MP recently spoke with Dr. Simon Poole, a medical doctor, author, and expert Mediterranean diet consultant. He is a founding member of the British and European Associations of Lifestyle Medicine, a council member of The US True Health Initiative, a senior international collaborator with the Global Centre for Nutrition and Health in Cambridge, and was awarded Fellowship of the British Medical Association for services to the profession in 2018, which included longstanding membership of Council of the Royal College of General Practitioners and Public Health Medicine Committee. Dr Poole is a recognized international authority and speaker on the Mediterranean Diet, and the author of the award-winning books “The Olive Oil Diet” and “The Real Mediterranean Diet.”
What is the Mediterranean Diet, and where does its name come from?
The Mediterranean Diet was first described by American researchers in the 1960s who observed the extraordinary health and longevity of people living in some areas of Greece and Italy. Their diet consisted of fresh, seasonal foods such as vegetables, whole grains, beans, nuts, artisanal cheeses, and sheep or goat yogurt, herbs, and spices, with fish, poultry, and ubiquitous olive oil. Processed foods and red meat were eaten less often and occasional sweet desserts were prepared with natural ingredients such as honey and nuts, though more often meals were completed with fresh fruit.
The Mediterranean is a region where lands of three continents border the Mediterranean Sea, and its boundaries have been defined by the area in which olive trees flourish. It is no coincidence that the various local versions of the Mediterranean diet from the Middle East, across the countries of Southern Europe and Northern Africa to the west of France, all include extra virgin olive oil as a foundation of nutrition. Of course, many parts of the world enjoy a Mediterranean climate so now California, South Africa, and Australia can produce the foods of the Mediterranean.
The word “diet.” although used in recent times to describe a pattern of eating to lose weight, actually has its roots in the Greek “diaita,” which means “way of life” and it is often observed that the benefits of the diet extend to the way in which food is celebrated and consumed in company and conviviality.
What are the staple food items for each food group?
Meat
Meat is enjoyed as part of the Mediterranean Diet in smaller quantities than in a Western diet. Thomas Jefferson regarded meat as a condiment to a vegetable-rich meal and this follows the principles of the Mediterranean Diet he would have learned about during his time as a US emissary in Southern Europe. Fresh fish or free-roaming poultry was the main source of meat, eaten a few times a week, with red meat reserved for special occasions and festivals. Though there are many festivals in the culture of the Mediterranean, sharing a goat or lamb stew cooked in olive oil with herbs and spices would have been limited more by affordability than the excuse to celebrate!
Dairy
There is a great difference between the processed cheeses and low fat, high sugar yogurts consumed in the Western world and the rich, matured, often raw cheeses and yogurt made from the milk of the local free-roaming goats or sheep, grazing on a variety of grasses and vegetation. This is reflected in the healthier fats in the dairy of the traditional Mediterranean Diet and in the positive probiotic effects which are beneficial for a diverse gut microbiome
Carbohydrates
Carbohydrates are generally very low GI. This means that the sugars are absorbed more slowly, avoiding the peaks and troughs which can cause insulin resistance and increased risk of obesity and diabetes. Colorful, antioxidant-rich vegetables and whole grains which are high in fiber are the mainstays of carbohydrate intake in the Mediterranean Diet. Combining these ingredients with extra virgin olive oil further slows absorption and increases insulin sensitivity.
Fruit
Fruit is often enjoyed at the end of a meal. Fruits such as apples, oranges, and grapes are a healthy and low GI sources of vitamins, minerals, and fiber.
Condiments
Herbs and spices have a special place in the diet. The Mediterranean region was at the heart of the Spice route in ancient times, and these ingredients were assimilated into local cuisine to add flavor and interest to dishes. Physicians often valued them for their health benefits and the antioxidant and anti-inflammatory properties of herbs such as rosemary or oregano and spices such as chili and turmeric are now the subject of scientific research to understand their possible role as adjuvants to conventional treatments for cancers and other medical conditions.
How does alcohol fit into the Mediterranean diet?
A small glass of wine enjoyed with a meal can be part of a Mediterranean Diet, and there is evidence to suggest that this has benefits for heart health. Red wine contains many antioxidants including compounds called polyphenols which originate in the skins of grapes. There is evidence that the absorption of these antioxidants is enhanced by a meal rich in extra virgin olive oil, illustrating that the “alchemy” of the benefits of the Mediterranean Diet is often to be found in food and ingredient combinations.
What desserts do people generally have while on the Mediterranean diet?
Desserts are usually prepared with pastry using healthy extra virgin olive oil and often feature nuts which are known to be a great source of healthy fats and minerals as well as antioxidants. Locally sourced, unprocessed wildflower honey is frequently used as a sweetener which is prized for its antibacterial and immune-supporting properties.
How can someone easily transition into the Mediterranean Diet?
The Mediterranean Diet is an enjoyable pattern of eating that includes very tasty foods, so it is easy to transition and then to maintain the way of preparing fresh and beautiful meals. Having the best ingredients available is key and then setting a little time aside for cooking from scratch is important, though it is not necessary to follow complicated recipes – rather, it is more helpful to focus on combining the staples together to produce simple but healthy and delicious meals. Extra virgin olive oil for cooking and drizzling with colorful vegetables is a good base from which to start most meals.
What are the health benefits of the Mediterranean diet?
The health benefits can be quite extraordinary. The Mediterranean Diet is associated with a reduced risk of many chronic diseases – heart disease, stroke, many types of cancer, chronic inflammatory conditions, obesity, diabetes, and even Alzheimer’s Disease. There is also evidence to show that people feel better as well. Well-being is enhanced, and markers of aging can be seen to be reduced.
What are some potential downfalls of following the Mediterranean Diet?
The Mediterranean Diet is perceived as being more expensive than a Western diet, however, this depends on how meals are planned and prepared, and it is certainly possible to have a healthy Mediterranean Diet for a reasonable cost. Extra virgin olive oil is a very healthy food, but unlike processed vegetable oils, it cannot be produced cheaply. Combined with fresh, seasonal plant foods, it is possible to create the foundations of the diet for a reasonable weekly budget. What proportion of a household income is spent on food is also a choice. For some people, good quality nutritious food and its preparation is considered a valued investment of time and money and something to be prioritized.
Is there anything else you’d like to add?
I hope that during my thirty years as a practicing doctor, I have made a tangible difference to the health and wellbeing of my patients. As I have learned more about the extraordinary benefits of the Mediterranean Diet and have focused on advocacy and work to communicate its profound effects, I hope that more and more people will find a path to greater fitness and well-being.
