pinkney, J. (2013). Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes1-3. In American Journal of Clinical Nutrition (Vol. 97, Issue 3, pp. 505–516). Am J Clin Nutr. https://doi.org/10.3945/ajcn.112.042457
- Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 diabetes mellitus: A review of current trends. In Oman Medical Journal (Vol. 27, Issue 4, pp. 269–273). Oman Medical Specialty Board. https://doi.org/10.5001/omj.2012.68
- Shiroma, E. J., & Lee, I. M. (2010). Physical activity and cardiovascular health: Lessons learned from epidemiological studies across age, Gender, and race/ethnicity. In Circulation (Vol. 122, Issue 7, pp. 743–752). Lippincott Williams & Wilkins. https://doi.org/10.1161/CIRCULATIONAHA.109.914721
- Carnethon, M. R. (2009). Physical Activity and Cardiovascular Disease: How Much Is Enough? American Journal of Lifestyle Medicine, 3(1_suppl), 44S-49S. https://doi.org/10.1177/1559827609332737
- Winzer, E. B., Woitek, F., & Linke, A. (2018). Physical activity in the prevention and treatment of coronary artery disease. In Journal of the American Heart Association (Vol. 7, Issue 4). American Heart Association Inc. https://doi.org/10.1161/JAHA.117.007725
- Anand, S. S., Hawkes, C., De Souza, R. J., Mente, A., Dehghan, M., Nugent, R., Zulyniak, M. A., Weis, T., Bernstein, A. M., Krauss, R. M., Kromhout, D., Jenkins, D. J. A., Malik, V., Martinez-Gonzalez, M. A., Mozaffarian, D., Yusuf, S., Willett, W. C., & Popkin, B. M. (2015). Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System A Report from the Workshop Convened by the World Heart Federation. In Journal of the American College of Cardiology (Vol. 66, Issue 14, pp. 1590–1614). Elsevier USA. https://doi.org/10.1016/j.jacc.2015.07.050
- Malhotra, A., Redberg, R. F., & Meier, P. (2017). Saturated fat does not clog the arteries: Coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. In British Journal of Sports Medicine (Vol. 51, Issue 15, pp. 1111–1112). BMJ Publishing Group. https://doi.org/10.1136/bjsports-2016-097285
- Schwingshackl, L., & Hoffmann, G. (2012). Monounsaturated fatty acids and risk of cardiovascular disease: Synopsis of the evidence available from systematic reviews and meta-analyses. In Nutrients (Vol. 4, Issue 12, pp. 1989–2007). MDPI AG. https://doi.org/10.3390/nu4121989
- Aune, D., Giovannucci, E., Boffetta, P., Fadnes, L. T., Keum, N. N., Norat, T., Greenwood, D. C., Riboli, E., Vatten, L. J., & Tonstad, S. (2017). Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-A systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology, 46(3), 1029–1056. https://doi.org/10.1093/ije/dyw319
- Akil, L., & Anwar Ahmad, H. (2011). Relationships between obesity and cardiovascular diseases in four southern states and Colorado. Journal of Health Care for the Poor and Underserved, 22(4 SUPPL.), 61–72. https://doi.org/10.1353/hpu.2011.0166
- Abbot, N. C., Stead, L. F., White, A. R., & Barnes, J. (1998). Hypnotherapy for smoking cessation. In The Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd. https://doi.org/10.1002/14651858.cd001008
- Varghese, T., Schultz, W. M., McCue, A. A., Lambert, C. T., Sandesara, P. B., Eapen, D. J., Gordon, N. F., Franklin, B. A., & Sperling, L. S. (2016). Physical activity in the prevention of coronary heart disease: Implications for the clinician. Heart, 102(12), 904–909. https://doi.org/10.1136/heartjnl-2015-308773
- Micha, R., Michas, G., & Mozaffarian, D. (2012). Unprocessed red and processed meats and risk of coronary artery disease and type 2 diabetes - An updated review of the evidence. In Current Atherosclerosis Reports (Vol. 14, Issue 6, pp. 515–524). NIH Public Access. https://doi.org/10.1007/s11883-012-0282-8
- Zazpe, I., Beunza, J. J., Bes-Rastrollo, M., Warnberg, J., De La Fuente-Arrillaga, C., Benito, S., Vázquez, Z., & Martínez-González, M. A. (2011). Egg consumption and risk of cardiovascular disease in the SUN Project. European Journal of Clinical Nutrition, 65(6), 676–682. https://doi.org/10.1038/ejcn.2011.30
- Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., Maria Lamuela-Raventos, R., Serra-Majem, L., Pintó, X., Basora, J., Angel Muñoz, M., Sorlí, J. V, Alfredo Martínez, J., & Angel Martínez-González, M. (2013). Primary prevention of cardiovascular disease with a mediterranean diet. In Zeitschrift fur Gefassmedizin (Vol. 10, Issue 2, p. 28). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa1200303
- Liyanage, T., Ninomiya, T., Wang, A., Neal, B., Jun, M., Wong, M. G., Jardine, M., Hillis, G. S., & Perkovic, V. (2016). Effects of the mediterranean diet on cardiovascular outcomes-a systematic review and meta-analysis. In PLoS ONE (Vol. 11, Issue 8). Public Library of Science. https://doi.org/10.1371/journal.pone.0159252
- Huedo-Medina, T. B., Garcia, M., Bihuniak, J. D., Kenny, A., & Kerstetter, J. (2016). Methodologic quality of meta-analyses and systematic reviews on the Mediterranean diet and cardiovascular disease outcomes: A review. In American Journal of Clinical Nutrition (Vol. 103, Issue 3, pp. 841–850). American Society for Nutrition. https://doi.org/10.3945/ajcn.115.112771
- Rees, K., Hartley, L., Flowers, N., Clarke, A., Hooper, L., Thorogood, M., & Stranges, S. (2013). “Mediterranean” dietary pattern for the primary prevention of cardiovascular disease. In Cochrane Database of Systematic Reviews (Vol. 2013, Issue 8). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD009825.pub2
- Zaccai, J. H. (2004). How to assess epidemiological studies. In Postgraduate Medical Journal (Vol. 80, Issue 941, pp. 140–147). The Fellowship of Postgraduate Medicine. https://doi.org/10.1136/pgmj.2003.012633
- PAGE, I. H., STARE, F. J., CORCORAN, A. C., POLLACK, H., & WILKINSON, C. F. (1957). Atherosclerosis and the fat content of the diet. Circulation, 16(2), 163–178. https://doi.org/10.1161/01.CIR.16.2.163
- Patino, C. M., & Ferreira, J. C. (2018). Inclusion and exclusion criteria in research studies: Definitions and why they matter. In Jornal Brasileiro de Pneumologia (Vol. 44, Issue 2, p. 84). Sociedade Brasileira de Pneumologia e Tisiologia. https://doi.org/10.1590/s1806-37562018000000088
- Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M. T., Corrà, U., Cosyns, B., Deaton, C., Graham, I., Hall, M. S., Hobbs, F. D. R., Løchen, M. L., Löllgen, H., Marques-Vidal, P., Perk, J., Prescott, E., Redon, J., … Gale, C. (2016). 2016 European Guidelines on cardiovascular disease prevention in clinical practice. In European Heart Journal (Vol. 37, Issue 29, pp. 2315–2381). Oxford University Press. https://doi.org/10.1093/eurheartj/ehw106
- Willett, W. C. (2012). Dietary fats and coronary heart disease. In Journal of Internal Medicine (Vol. 272, Issue 1, pp. 13–24). J Intern Med. https://doi.org/10.1111/j.1365-2796.2012.02553.x
- Castelli, W. P., Anderson, K., Wilson, P. W. F., & Levy, D. (1992). Lipids and risk of coronary heart disease The Framingham Study. Annals of Epidemiology, 2(1–2), 23–28. https://doi.org/10.1016/1047-2797(92)90033-M
- Menotti, A., & Puddu, P. E. (2015). How the Seven Countries Study contributed to the definition and development of the Mediterranean diet concept: A 50-year journey. Nutrition, Metabolism and Cardiovascular Diseases, 25(3), 245–252. https://doi.org/10.1016/j.numecd.2014.12.001
- Safouris, A., Tsivgoulis, G., Sergentanis, T., & Psaltopoulou, T. (2015). Mediterranean Diet and Risk of Dementia. Current Alzheimer Research, 12(8), 736–744. https://doi.org/10.2174/1567205012666150710114430
- Benson, G., Pereira, R. F., & Boucher, J. L. (2011). Rationale for the use of a mediterranean diet in diabetes management. Diabetes Spectrum, 24(1), 36–40. https://doi.org/10.2337/diaspect.24.1.36
- Schwingshackl, L., Schwedhelm, C., Galbete, C., & Hoffmann, G. (2017). Adherence to mediterranean diet and risk of cancer: An updated systematic review and meta-analysis. In Nutrients (Vol. 9, Issue 10). MDPI AG. https://doi.org/10.3390/nu9101063
- Dontas, A. S., Zerefos, N. S., Panagiotakos, D. B., & Valis, D. A. (2007). Mediterranean diet and prevention of coronary heart disease in the elderly. In Clinical interventions in aging (Vol. 2, Issue 1, pp. 109–115). Dove Press. https://doi.org/10.2147/ciia.2007.2.1.109
- Boucher, J. L. (2017). Mediterranean eating pattern. Diabetes Spectrum, 30(2), 72–76. https://doi.org/10.2337/ds16-0074
- Fulkerson, J. A., Story, M., Mellin, A., Leffert, N., Neumark-Sztainer, D., & French, S. A. (2006). Family Dinner Meal Frequency and Adolescent Development: Relationships with Developmental Assets and High-Risk Behaviors. Journal of Adolescent Health, 39(3), 337–345. https://doi.org/10.1016/j.jadohealth.2005.12.026
- Dunn, C., Haubenreiser, M., Johnson, M., Nordby, K., Aggarwal, S., Myer, S., & Thomas, C. (2018). Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain. In Current obesity reports (Vol. 7, Issue 1, pp. 37–49). Curr Obes Rep. https://doi.org/10.1007/s13679-018-0299-6
- Dernini, S., & Berry, E. M. (2015). Mediterranean Diet: From a Healthy Diet to a Sustainable Dietary Pattern. Frontiers in Nutrition, 2. https://doi.org/10.3389/fnut.2015.00015
- Keys, A., Menotti, A., Aravanis, C., Blackburn, H., Djordevič, B. S., Buzina, R., Dontas, A. S., Fidanza, F., Karvonen, M. J., Kimura, N., Mohaček, I., Nedeljkovič, S., Puddu, V., Punsar, S., Taylor, H. L., Conti, S., Kromhout, D., & Toshima, H. (1984). The seven countries study: 2,289 deaths in 15 years. Preventive Medicine, 13(2), 141–154. https://doi.org/10.1016/0091-7435(84)90047-1