Mediterranean diet

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The Mediterranean diet is a modern nutritional model originally inspired by the traditional dietary patterns of some of the countries of the Mediterranean Basin. The most commonly-understood version of the Mediterranean diet was presented by Dr. Walter Willett of Harvard University's School of Public Health in the mid-1990's. Based on "food patterns typical of Crete, much of the rest of Greece, and southern Italy in the early 1960s", this diet, in addition to "regular physical activity" (e.g. farm labor), emphasizes "abundant plant foods, fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts". Total fat in this diet is "<> 35%" of calories, with saturated fat at 8% or less of calories. The diet is often cited as beneficial for being low in saturated fat and high in monounsaturated fat and dietary fiber.

This diet is not typical of all part of the Mediterranean basin. In central Italy, for instance, lard and butter are commonly used in cooking, and olive oil is reserved for dressing salads and cooked vegetables. In North Africa, wine was traditionally not consumed by Muslims. In both North Africa and the Levant, sheep's tail fat and rendered butter (samna) are the traditional staple fats. In inland areas before refrigeration, fish was largely unknown, even in Greece and Southern Italy.

Although it was first publicized in 1945 by the American doctor Ancel Keys stationed in Salerno, Italy, the Mediterranean diet failed to gain widespread recognition until the 1990s. It is based on what from the point of view of mainstream nutrition is considered a paradox: that although the people living in Mediterranean countries tend to consume relatively high amounts of fat, they have far lower rates of cardiovascular disease than in countries like the United States, where similar levels of fat consumption are found. A parallel phenomenon is known as the French Paradox.

One of the main explanations is thought to be the large amount of olive oil used in the Mediterranean diet. Unlike the high amount of animal fats typical to the American diet, olive oil lowers cholesterol levels in the blood. It is also known to lower blood sugar levels and blood pressure. Research indicates olive oil prevents peptic ulcers and is effective in treatment of peptic ulcer disease, and may be a factor in preventing cancer. In addition, the consumption of red wine is considered a possible factor, as it contains flavonoids with powerful antioxidant properties.

Michael Pollan in his book "In Defense of Food" suggests the explanation is not any particular nutrient, but the combination of nutrients found in unprocessed food.^{[citation needed]}

Dietary factors may be only part of the reason for the health benefits enjoyed by these cultures. Genetics, lifestyle (notably heavy physical labor), and environment may also be involved.

Although green vegetables, a good source of calcium and iron, as well as goat cheese, a good source of calcium, are dommon in the Mediterranean diet, concerns remain whether the diet provides adequate amounts of all nutrients, particularly calcium and iron.^{[citation needed]}

Medical research

The Seven Countries Study found that Cretan men had exceptionally low death rates from heart disease, despite moderate to high intake of fat. The Cretan diet is similar to other traditional Mediterranean diets: consisting mostly of olive oil, bread, abundant fruit and vegetables, fish, and a moderate amount of dairy foods and wine.

The Lyon Diet Heart Study set out to mimic the Cretan diet, but adopted a pragmatic approach. Realizing that some of the people in the study (all of whom had survived a first heart attack) would be reluctant to move from butter to olive oil, they used a margarine based on rapeseed (canola) oil. The dietary change also included 20% increases in vitamin C rich fruit and bread and decreases in processed and red meat. On this diet, mortality from all causes was reduced by 70%. This study was so successful that the ethics committee decided to stop the study prematurely so that the results of the study could be made available to the public immediately.