I was born with a view of the Mediterranean. I have lived in two other Mediterranean countries. This article is inter-Mediterranean, started in one, and completed in another Mediterranean country. Moreover, part of it was written while sailing the Mediterranean. My diet looks irresistibly Mediterranean.
However, I will not write an ode to the Mediterranean diet. I will not write about its history, nor about its effects on the microbiome (1), on the risk of cardiovascular disease (2), cognitive health (3), diabetes (4), etc. Instead, I will try to show why branding the Mediterranean, or any other diet, is not the best move.
Mediterranean Idealization
Few terms in nutrition sound as convincing as the Mediterranean diet. It is so convincing that I have never heard any criticism of it. There is no theoretical chance that you have not heard of it, and the probability is low that you do not follow at least some of its principles. Probably the most popular diet today is popular not only in the Mediterranean, not only in Europe, but worldwide. Moreover, the Mediterranean diet is considered the gold standard in preventive medicine.
People who live in the Mediterranean region have a lower-than-average rate of cardiovascular disease, which is largely attributed to the Mediterranean type of diet. Although it generally includes a high intake of vegetables, fruits, oily fish, the use of olive oil as the primary source of fat, and a low intake of red meat, there is no precise definition of the Mediterranean diet, nor are the exact components responsible for the observed positive effects identified. The term refers to a diet present in a fairly wide geographical area, so it is not surprising that dietary habits differ significantly between countries, peoples, and cultures. Uniting these habits under one “diet” is an impossible, and unnecessary, task.
Furthermore, by idealizing the Mediterranean diet, we miss out on taking advantage of the cultural and taste diversity that different (non-Mediterranean) eating styles, foods, and flavors can offer us.
The Mediterranean Diet Works
The Mediterranean diet enjoys almost unanimous respect among laymen and scientists alike. The scientific basis behind its effects is relatively strong, though not without its controversies (5).
When I say that the Mediterranean diet works, I mean that research almost without exception shows its positive effects on health. But have you ever asked yourself… Compared to what?
If we compare the Mediterranean diet to the Average Diet, the benefits are obvious. This is what the vast majority of studies do. This is also what laymen do when talking about the benefits of the Mediterranean diet.
But if instead of the Average Diet we decide to compare it to a Healthy Diet, the benefits diminish (6), and I would dare say they completely disappear. Logically so, since a Healthy Diet shares principles with the Mediterranean one.
We must not forget that diet is just one component of a lifestyle that affects health. And the Mediterranean in that context offers much more. It is not impossible, in fact, it is very likely, that a good part of the effects of the Mediterranean diet are the result of the Mediterranean lifestyle, characterized by spending significant time outdoors, engaging in physical activity, and being in company (7).
What After the Mediterranean Diet?
Branding the Mediterranean diet as a “diet” (way of eating) is unnecessary. Why not skip this intermediate step of following a certain “themed” diet and jump directly to a healthy diet? Why limit ourselves to a specific geographic region?
What about components that are not Mediterranean but have a positive impact on health? Do we abandon the Mediterranean diet by accepting them? What will happen when we discover another way of eating associated with health benefits? Will we give up the Mediterranean diet?
The Mediterranean diet is not the only way to achieve a healthy diet. Healthy eating can be achieved in many different ways, as long as all of an individual’s nutritional needs are met, harmful substance intake is minimized, and the individual is satisfied with it.
This is not a critique of the Mediterranean diet. This is a critique of branding healthy eating. Therefore, allow me to propose abandoning branding, taking the best from all “diets,” and following… a Healthy Diet. A Healthy Diet open to Nordic, Saharan, Antarctic, and Mediterranean principles, if they prove to be good for our health.
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References
- De Filippis, F. et al. High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut 65, 1812–1821 (2016).
- Estruch, R. et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N. Engl. J. Med. 378, e34 (2018).
- Valls-Pedret, C. et al. Mediterranean diet and age-related cognitive decline: A randomized clinical trial. JAMA Intern. Med. 175, 1094–1103 (2015).
- Georgoulis, M., Kontogianni, M. D. & Yiannakouris, N. Mediterranean diet and diabetes: Prevention and treatment. Nutrients 6, 1406–1423 (2014).
- Kolata, G. That Huge Mediterranean Diet Study Was Flawed. But Was It Wrong? The New York Times (2018). Available at: https://www.nytimes.com/2018/06/13/health/mediterranean-diet-heart-disease.html. (Accessed: 25th September 2019)
- Lemming, E. W., Byberg, L., Wolk, A. & Michaëlsson, K. A comparison between two healthy diet scores, the modified
- Mediterranean diet score and the Healthy Nordic Food Index, in relation to all-cause and cause-specific mortality. Br. J. Nutr. 119, 836–846 (2018).
- Willett, W. C. et al. Mediterranean diet pyramid: A cultural model for healthy eating. American Journal of Clinical Nutrition 61, 1402S-1406S (1995).