- The landmark Seven Country Study coordinated by Ancel Keys in the 1960’s revealed that there were lower rates of coronary artery disease (CAD) and all-cause mortality in Greece and other southern European nations, where people follow diets rich in olive oil, fish, nuts, and vegetables high in fiber.1, 2
- The traditional Mediterranean diet is characterized by abundant plant foods (vegetables, breads, pastas, beans, nuts, and seeds). Fresh fruit is the typical daily dessert, and olive oil is used as the principal source of fat (Figure 059).
- Dairy products (principally cheese and yogurt), fish and poultry are consumed in low to moderate amounts.3 Red meat and egg are consumed in low amounts. Wine is consumed in low to moderate amounts, usually with meals.
- Greater adherence to the traditional Mediterranean diet is associated with a significant reduction in total mortality.4
- This diet is typically high in total fat (35-45% of energy) but low in saturated fat (7-8% of energy) and high in monounsaturated fat (20-25% of energy).
- The 6 beneficial components of this diet have recently been elucidated. They are vegetables, fruit, nuts, fish, legumes, and whole grain cereal, which form the basis for the “Prudent Diet”. 4, 5
1. Keys A. Mediterranean diet and public health: personal reflections. Am J Clin Nutr. 1995;61(6 Suppl):1321S-1323S.
2. Keys A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Cambridge: Harvard University Press; 1980.
3. Estruch R, Martinez-Gonzalez MA, Corella D, et al. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. Jul 4 2006;145(1):1-11.
4. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. Jun 26 2003;348(26):2599-2608.
5. Enas EA, Senthilkumar A, Chennikkara H, Bjurlin MA. Prudent diet and preventive nutrition from pediatrics to geriatrics: current knowledge and practical recommendations. Indian heart journal. Jul-Aug 2003;55(4):310-338.