Part 9: What About the Mediterranean Diet?

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Spoiler alert: At the end of the movie The Sixth Sense the main character, Dr. Malcolm Crowe, realizes that he is yet another dead person that Cole can see. Cole told him earlier in the movie that the dead people "only see what they want to see." Malcolm suddenly becomes aware of all the details he missed to indicate that he was no longer alive, such as his wife dining alone and not answering him. One set of events, but two points-of-view. Two different views that see the same event in different ways.

The Mediterranean Diet is very similar to this concept. The Mediterranean Diet is known popularly as the fish, olive oil, and red wine diet, because that is one viewpoint that has been taken with regards to the results of several medical studies on this diet. But the other viewpoint that is grossly overlooked is that the bulk of the actual Mediterranean Diet is a whole foods, plant-based diet with lots of physical activity. Because of these two drastically different view points, many myths have been perpetuated about the health benefits of consuming the Mediterranean Diet. In today's post, I hope to clear up some of these myths and point you to the truth.

Background:
The Mediterranean Diet originated from an American nutritionist, Ancel Keys, who led the "Seven Countries Study" in the late 1950s. The "Seven Countries Study" evaluated the health status, diet, and lifestyle factors of populations from seven different countries. One of these countries was the island of Crete. In the study, Keys learned that the population of Crete had significantly lower rates of heart disease than many other countries, including the United States. Now here is where "The Sixth Sense" dichotomy comes in...

At the time of the study, the population of Crete was primarily agricultural (high levels of physical activity) and ate a diet consisting of mostly whole grains, vegetables, and fruits, with some fish, red wine, about 3 Tbsp of olive oil per day, and limited amounts of meat and dairy.  One point-of-view is that the fish, olive oil, and red wine were the "super foods" that kept this population healthy. Another (my) point-of-view is that this population was healthy in spite of the small amounts of fish, oil, and red wine (and meat and dairy) that were consumed. In other words, their primarily whole foods, plant-based diet and physically active lifestyle protected their health from the detrimental habits of consuming little to moderate amounts of oil, fish, meat, and dairy. Not the other way around. In fact, as it pertains to heart disease, Dr. Caldwell Esselstyn has shown that the reversal of arterial blockages (i.e. a true cure to heart disease) is made possible on a whole foods, plant based diet that is very low in fat and excludes meat, dairy, and oil.

But this is not the news that people want to hear. As Dr. John McDougall says, "people like to hear good news about their bad habits." Hence, fish, olive oil, and red wine to the rescue!

What about the population of Crete today? They continue to consume fish, olive oil, and red wine, but have adopted a more Westernized diet (higher amounts of meat and dairy in the diet) and reduced the amount of physical activity since the country became more industrialized. The population's health has declined. This phenomenon has been observed in other populations as well, such as Hawaii.

However, the Mediterranean Diet continues to be very popular today. The non-profit company Oldways, founded by K. Dun Gifford, continues to provide information about how to adopt the Mediterranean Diet. Sadly but not surprisingly, K. Dun Gifford passed away in 2010 at age 71...from a heart attack. The sad part is that the man who created his company to promote healthy eating suffered from the effects of unhealthy eating. So let's discuss the benefits and detriments of eating the Mediterranean Diet according to the pyramid below.

Summary of Diet Recommendations:
Today's Mediterranean Diet consists primarily (base all your meals on these foods) of fruits, vegetables, mostly whole grains, legumes, nuts, seeds, herbs, spices, and olive oil. Fish and seafood is recommended at least two times per week. Poultry, eggs, cheese, and other dairy products are recommended in "moderate" amounts "daily to weekly." Red meats and sweets are recommended less often. Physical activity is also recommended, but no specific amounts are provided.

What's Good?
It's wonderful that the Mediterranean Diet consists largely of a whole foods, plant-based diet. Lots of whole grains, legumes, fruits, and vegetables are recommended. I love how they say to "base every meal on these foods," though I would omit the olive oil completely because all it does is add unnecessary fat to the diet (recall from Part 1:What About the Standard American Diet? that 2 Tbsp of olive oil per day produces 24 lbs body fat per year). An easy way to switch your thinking when adopting a plant-based diet is to plan your meals around a whole grain, starch, or legume as opposed to planning meals around a meat item.

I also like how the "sweets" are recommended occasionally. I love my sweet treats, but they should be kept as treats, not a regularly consumed item.

It is also nice to see that the Mediterranean Diet recommends regular physical activity, though it would be nice to see some specific recommendations on frequency and intensity. I recommend at least 5 days per week, at least 45-minute sessions, aiming to keep your heart rate in your target zone (you're out of breath enough that you can still talk, but would rather not). I also recommend a variety of physical activity: weight-training, cardiovascular, and yoga/stretching.

What's Bad?
The recommendation to eat fish at least twice per week is misleading advice. I recommend eliminating all animal products, including fish, from your diet. Fish is commonly, but mistakenly, considered a health food or as one of those mythical "super foods" that surely everyone must need because of all the "good fats" and omega-3 fatty acids. Let's look at the real story about fish.

Fun Facts about Fish

In general, fish contain 1.5 to 2 times more cholesterol than chicken, pork, or beef.

Plants make all omega-3 and omega-6 fatty acids.
Fish, animals, and humans do not create omega-3 and omega-6 fats.
This means that fish get these fatty acids from eating plants.

Skip the middleman by eating plants directly, avoiding the harmful fat and cholesterol!

I also recommend avoiding dairy. That's why I think the recommendation to consume "moderate" portions of dairy products is very poor advice (it's also very vague). Dairy is not a healthy food to consume, even in small amounts. It's high in fat, cholesterol, sugar, estrogen, and concentrated animal protein.

The notion that olive oil is "the good kind of fat" is just plain silly. Yes, there are different forms of fat, but fat is fat (recall Fun Facts about Fat from Part 8: What About the Raw Foods Diet?). The human body creates, from other nutrients, all forms of fat needed except two: omega-3 and omega-6 which, as described above, are only created by plants. Plant foods and whole grains do contain small amounts of fat, more than enough for your bodily needs. There's simply no good reason to include extra fat in your diet.

You must also be aware that certain plant foods are unusually high in fat. Avocados, nuts, nut butters, seeds, and olives are examples of this. These higher fat plant foods still contain healthy nutrients, but also contain very high levels of fat. If seeking to lose weight, you should limit your intake of these foods to a couple times a week. Even if you are at your optimal weight, these higher fat plant foods should not be consumed every day.

Animal products of any kind are not beneficial to a person's health because of the high-fat content, cholesterol, and acid load it puts on the body from the excess protein consumption. The Mediterranean Diet would look perfect if it omitted the meat, fish, dairy, and olive oil, as opposed to making those items the "hero" of why the Crete population was healthy in the 1950s. It is such a shame to overlook the real hero of their former state of health: the whole foods, plant-based diet.

Bottom Line:
The original Mediterranean Diet (Crete population in the 1950s) consisted of a very physically active lifestyle and a primarily whole foods, plant-based diet with limited amounts of meat and dairy. The decreased health of this population as it adopted a more Westernized diet while continuing to consume fish, olive oil, and red wine supports the notion that it was not the fish, olive oil, and red wine that kept the population healthy -- it was the plant-based diet that had a protective effect. As it stands today, the popular Mediterranean Diet recommends consuming olive oil, fish, meat, and dairy -- all of which are unhealthy for you. A whole foods, plant-based diet is the key to better health, not added oils, fish, or red wine.

Here is an interesting video clip of Dr. Pam Popper (The Wellness Forum) speaking about the Mediterranean Diet myth.

Next -- Part 10: What About the Paleo Diet?
Previous -- Part 8: What About the Raw Foods Diet?
Introduction to the 10-Part Series