Nov. 13, 2023 -- What is the first thing that comes to mind when you think about the word “diet?“ For most people, diet means giving up enjoyable foods, regimented eating hours, and counting calories. Dig a bit deeper into the origins of the word and it becomes more palatable: The word "diet" comes from the Greek word "diata," which means a way of life or living.
For Ancient Greeks, diata meant visits to healing temples, saunas, meditation rooms, and most importantly, enjoyment of a variety of foods in a social atmosphere. This pattern of eating and living created a blueprint for what would eventually be coined the Mediterranean Diet, a holistic approach to life where the whole is much greater than the sum of its parts.
“I like to say that the Mediterranean Diet is a helpful and pleasurable lifestyle plan that allows you to eat a lot of what is good for you -- and enjoy a little bit of what isn’t on occasion -- without giving anything up,” said Amy Riolo, an award-winning chef, television host, and author of 16 books. Riolo was named as ambassador of Italian cuisine in the U.S. and ambassador of Mediterranean cuisine in the world by the Italian news agency ANSA.
“The diet is more than just about the food you eat,” added Pam Fullenweider, a registered dietitian who specializes in the Mediterranean Diet and a culinary nutritionist. “It’s the lifestyle components of daily exercise and social connectivity – enjoying meals with others – that makes it so unique.”
Lifestyle, With Benefits
For years, the Mediterranean Diet has taken first or second place in U.S. News & World Report’s annual “Best Diets” rankings. There are reams of evidence supporting its value, with multiple studies demonstrating that when the primary pillars of the Mediterranean lifestyle – nutrition/eating, exercise/physical activity, and social connectivity are embraced – a wealth of benefits, including heart health, mental wellness, staving off cognitive decline, blood sugar control, and longevity can be realized.
Stefanos Kales, MD, a preventive medicine doctor and professor of medicine at Harvard Medical School in Boston, has been studying the lifestyle for decades. He also has a personal connection, explaining that his Greek grandmother was the bridge to the Mediterranean, especially Crete.
“When I grew up, I was fortunate that my grandmother, who was well into her 90s, spent a lot of time with us. She was always using olive oil, and would go out and pick what were basically weeds for any other American. But they were valuable greens for cleaning and preparation,” he said.
He noted that later when he was a student, the value of this connection to the past was reinforced time and again.
“Great nutrition professors espoused that the best way to eat was by mimicking what your grandparents were telling you,” he said.
Kales said the Mediterranean lifestyle grew out of necessity. Olives, which are indigenous to the Mediterranean region, cannot be eaten raw, so people learned to cultivate and prepare them, including harvesting the ripe or semi-ripe fruit and pressing it into oil. The diet was plant-forward and relied on wild greens, fruits and vegetables in season, breads made of whole grains, and homemade wine. Meat and dairy were not regularly eaten. The lifestyle was agrarian, and people walked up to 10 km (6.2 miles) daily. They had adequate rest and took siestas in the afternoon.
The social aspect – breaking bread together – was and is essential.
“Incorporating the social aspect of eating, making sure that you’re eating not just to nourish your body but to nourish your soul so that you are not just enjoying the food, but eating and enjoying it with others, is key in the Mediterranean Diet,” said Rahaf Al Bochi, a registered dietitian, nutritionist, and owner of Olive Tree Nutrition, a virtual nutritional consulting practice. Al Bochi, who is also a spokesperson for the Academy of Nutrition and Dietetics, is very familiar with the Mediterranean lifestyle having grown up in the Mediterranean Middle East.
Studies about so-called Blue Zones, where where people consistently live past the age of 100, “talk about the one day meal – the midday meal when everyone’s together and how many psychological effects they reap from that,” said Riolo. In turn, the positive effects of socialization help “fuel the hormones of digestion and metabolism, and how we store fat.”
Unlike many “quick fix” diets that include a specific list of foods or a specific meal plan to follow for a set period of time, the Mediterranean lifestyle is sustainable – namely because it emphasizes flavor, enjoyment, physical activity, and socializing.
“Instead of focusing on just weight as an outcome, it focuses on how food makes you feel, gives you energy, helps you feel more vibrant, and helps reduce your risk of chronic diseases,” said Al Bochi.
Key food categories include lots of vegetables, fruits, nuts, legumes, whole and unrefined grains, and olive oil; moderate intake of fish; little dairy, meats, and poultry; and a moderate amount of wine with meals. These categories are adaptable to one’s cultural heritage and background, a point emphasized by both Al Bochi and Riolo. And the overall benefits of the Mediterranean lifestyle -- benefits that included a lower risk of dying from any cause and from cancer – reinforce that it is adaptable regardless of where one lives, according to a recent study co-authored by Kales.
Another important factor is that it is never too late to get started:
- Take a quick assessment of your plate and identify where the gaps are. “Instead of thinking about what foods you want to limit or avoid, which is usually the diet mentality that people fall into, think about what you can add,” Al Bochi said. “Is it more fruits, more vegetables, more fiber-rich whole grains or beans and legumes?”
- Focus on the quality and freshness of the ingredients, and aim for what’s in season, advised Riolo. Frozen fruits and vegetables might be the freshest and most affordable option and that is perfectly acceptable.
- Think about time and your own budget and compare them with your desired outcomes. It’s helpful to decide when you will be able to prepare food. Socializing time can also involve cooking with others or inviting friends for dinner.
- Don’t try to or change too many things at once, said Fullenweider; take it one step at a time. “Maybe it is as simple as adding chopped veggies to scrambled eggs or more greens to pasta,” she said.
- Consider the whole and not just the individual parts. To fully reap the health and nutrition benefits, the Mediterranean lifestyle also relies on physical activity with the emphasis on what is pleasurable, be it walking, gardening, dancing, swimming, etc., Riolo said.
- Avoid cherry picking. Drinking more red wine or adding olive oil to meals won’t result in the totality of the benefits.
- Finally, focus on flavor as much as nutrition. “I believe that the Mediterranean lifestyle is a love language,” Riolo said. “There’s a thing in Italian that the food that’s enjoyed more is better digested.”