Mediterranean Diet

Why Is the Mediterranean Diet the Best Diet? How to Follow It, Its History and Scientific Studies

Mediterranean cuisine is rich in aromas and flavors, reflecting the tastes and spirit of people who live in harmony with nature. Drawing on traditional Mediterranean cooking, the Mediterranean diet has evolved through the lifestyles of the region's peoples into a versatile, healthy dietary model recognized worldwide. On our page dedicated to the Mediterranean diet, we first introduce what the diet is, its main components and its history. We then list separate articles on scientific studies showing how it may benefit or protect against many diseases, particularly cancer, diabetes, cardiovascular disease and dementia. Let us explore the fascinating history of the Mediterranean diet, which leads major international diet rankings and has proven benefits for longevity.

The name “Mediterranean diet” comes from the Mediterranean basin. Historians describe the region as the  cradle of society . The entire history of the ancient world unfolded within these geographical boundaries. Spanning parts of Europe, Asia and Africa, the area has been a meeting place for people with different cultures, traditions, languages and lifestyles.

Many civilizations ruled these lands, including the Sumerians, Assyrians, Babylonians and Persians. Later came the Cretans, Phoenicians and Romans, who increased the land's productivity. Cultural encounters and exchanges gradually influenced eating habits. In ancient Rome, for example, the general population's food culture consisted of bread, wine and oily foods. This pattern changed through interactions during the Middle Ages. Cheese, vegetables, grilled fish, seafood and small amounts of red meat gradually became part of Mediterranean food culture.

Diets differed between continents during this period. Mediterranean food culture gradually spread elsewhere and was adopted by other societies. Europe's eating habits, for example, differed in some respects. Grain was used more often for beer, small gardens were set aside for vegetables, and lard was commonly used in cooking. Europeans who encountered Mediterranean cuisine were influenced by it and adopted its food culture.

Mediterranean food culture continued spreading to other continents, passing from the southern shores of the Mediterranean into the Arab world. The importance placed on agriculture there made a decisive contribution to changing the Mediterranean culture built by Rome. New spices were introduced and new recipes developed.

Another historical event contributing to Mediterranean food culture was Europeans' discovery of the Americas. It introduced vegetables such as potatoes, corn and beans. Tomatoes became the first red vegetable to symbolize Mediterranean cuisine. These developments show how deep the history of today's Mediterranean diet runs.

The centuries-old history of the Mediterranean diet

Olives were first made into olive oil 2,500 years ago . Wine production from grapes probably dates back 6,000 years. Cereals, wheat and legumes such as lentils are thought to have appeared 9,000–10,000 years ago. Fish was one of the earliest means of barter and subsistence in coastal regions. Consumption of milk and dairy products in Europe dates back at least 9,000 years. Animals such as goats, cattle, sheep and camels are known to have been used 10,000 years ago. The importance of red meat and dairy may have changed today, but both have deep roots in Mediterranean cuisine.

The discovery of Mediterranean cuisine as a diet

Culinary and nutritional cultures gradually gave rise to the concept of diet. In 1917, the first Academy of Nutrition and Dietetics was established in America to conserve food and improve public health. As the academy developed, the health effects of different diets attracted scientists' interest and encouraged research.

The health benefits of the Mediterranean diet were first identified in 1952 by the American physiologist Ancel Keys and his wife, biochemist Margaret Keys.

Ancel Keys began his academic career as a biologist. He earned his master's and doctoral degrees at Berkeley in 1928 and 1930, respectively, and specialized in physiology with a doctorate at Cambridge in 1936. In 1939, he founded the world-renowned Laboratory of Physiological Hygiene at the University of Minnesota School of Public Health and directed it for 33 years.

From the 1950s, he became interested in high-altitude physiology, the effects of altitude on the human body, and human nutrition. His nutritional research led him to recognize a possible link between diet and cardiovascular disease. He began quasi-experimental studies of blood pressure, blood cholesterol and diet in Spain and Italy.

Keys observed that poor residents of small towns in southern Italy were healthier than wealthy New Yorkers. He believed that this difference, which wealth could not explain, was related to food . He began studying the health effects of eating patterns, what we would now call a “diet.” Focusing on the foods eaten by the region's people, he launched the famous Seven Countries Study.

The Seven Countries Study found that people following the Mediterranean diet had much lower blood cholesterol levels than Americans. Coronary heart disease occurred very infrequently among those following this diet. Keys thought this might be due to eating plenty of olive oil, vegetables and whole-grain carbohydrates, with little meat.

The Keys couple wrote books to share the valuable findings of their quasi-experimental Mediterranean research and introduce the Mediterranean diet. In “How to Eat Well” and “How to Eat Well and Stay Well the Mediterranean Way,” they discussed its favorable relationship with cardiovascular disease and its benefits. These books became bestsellers in the 1970s, and Keys appeared on the cover of Time magazine.

Inspired by Keys, many researchers began analyzing relationships between dietary habits and chronic diseases. As the health benefits of the Mediterranean diet became apparent, it continued to receive recognition from respected institutions.

The development of the Mediterranean diet food pyramid

In the 1990s, the International Olive Oil Council promoted olive oil as a central component of the diet. In 1992, the Harvard School of Public Health first developed the Mediterranean Food Pyramid.

Mediterranean diet food pyramid updated in 2000

Recognition of the Mediterranean diet as UNESCO heritage

It is not enough to describe Mediterranean cuisine solely through the foods in the pyramid. Nor is it accurate to define a single Mediterranean diet. The languages, cultures, cooking techniques and styles of Mediterranean countries and peoples produce regional variations. An ancient past and millennia of migration and trade introduced new ingredients and innovations. This explains the different food traditions in countries such as Cyprus, Morocco, Lebanon, Greece, Spain and Türkiye. No Mediterranean country considers its diet identical to that of its ancestors. For the same reason, the multinational group nominating Mediterranean food traditions to UNESCO could agree only on the broadest framework.

In 2013, the United Nations Educational, Scientific and Cultural Organization (UNESCO) added the Mediterranean diet to its list of the Intangible Cultural Heritage of Humanity.

Many popular diets have come and gone over the years. The Mediterranean diet, however, has frequently appeared in the top ten on lists of the world's best diets. The Mediterranean diet and diets derived from it, such as the DASH diet, have ranked first for the past seven years among the best diets selected by the large scientific panel of US News & World Report.

The Mediterranean diet is therefore not just an extraordinary richness of food, but also a point of contact between people and regions. In a globalized world of increasing migration, preserving traditional cuisines may be more important than it seems. Global research shows that the diet's main principles are present in many traditional cuisines. For example, beans, squash and tomato sauce from Mexico, far from the Mediterranean, are used in the Mediterranean diet. Fermented foods in traditional Chinese cuisine are a component of all healthy diets. Many nutritious, healthy foods can be found across different cultures.

Beyond the pleasure of eating and drinking, nutrition has become important for everyone seeking a healthy, long life. A nutritionally healthy diet and an active lifestyle are recognized as a model everyone should follow.

A similar situation is found in the regions called Blue Zones . Their residents are known for living the longest. Diets in these five areas around the world are similar but not identical. Despite living in different regions, people in Blue Zones share many principles of living, one of the most important being nutrition.

Key shared characteristics of people in Blue Zones are active lifestyles, strong social connections, predominantly vegetable-based diets and not smoking.

The Mediterranean diet is a traditional diet shaped by the joy, conversation and agricultural interests of the region's peoples. In a world where cultural heritage is rapidly disappearing, some foods become unnecessarily fashionable while others fail to receive the attention they deserve and are treated as ordinary. Although it is a traditional way of eating, it is wise to benefit from the unique features of the Mediterranean diet, whose scientific effects have been demonstrated repeatedly.

REFERENCES:

1. Roberta ALTOMARE et al., The Mediterranean Diet: A History of Health, Iran J Public Health, 2013

2. The Conservation, How the Mediterranean diet became No. 1 — and why that’s a problem, February 2020

Below, you can explore scientific studies on the Mediterranean diet in order from newest to oldest.