According to Greek researchers, the components of the Mediterranean diet that contribute to longer lifespan are:
- moderate alcohol consumption
- low consumption of meat
- high consumption of vegetables, fruits, nuts, olive oil, and legumes
The following didn’t seem to contribute much, if any:
- cereals (the grain of a grass such as wheat, corn, oats)
- dairy products
- fish and seafood
Investigators at the University of Athens examined the Greek portion of the European Prospective Investigation into Cancer (EPIC) and Nutrition, which included 23,349 men and women free of diabetes, cancer, and coronary heart disease at the outset. Food habits were documented by questionnaire.
The focus of this particular study was death rates over an average follow-up of 8.5 years. Adherence to the traditional Mediterranean diet ranged from minimal to high, as would be expected.
As with numerous other studies of the Mediterranean diet, higher adherence to the Mediterranean diet was associated with lower chance of death.
My Comments
The lack of benefit from fish is unexpected. I have no explanation. A preponderance of evidence elsewhere suggests fish consumption helps prolong life via lowered rates of heart disease.
Alcohol can be dangerous, of course. Some people should not partake, ever.
For people with diabetes who wish to avoid the carbohydrate load in cereals and dairy products, you don’t need to worry much about cutting those out of an otherwise Mediterranean-style diet.
Reference: Trichopoulou, Antonia, et al. Anatomy of health effects of the Mediterranean diet: Greek EPIC prospective cohort study. British Medical Journal, 338 (2009): b2337. DOI: 10.1136/bmj.b2337.
Diabetic Mediterranean Diet 
When I was in Greece, I noticed everybody ate a lot of fish – maybe it’s a threshold effect, maybe benefits plateau above a certain level?
Re: fish…..I’ve often wondered about that (in relation to Crete).
My understanding is that Keys went to mountainous villages in Crete, where they did eat fish, but not heaps (couple times a week or something).
Were the people there healthier than those on the coast, who (presumably) ate more fish?
Anyone know?
Steve
Australia
I don’t know, Steve.
But if coastal and alpine disease/mortality rates vary, there would be many factors in addition to fish consumption to be considered.
I’m sure you’re right, Jonathan. The American Heart Association recommends fish twice per week. They must have looked at various “doses” before coming up with that number.
-Steve
I thought that the protective effects of fish were usually seen in Japanese or Norweigan countries? I suspect that protective effects are more noticeable in populations where the omega 6 to 3 ratio is dramatically out of whack.
Could it be that the cretan style diet (with walnuts, purslane etc) providing more plant Omega 3’s ‘needed’ less fish, whereas the Japanese (or diets with less plant Omega 3) require more fish?
A while back I went through a phase of heavy fish consumption. Tin of salmon, sardines or mackeral for lunch – and sometimes fish at dinner time also. I do recall this having an overall positive effect. Well, I at least felt really good / healthier!
A recommendation I’ve read (in the Omega diet book) was 2g daily of plant Omega 3. That’s what I aim for, and the easiest way to get it that fitted in with my diet style is an ounce of walnuts per day.
Steve
Australia
Keep in mind that what is referred to in the literature as plant or animal omega 3 are actually quite a bit different chemically and physiologically.
Plant omega 3s are typically ALA (alpha linolenic acid) which is fat composed of 18 carbons and 3 double bonds. Animal omega 3s are typically EPA and to a lesser extent DHA which are longer chains (20 and 22 carbons respectively) with 5 double bonds. It may not sound like much it makes a big difference.
Simplisticly, ALA is converted to EPA through several steps and then EPA can be converted to DHA. In many species of animals, that occurs with high efficiency. We humans, however, are NOT able convert ALA down to EPA/DHA very efficiently at all. Consequently, ALA does some different things in our bodies. We just don’t know very well what those are yet. Most of the data showing reductions in disease are done with specifically EPA.
It may be that plant omega 3s are very healthy (we know that nuts are healthy but nuts are more than just isolated ALA). We don’t know yet but they should not be grouped with EPA.
I agree Isaac. I’ve been doing a lot of reading lately on Omega 3, and what I’m reading indicates that “plant” (ALA) Omega 3 has benefits separate to “marine” Omega 3 (EPA, DHA, DPA)
steve
Oz