Is this the Healthy Mediterranean Diet?

Photo: Calle D

Photo: Calle D

What is the Mediterranean diet? Do you know? A reader sent me this picture, from a place in Spain. The picture provides good evidence on how the fuzzy concept of the “Mediterranean diet” can be applied to almost anything.

If the “Mediterranean diet” is about vegetables, fish, olive oil and various other real foods, free of processed junk, then it’s certainly a very healthy diet. But if you, unbelievably enough, mean bread with low-fat margarine on it (as some do), then it’s just as unhealthful as the breakfast in the picture.

What is the Mediterranean diet to you?

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23 comments

Top comments

  1. tobi
    I believe the term is often used to promote a mostly vegetarian/pescatarian diet full of fruit and vegetables and olive oil. Nothing wrong with these great foods... It also, according to Wikipedia, includes plenty of unrefined cereals (oh, the plethora of whole wheat pasta and heavy dark bread in those countries...) and legumes, moderate dairy , and low meat consumption. I guess the folks who defined it somehow overlooked the salami, prosciutto, capocollo, pancetta, meatballs, jamón serrano, chorizo, salchichón, and so on, and how about the Greek idea of vegetarian from "My Big Fat Greek Wedding"?
    "What?? He's a vegetarian??? No problem - I cook lamb"
    http://www.youtube.com/watch?v=iFemw_6a-Tg
    Read more →
  2. Carlotta
    Hi guys! I'm Italian, from Rome exactly. I strongly believe that the TRUE Mediterranean Diet can be a good and healthy alternative to the LCHF way of eating. What people usually say about the Mediterranean diet is so misleading...we need to be more specific on this point. Yes, it would be unfair to say that the Med. diet does not allow the consumption of grains; however, it does not permit to eat a huge amount of cereals, bread, pasta and so forth. Indeed, usually in Italy a normal portion of pasta, bread or rice in a family lunch is 80 grams. I usually feel full even with 60 grams but I am a lean girl. In order to be faithfull to the Med. diet you should then eat no refined grains and no processed food. This means: whole grain and home made food. Very little sugar (or honey). Italians do not eat brioches and pastries all the time, at least the lean ones. Cafè sells them... I know, anyhow that is not what Italians usually eat for breakfast, nor what the Med. diet tells us to eat. Tourists eat them in order to feel like Italians but that is a mith. Usually we eat a SLICE of bread with jam (made of fruit and not just of sugar) and butter, or a slice of cake, some cookies, a tea or some milk, yogurt, some fruit, nuts and, obviously, ESPRESSO. We Italians consume very larg amount of olive oil, some BUTTER, dairy, wonderful cheeses and salami (even though the true med, diet is pretty restrictive about cheeses, dairy and butter...just few times a week it says). Then we eat meat, fish, EGGS, legumes. Sometimes we eat some gelato ( once a week or twice usually in SUMMER and not every day! ), some cake and so on... however even on this stuff, the true Med. diet is pretty restrictive: once a week. I know that there are a lot of miths and legends about Italy outside our country and come to visit Italy as a tourist could not change false opinions, as in that way you are not eating and living as Italians do, but just as tourists. Of course you can eat all the junk food you want even here, globalization is globalization after all. However, lean people do not eat that "cr##" often . I almost never do. No margarine, no trans fat. At last but not least , it is important to remember that not every Italian follows the true Med. diet, just a small percentage does, however, the majority still has a good way of eating even if not perfect.
    Hope I helped you guys.
    Read more →

All comments

  1. FrankG
    It certainly seems to be one of those terms which is tossed around as if it means the same thing to thing everyone :-P

    Lat time I checked there were over 20 countries with coastlines on the Med.. each with their own distinct culture and traditions... not to mention the local varieties within any one of those countries.

    But if it is broadly taken to mean: good food, prepared at home and eaten at the family table... made from fresh, local, seasonal, real, whole sources, then I'm 100% behind it :-)

  2. tobi
    I believe the term is often used to promote a mostly vegetarian/pescatarian diet full of fruit and vegetables and olive oil. Nothing wrong with these great foods... It also, according to Wikipedia, includes plenty of unrefined cereals (oh, the plethora of whole wheat pasta and heavy dark bread in those countries...) and legumes, moderate dairy , and low meat consumption. I guess the folks who defined it somehow overlooked the salami, prosciutto, capocollo, pancetta, meatballs, jamón serrano, chorizo, salchichón, and so on, and how about the Greek idea of vegetarian from "My Big Fat Greek Wedding"?
    "What?? He's a vegetarian??? No problem - I cook lamb"
    http://www.youtube.com/watch?v=iFemw_6a-Tg
  3. bill
    Looks more like the crappy "continental" breakfasts
    that many hotels here in the US seem to be offering these days.
  4. Paul the rat
  5. Jo
    I've travelled around the Med a lot and I mostly remember the delicious sausages, cheese and bread. Bread is obviously a carby food, but it seems less processed than the stuff we get back in the UK. I break my 'no bread' rule often when travelling in Mediterranean countries. In fact now I think about it, the food available tends to be less processed generally, which is probably significant.

    The poster looks like a tourist menu - I bet the locals don't eat like that.

  6. Nicole Champeau
    In urban Mediterranean areas the almost universal breakfast is white bread or a pastry and coffee. Italy bases its cuisine on carbohydrates and gelato is practically a religion. Although they eat less processed food than we do in the states, their diet is not very healthy, and bears little resemblence to what we call the "Mediterranean" diet. People make a lot of out of the fact that obesity is less frequent in Italy than it is in the states, but any American who travels in Italy will quickly figure out why- food in Italy is very expensive.
  7. Galina L.
    I saw what people ate in Turkey - another Mediterranean country. It looked like that a big portion of everyday consumption was represented by vegetables with olive oil, meat(mostly lamb) was on a sparse side, fish abandoned. Big variety of breads and sweets (I did'n eat that) was present. The main difference I noticed - the absence of sauces, just olive oil and vinegar for a dressing, no mayo, hummus as a spread, many olives, not much of deli meats, only dry and very salty cheeses. Only black coffee was available,
  8. Carlotta
    Hi guys! I'm Italian, from Rome exactly. I strongly believe that the TRUE Mediterranean Diet can be a good and healthy alternative to the LCHF way of eating. What people usually say about the Mediterranean diet is so misleading...we need to be more specific on this point. Yes, it would be unfair to say that the Med. diet does not allow the consumption of grains; however, it does not permit to eat a huge amount of cereals, bread, pasta and so forth. Indeed, usually in Italy a normal portion of pasta, bread or rice in a family lunch is 80 grams. I usually feel full even with 60 grams but I am a lean girl. In order to be faithfull to the Med. diet you should then eat no refined grains and no processed food. This means: whole grain and home made food. Very little sugar (or honey). Italians do not eat brioches and pastries all the time, at least the lean ones. Cafè sells them... I know, anyhow that is not what Italians usually eat for breakfast, nor what the Med. diet tells us to eat. Tourists eat them in order to feel like Italians but that is a mith. Usually we eat a SLICE of bread with jam (made of fruit and not just of sugar) and butter, or a slice of cake, some cookies, a tea or some milk, yogurt, some fruit, nuts and, obviously, ESPRESSO. We Italians consume very larg amount of olive oil, some BUTTER, dairy, wonderful cheeses and salami (even though the true med, diet is pretty restrictive about cheeses, dairy and butter...just few times a week it says). Then we eat meat, fish, EGGS, legumes. Sometimes we eat some gelato ( once a week or twice usually in SUMMER and not every day! ), some cake and so on... however even on this stuff, the true Med. diet is pretty restrictive: once a week. I know that there are a lot of miths and legends about Italy outside our country and come to visit Italy as a tourist could not change false opinions, as in that way you are not eating and living as Italians do, but just as tourists. Of course you can eat all the junk food you want even here, globalization is globalization after all. However, lean people do not eat that "cr##" often . I almost never do. No margarine, no trans fat. At last but not least , it is important to remember that not every Italian follows the true Med. diet, just a small percentage does, however, the majority still has a good way of eating even if not perfect.
    Hope I helped you guys.
  9. Ari
    I think it's noteworthy that most of the major studies which have found the Mediterranean diet (MD) to be so healthy are ones in which it was compare to LOW FAT diets. The large recent MEDIPRED trial published in the New England Journal and cited all over the media, compared 2 versions of the MD (one with supplemented olive oil and another with supplemented mixed nuts) to what the authors called the "control diet". Such was the faith in low fat diets being healthy that they called low fat a 'control group'. In fact, this was probably the real study arm. (Keep in mind that the study was done in Spain).
    The study is being hailed as demonstrating that MD reduces cardiovascular mortality, stroke etc. What it may very well have proven was that low fat diet increase these outcomes.

    I also agree with the comments above that point out that the diet is very vaguely defined. It might just be a version of the western diet with less processed food and slightly more fat and less carbs.

  10. SEL
    My very Turkish grandfather would NOT sit down to a meal if it didn't have meat in it. HE was a serious smoker, lazy as, stick thin, loved his food, his woman, died at 97 of old age, not of cancer or heart condition. Never lived in an industrial city, just atop a peak overlooking Mesapotamia, he only ever ate locally grown fruit and veg and locally raised meat and chicken. Didn't eat fish. Loved his bread and butter in the mornings.

    Typical Tukish breakfast ( coastal areas ie the Med and Agean regions):

    Olives, Cheeses, Eggs, Sucuk ( spicy turkish sausage sliced and fried), salamis, sausages,some bread to pop that last mouthful of Butter and pure fruit jam or honey on. There is always sliced cucumbers and tomatoes and green peppers at the breakfast table. Don't forget the no. 1 drink- black tea.

    Lunch: Usually a light meal with a veggie and olive oil foundation, yogurt full fat of course. MAybe some seasonal fruit.

    Dinner: In the winter fish is consumed in copious amounts as it becomes very cheap and even the poorer families can afford it.

    MEat or meat-containing vegetable or bean dishes are the norm, usually served with side of rice or some pasta, cold veg side dishes in olive oil.

    Now, to this general diet add some seasonal fruit, all matter of greenery (herbs and veg), Turks consume serious amounts of parsley and salad greens and OMG sooo many vegetables. Food is usually homecooked from fresh ingredients. Coffee is consumed usually daily but tea is just a way of life.

    The rise in obesity has come with steering away from this way of life with fast food and sweets and dessert being available so easily. The younger generation is being fed cereals (" like AMERICA!!") and it shows in the size of the kids. Heavy kids were never to be seen before, now the are growing in numbers.

    Inland area diet is usually very pasta/ pastry based, meat, butter alot of grain and more meat. Serious amount of meat. And butter. And did I mention meat?

    For all this though, diabetes is not super common and most of the population is not obese or even close. The women have amazing skin and hair.

    The holiday spots are very different to the reality of the rest of the population. I don't live there now but can see the changes every time I visit.

    Reply: #11
  11. PeteC
    Great anecdote SEL, thanks.

    "HE was a serious smoker, lazy as, stick thin, loved his food, his woman, died at 97 of old age, not of cancer or heart condition".

    Turkish tobacco is pretty heavy stuff, too!

  12. 2 comments removed
  13. Galina L.
    So you can see how plant-based diet can help loose weight? Well, I can tell a dawn-side of a plant-based diet, which is rarely discussed. First of all, for many people excessive fiber irritates stomach. For thous who can tolerate fiber better, it is the excellent way to stretch their stomach. People who participate in food-eating competitions, eat on purpose a lot of vegetables everyday in order to be "in shape" to compete eating donuts or hot dogs. It is easier to binge on wrong foods with stretched stomach. Eating vegetables do not keep you not hungry for a long time, so it robs you from of benefits of intermittent fasting. People who live in a Mediterranean region went around above-mentioned disadvantages by adding a lot of olive oils in their veggies.
    Eating too many vegetables can turn somebody into an always hungry glutton with over-stretched stomach, which could help to gain weight .
  14. Paul the rat
    Thank you from all of us DietDoctor!
  15. eddy
    Don't forget the daily glass of red wine.

    I believe it is the use of olive oil that contributes significantly to the health of those who follow this diet.
    When I practice the Med. Diet I eat mainly fresh salads, Fresh Fruits, Nuts, Olive Oil, Honey & yogurt, eggs, some pasta, whole grain bread and whole grains , unsalted butter, and fish, chicken, and lamb.

    I do not think of croissants and pastries as a Med. Diet. In fact I remember being in Greece many years ago and the pastry was not sweet as they did not use much sugar.

    Fast food diets like the McDonalds and the Wendys, sodas, processed cereals, and candies for snacks are all contributing to obesity epidemic.
    When I grew up sodas were considered a treat and were seldom in the house.

    Keep in mind until the arrival of the fast food outlets if one ate out it would be in a restaurant as this was expensive it was only done on certain occasions.

    Reply: #17
  16. Zepp
    The strange thing about Medeteranian diet is that its healty effect diminish whit the distance to the medeteranian sea!

    And there are studies that says that old fasihon eating of other countrys is as good as the medeteranian diet.. as long as they eat those old fashion foods and eat them as fresh food!

    And then.. the medeteranian population is not that healty anymore, becuse they dont eat that old fashion food anymore!

    And the real culprit of the whole diet debacle is.. eat fu**ng real food for healt.. then you probably dont need to even think about LCHF and other dieting at all!

    Reply: #18
  17. Jo
    Some interesting points! I was also thinking other contributions to health may be the sunshine and the practice of siesta.
    Reply: #19
  18. Zepp
    Sorry to say.. more sun was a bigger contributor to more skinn cancer.. and the siesta was to avoid to much sun and heat!

    If we tryes a medeteranian diet up here in scandinavia.. its gonna be canned.. and thats not originaly fresh medeteranian diet anyhow.

    Reply: #21
  19. eddy
    I forgot to mention the tasty tzatziki sauce, hummus and stuffed vine leafs.
  20. Jo
    I don't think there's a lot of skin cancer in the Med. Those with Mediterranean ancestry have darker skins. They do in my family anyway. Send a Scandinavian down there and it's a different story!
  21. murray
    Here is part of the report from a study done in 2009 that attempted to isolate which components of the so-called Mediterranean diet were beneficial. I also recall a study that observed Greeks on average eat 50 pounds of cheese per year, which is almost a pound per week. So with lots of olive oil, nuts, cheese and moderate meat, it is not a low fat diet.

    "Eating more vegetables, fruits, nuts, pulses and olive oil, and drinking moderate amounts of alcohol, while not consuming a lot of meat or excessive amounts of alcohol is linked to people living longer.
    However, the study also claims, that following a Mediterranean diet high in fish, seafood and cereals and low in dairy products were not indicators of longevity.
    While several studies have concluded that the Mediterranean diet improves chances of living longer, this is the first to investigate the importance of individual components of the diet.
    Professor Dimitrios Trichopoulos at the Harvard School of Public Health explains that they have surveyed over 23,000 men and women who were participants in the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC).
    Participants were given dietary and lifestyle questionnaires when they enrolled onto the study and they were subsequently followed up for around 8.5 years with interviews. Their diets were rated from 0 to 10 based on the level of conformity to a traditional Mediterranean diet.
    As part of the interview process, participants were also asked about their smoking status, levels of physical activity and whether they had ever been diagnosed with cancer, diabetes and heart disease.
    The authors maintain that when high intake of vegetables, low intake of meat or moderate alcohol intake were excluded from the rating system, the benefits of following a Mediterranean diet were substantially reduced"

  22. Tony Nguyen
    I've travelled around the Med a lot and I mostly remember the delicious sausages, cheese and bread. Bread is obviously a carby food, but it seems less processed than the stuff we get back in the UK.
    Thanks for sharing this post. Hope to read more helpful information from you. Have a nice day.
    http://vkool.com/high-calorie-foods-fast-food-items-1000-calories/
  23. Barbara
    I have been going to Greek Islands ,many remote, for many, many years( I am in my 70s) I can remember one village shop had containers from which you helped yourself and bought different nuts, seeds( sunflowers seeds still had to have their husks removed) and dried pulses as snacks. It was with great sadness that one year on returning to that village the nuts and pulses had been removed to be replaced by different kinds of boiled sweets.
    When thinking a the Mediterrean diet one has to remember that when research was done after WW2 the Cretans were found to be the healthiest. In fact much of our regard for olive oil dates from this time and this research .No account,however, was taken to the fact that Greek Orthodox Christianity did,and does, involve fasting regularly. Many of the friends I have made in Crete still fast weekly. This may have a bearing on the health benefits of the Mediterrean diet of which the original Greek diet is a fine representative.
  24. Bo
    That was a typical spanish breakfast for Spanish people. No porridge, no musli. I am a Swede and I think we have better food habits than them. Full fat milk is not dangerous and the cheese use to be 17 to 32 % fat. They have Barro integral and it is OK, but you have to be there early. I have been an ovo-lacto vegetarian for many years and now I am a pescetarian. These two hated diets seems to be the best for health. I will allways defend these two hated diets. I do not think meat eater and alco diets are healthy wether they call it mediterranian or flexitarian. If they think red meat is unhealthy why do the hippocrites eat it. Why should I pretend chickens have a good and healthy life and I would get healthy by eating them. No birdy nam nam for me. Egg yolks I eat very seldom. They say ARA is good but LA is bad these experts. I prefer nuts to meat, chickens and eggyolk with all their ARA. The only thing I liked in Marrocco was Tajine bel khodra. I have never seen sprouts or mushrooms served around the mediterranian.

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