The Mediterranean diet was listed as one of the items on the UNESCO Representative List of the Intangible Cultural Heritage of Humanity in 2010. Thus, the Mediterranean diet is the ideal model for eating habits that prevent chronic diseases.
There is increasingly more proof that demonstrates the beneficial effects of the Mediterranean diet on cardiac insufficiency, both in terms of it progression and mortality rate. The study of prolonged adherence to this type of eating habit periodically yields new, positive results for human health and, consequently, for preventing diseases.
Alejandro Monzó – Neolife Nutrition and Nursing Unit
The Mediterranean diet includes different compounds that favorably modulate the relative expression of certain genes.
The main characteristics of a Mediterranean diet include an abundance of foods of plant origin, virgin olive oil as the main source of fat, consumption of fish and poultry in low or moderate amounts, a relatively low intake of red meats and moderate consumption of wine, normally with meals (Figure 1) (1).
Amongst the healthy properties of the Mediterranean diet, we can note that it is a balanced, varied diet that supplies an adequate amount of nutrients. It is low in saturated fat and high in monounsaturated fatty acids, complex carbohydrates, and dietary fiber. What most makes the Mediterranean diet stand out is the type of fat that it is characterized by (olive oil, fish, and nuts), the proportions of main nutrients (cereals and vegetables as the main dishes and meats or similar as side dishes), and its richness in micronutrients, originating from the use of fresh, local, seasonal vegetable products, as well as aromatic herbs and seasonings. It also features a high antioxidant load and other beneficial substances of plant origin (1,2).
It is a diet that has been sufficiently proven as palatable, possible, sustainable, and respectful of biodiversity. Public health strategies should encourage populations to adopt healthy eating habits like the Mediterranean diet to ensure healthier populations and protect the environment. The great historical past of the Mediterranean diet and the long tradition of its use without evidence of adverse effects makes it very promising for public health (1,2,3).
According to current evidence, the Mediterranean diet is a dietary approach that is recommended to prevent chronic diseases, includingcardiovascular diseases, type 2 diabetes, and certain types of cancer. The beneficial mechanisms of following this type of diet include the reduction of blood lipids and inflammatory and oxidative stress markers, as well as an improvement in insulin sensitivity, endothelial function, and antithrombotic function (4). These effects may be explained by the bioactive ingredients contained in the foods that make up the Mediterranean diet, such as polyphenols, monounsaturated and polyunsaturated fatty acids, vitamins, minerals, and dietary fiber (4, 5).
The PREDIMED Study (Prevention with the Mediterranean Diet Study) is a randomized controlled clinical trial aimed at assessing the possible effects of two nutritional interventions involving the traditional Mediterranean diet on the risk of major cardiovascular complications (3, 5). After 5 years of follow-up, it was shown that, compared with a low-fat diet, the Mediterranean diet (without calorie restriction and enriched with extra virgin olive oil or nuts) reduced the incidence of cardiovascular complications in a sample of nearly 7,500 participants of advanced age with high cardiometabolic risk by 30%. This study represents the highest level of scientific evidence of primary prevention of cardiovascular disease with a dietary pattern so far. In addition, it has been shown that a 2-point increase in adherence to the Mediterranean diet significantly reduces mortality and/or cancer incidence by 6%. In the PREDIMED study, it was shown that the two combined Mediterranean diet groups had less risk of developing breast cancer than the control group (2).
Likewise, the PREDIMED Diabetes study showed that prolonged adherence to the Mediterranean diet (without caloric restriction, rich in monounsaturated fat and bioactive polyphenols) significantly reduced the risk of type 2 diabetes in people with high cardiometabolic risk (2). Additionally, a meta-analysis of 50 studies with 534,906 participants, including type 2 diabetics, demonstrated the benefits of the Mediterranean diet on different aspects of metabolic syndrome (6): the waist circumference (-0.42 cm), HDL cholesterol (+ 1.117 mg/dl), triglycerides (-6.14 mg/dl), systolic and diastolic blood pressure (-2.35 and at 1.58 mmHg, respectively).
Other results show that the Mediterranean diet is associated with better cognitive function, with lower risk of cognitive impairment, and with lower risk of general dementia and Alzheimer’s disease – although it is not possible to establish a cause-effect relationship (2). In the great Nurses’ Health Study, the Mediterranean diet was associated with greater telomere length (telomeres are repetitive sequences at the end of chromosomes that are linked to a greater longevity). In the PREDIMEDstudy, this effect was only obtained in women (2).
It is worth mentioning a new study carried out by experts from Harvard University (7). A metabolic signature has been identified that can assess an individual’s adherence and metabolic response to the Mediterranean diet and help predict the future risk of developing cardiovascular disease. This signature consists of 67 metabolites (molecules produced by metabolic processes that circulate through the bloodstream and can be measured through a blood sample) and allows researchers to determine which people are more adherent to the Mediterranean diet and, also, their metabolic response to said type of diet. Thus, the metabolic signature could be an objective tool for the scientific community, as it reflects the metabolic response of individuals to diet and the risk of cardiovascular disease. Therefore, scientists note that it has great potential to help establish personalized diets in the future.
As a conclusion, the Mediterranean diet is a valuable cultural asset that represents much more than just a basis for nutrition. It is a healthy and balanced lifestyle that includes recipes, ways of cooking, celebrations, customs, typical local and seasonal products, as well as various human activities. It has proven to bring great benefits for human health and, currently, is under study in different pieces of research that, undoubtedly, will yield new and promising data in the future. According to the World Health Organization (WHO), the Mediterranean diet is the most recommendable way to eat in order to have a good quality of life and prevent chronic diseases that are so present nowadays – and these are key objectives in the global health program that characterize Neolife.
BIBLIOGRAPHY
(1) Fundación Dieta Mediterránea. (2010). “La pirámide de la Dieta Mediterránea: un estilo de vida actual”.
URL: https://dietamediterranea.com/nutricion-saludable-ejercicio-fisico/
(2) De Luis Román, D.A. Bellido Guerrero, D. García Luna, P.P. Olivera Fuster, G. (2017). “Dietoterapia, nutrición clínica y metabolismo”. Third edition. Sociedad Española de Endocrinología y Nutrición. Grupo Aula Médica, S.L. Madrid, Spain.
(3) Salas-Salvadó J. & Mena-Sánchez G. (2017). “El gran ensayo de campo nutricional PREDIMED”. Nutr Clin Med. Vol. 11(1): 1-8.
URL: https://www.aulamedica.es/nutricionclinicamedicina/pdf/5046.pdf
(4) Schwingshackl, L. et al. (2019). “Mediterranean diet and health status: active ingredients and pharmacological mechanisms”. British Jorunal of Pharmacology.
URL: https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/bph.14778
(5) Estruch R. et al. (2013). “Primary prevention of cardiovascular Disease with a Mediterranean diet”. N Engl J Med 368:1270-90.
URL: https://www.nejm.org/doi/full/10.1056/NEJMoa1200303
(6) Kastorini, C-M. et al. (2011). “The effect of Mediterranean Diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals”. J Am Coll Cardiol. Vol. 57(11):1299-313.
URL: https://pubmed.ncbi.nlm.nih.gov/21392646/
(7) Li J. et al. (2020). “The Mediterranean diet, plasma metabolome, and cardiovascular disease risk”. European Heart Journal, ehaa209.