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The Mediterranean Diet Guide
I was giving a talk to a group of physicians the other day when one asked if I had any simple handouts about the Mediterranean diet. I mentioned that there were a lot of handouts in the "For Physicians" section on the Web site.

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Mediterranean Diet, Weight Control, and Weight Loss
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Mediterranean Diet and Heart Disease: Current Research

Here at Dr. Gourmet we've written a lot about the Mediterranean Diet and how it not only can help you live longer; protect you from heart disease, high blood pressure, stroke and other heart problems; and is also the best diet for those with type 2 diabetes. What is called the Mediterranean Diet is not what you'd think of as a diet per se: there are no foods that you must eat, no foods you must not eat, and it doesn't demonize specific food groups or macronutrients (i.e., "all carbs are bad," or "never eat red meat."). This is why I like to describe it as a style or pattern of eating rather than a "diet."

Briefly, those following a Mediterranean dietary pattern eat more vegetables and legumes (like beans and peas), fruits, nuts, and whole grain cereals. Fish is their primary animal protein, but they do eat red meat (beef or port) and poultry on occasion. Dairy products are usually in the form of cheese or yogurt and they do not usually drink milk. Butter, which is mostly saturated fat, is only used sparingly - olive oil is the primary source of fat and is a monounsaturated fat. Finally, they drink a moderate amount of alcohol - mostly wine - and it's usually with meals. Just how well an individual adheres to this diet is easily calculated with a 9-point scoring system developed in the mid-90's by a Dr. Trichopoulou in Greece. (You can calculate your own Mediterranean Diet score here.)

Research into this pattern of eating has been going on since the 1960's, and there are dozens and dozens of published research studies on the subject. As I've talked about recently, however, it's important for new studies to be performed, because results gained with improved methods or focusing on larger groups can sometimes conflict with previous research.

To that end, a team in Greece headed by Dr. Trichopoulou continued her work into the Mediterranean Diet by reporting on a continuing large-scale study in Europe known as EPIC (European Prospective Investigation into Cancer and Nutrition) (Brit J Nutr 2012;108(4):699-709). They made use of information collected on the nearly 30,000 participants living in Greece, who were recruited between 1994 and 1999. At the start of the study the participants provided demographic information such as education level, smoking, amount of exercise, submitted to measurement of their Body Mass Index and their blood pressure, and responded to a detailed dietary questionnaire, which allowed the researchers to calculate their Mediterranean Diet score.

On regular intervals, for an average of ten years, the researchers followed up with the participants to check on their health status, specifically looking at heart problems such as heart attach, angina, or other heart problems, including death from those causes. They were then able to compare the Mediterranean Diet score of those who experienced heart problems with the scores of those who did not.

You probably won't be surprised when I tell you that those with a higher Mediterranean Diet score were much less likely to die of heart problems than those with a lower score: a score just two points higher meant a 19% lower risk of death for men; for women the risk is reduced by 25%. Even when the researchers excluded everyone of normal body weight and focused only on those who were overweight or obese, the results were the same.

What this means for you

While this doesn't tell us anything new, it's still important because this is such a large-scale, long-term study on a group of people who still largely follow this pattern of eating. This isn't comparing a group of people eating a "perfect" Mediterranean Diet with those eating cheeseburgers and fries every day - it's comparing those who are eating just a little bit better than others. Calculate your current Mediterranean Diet score today and find out what two areas you can make improvements in. Small changes can make a big impact on your health - and this study is (part of) the proof.

First posted: August 29, 2012