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Mediterranean Diet

Mediterranean diet and lifestyle linked to lower cancer and death risk

By Robby Berman on August 22, 2023 — Fact checked by Hannah Flynn

What is a Mediterranean lifestyle, and why might it help to lower death and cancer risk? Image credit: Paul Phillips/Stocksy.

  • A Mediterranean diet is not just a good idea for people living near the Mediterranean Sea, says a new study.

  • The study documents the health benefits of the Mediterranean diet, analyzing data from participants living in the United Kingdom.

  • Besides following a Mediterranean diet, a ‘Mediterranean’ attitude toward food and eating was even more important.

Numerous studies of people living in the Mediterranean area have demonstrated the health benefits of the Mediterranean diet — a largely plant-based diet, in which animal proteins play a smaller role than in Western diets.

A new study looks at the value of the Mediterranean diet — and the Mediterranean lifestyle — for people living elsewhere, in this case, the United Kingdom.

The study finds that higher adherence to the Mediterranean diet and lifestyle is associated with a 29% lower risk of all-cause mortality and a 28% lower risk of cancer compared to people who least follow the diet and lifestyle.

Using the questionnaire-based MEDLIFE index, the authors of the study analyzed the diet, habits, and health of 110,799 participants in the UK Biobankcohort.

The participants lived in England, Wales, and Scotland. Individuals were between 40 and 75 years old at the start of their involvement with the study — between 2009 and 2012 — and free of cardiovascular disease and cancer. They were followed until 2021.

The researchers measured people’s adherence to a Mediterranean lifestyle according to three “blocks”:

  1. consumption of foods typical of a Mediterranean diet

  2. following Mediterranean eating habits

  3. having adequate physical activity, rest, social contact, and conviviality associated with Mediterranean cultures.

All three of the above, individually, resulted in a reduction of mortality risk. The strongest reduction of cancer and all-cause mortality was associated with block three.

The study is published in Mayo Clinic Proceedings.

What are Mediterranean lifestyle habits?

The block the study found brought the greatest health benefit was block three. This suggests that the Mediterranean diet is as much about one’s lifestyle and attitude toward eating as it is about its list of recommended foods.

Block three was the only block associated with a reduced risk of cardiovascular disease.

Mediterranean dietician Conner Middleman, who was not involved in the study, told Medical News Today: “That was actually my favorite finding! Many nutrition studies analyze the foods people eat, but the Mediterranean lifestyle is about so much more than food! Following a Mediterranean lifestyle isn’t just about eating hummus, a nutty granola bar, or a salad once in a while.”

The study’s corresponding author, Dr. Mercedes Sotos Prieto, explained more about what following a Mediterranean lifestyle means.

“Conviviality relates [to] the context of eating ‘how’ we eat rather than ‘what’,” she noted.

Middleman expanded on this notion:

“It’s just as much about slowing down, enjoying life, spending time — including meals — with other people, managing your stress by taking breaks and playing, and being physically active in joyful ways like walking, dancing, gardening, fishing, swimming in a creek, etc.“

Cardiology dietician Michelle Routhenstein — also not involved in the study — explained why rest, relaxation, and leisurely socialization are so beneficial to overall health.

“When sleep, physical activity, and social connection are prioritized, these can cause a decrease in stress hormones like cortisol levels, which can improve dietary choices and metabolic functioning,” she told us.

Routhenstein said it is important to acknowledge the importance of such lifestyle behaviors on metabolic functioning, and cardiovascular health.

The Mediterranean way of eating

In addition to exercising and getting enough sleep, Middleman cited a 2008 study which found that, when asked about eating, American and British respondents focused on the presence of nutrients such as “protein,” “carbohydrates,” or “fat”, while Italian and French respondents most often responded with the emotions that eating inspired in them, such as “pleasure” or “joy.”

That same study described the Mediterranean way of eating:

“Three meals a day at fixed hours, modest portion sizes, table manners (no phones, no TV), snacking between meals (discouraged), second helpings (frowned upon), dietary variety (essential), eating environments (tables, eating off ‘real’ dishes, not in cars, at desks or while walking).”

What foods feature in a Mediterranean diet?

None of this is to minimize the health benefits of the Mediterranean diet itself.

“The mechanisms underlying the health benefits of the Mediterranean diet for heart disease include the antioxidant and anti-inflammatory properties of the foods included in the Mediterranean diet, namely fruits, vegetables, legumes, nuts, or olive oil that contain vitamins, minerals, polyphenols, [and] fiber,” explained Dr. Sotos Prieto.

The Mediterranean diet leaves a great deal of room for individual preferences. The general idea is to eat:

  • fruits, vegetables, and legumes — Middleman recommends eating fruits and vegetables that are in season

  • nutritious, minimally processed healthy fats, such as extra virgin olive oil, nuts and seeds and their butters, and avocados

  • high-quality, whole-grain carbohydrates — Middleman pointed out that while white bread, pasta, and rice often make their way to Mediterranean tables, their glycemic effect is offset by fiber-rich vegetables, fats, and proteins

  • aromatic herbs and spices.

It is equally important to reduce one’s consumption of:

  • dairy

  • large portions of meat

  • alcohol.

Tips on following a Mediterranean-style diet

One does not need to eat foods grown in the Mediterranean to follow a Mediterranean diet.

Routhenstein described a Mediterranean-style dinner of “4 ounces of salmon — seasoned with paprika, garlic, and lemon — with a large side of asparagus and a regular baked potato.”

Middleman also suggested an alternative that chimes with Western appetites: “A more typically ‘American’ dish might be roast chicken with [fresh and minimally unprocessed] roasted mixed vegetables (carrots, celery, onion, leeks, potatoes, green beans) and an old-fashioned, simple chocolate pudding, which can be made with nut milk to make it even more ‘Mediterranean’.”

It is also the case, said Middleman, that contemporary supermarkets provide a wide range of ready-washed vegetables and fruits that can form the basis of a delicious Mediterranean dish.

“Whenever people eat out,” said Middleman, “I suggest they choose restaurants whose food is both nutritious and delicious.”

She added that “[t]here are casual dining restaurants opening up all over the place these days that serve significantly more nutritious meals than old-style ‘fast food’ outlets.”

She also noted that by ordering thoughtfully, one can eat according to a Mediterranean diet at a wide range of international restaurants, including Thai, Chinese, Mexican, Italian, and Japanese eateries.

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Can a Mediterranean diet help keep heart disease, dementia, and cancer at bay?

By Katharine Lang on March 18, 2023 — Fact checked by

For some time researchers have suggested that a Mediterranean diet — high in fresh fruit and vegetables, beans, nuts, whole grains, and fish — may help lower heart disease risk and increase life expectancy. An increasing amount of scientific evidence now backs up this notion. Recent studies have linked reduced rates of cardiovascular disease, dementia, and cancers with Mediterranean diets. Medical News Today looked at the evidence and spoke to experts about the science behind the benefits of this diet.

Several recent studies suggest the Mediterranean diet can help keep several diseases and chronic conditions at bay. Image credit: Cameron Whitman/Stocksy.

Over the years, many diets have been proposed for keeping healthy or reducing the risk of specific diseases, but few of them have stood up to rigorous scientific scrutiny.

One exception, however, appears to be the Mediterranean diet.

Increasingly, studies are showing that there are significant health benefits for people who follow this eating plan. Not only has research shown that it reduces cardiovascular disease, but it may also benefit cognition, decrease diabetes risk, reduce the risk of some cancers, and alleviate symptoms of multiple sclerosis.

What is the Mediterranean diet?

The Mediterranean dietTrusted Source is an umbrella term referring to diets based on the historic eating habits of people who live around the Mediterranean Sea.

According to the American Heart AssociationTrusted Source, which recommends this type of diet for cardiovascular health, its key features are:

  • high intake of vegetables, fruits, whole grains, beans, and legumes

  • low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts

  • limited added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.

The Harvard School of Public Health adds to these recommendations, emphasizing the importance of healthy fats — olive oil, avocados, nuts, and oily fish.

It advises that people should eat red meat only occasionally, but get their protein from fish or seafood at least twice a week and eat small quantities of poultry, eggs, and dairy most days.

Although water should be a person’s main drink, people may also drink one or two small glasses of red wine each day, as per the traditional Mediterranean diet.

Researchers add, however, that a healthy diet should also be paired up with some form of enjoyable physical activity every day.

Dr. Scott Kaiser, a geriatrician, and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, noted:

“Research supports the benefits of adopting healthy lifestyle habits and indicates the critical importance this can play in shaping our future individual and collective health. […] Start with including lots of fresh vegetables — especially green leafy vegetables — and then enjoy fresh fruits— like berries — and other antioxidant-rich foods, along with fish, olive oil, and other foods rich in brain-healthy omega-3s.”

Why Mediterranean diets are healthy

Mediterranean diets have long been associated with benefits to cardiovascular health. In the mid-20th century, the Seven Countries study showed that dietary patterns in the Mediterranean and in Japan in the 1960s were associated with low rates of coronary heart disease and all-cause mortality.

Since then, research has shown that this type of diet not only benefits cardiovascular health, but it also reduces the risk of many other health conditions.

And recently, evidence has been increasing for the wide-ranging health benefits of following a Mediterranean diet. But what makes Mediterranean diets so healthy, exactly?

“The Mediterranean diet is characterized by high fruit and vegetables, high fiber, high levels of ‘good fats,’ moderate intakes of fish and meat, low amounts of high processed foods and sugary treat foods,” noted Dr. Eamon Laird, a visiting research fellow at Trinity College, Dublin, in Ireland.

“These food components give high amounts of fiber, good fats, antioxidants, polyphenols, vitamins and minerals — choline, vitamin C, potassium, B-vitamins, vitamin D from fish, etc. — [and] proteins which give health benefits throughout a large number of organ and tissue systems,” he explained.

Mediterranean diet and CVD

Lots of research has investigated the effect of a Mediterranean diet on the risk for cardiovascular disease (CVD).

A meta-analysis of several studies published in March 2023, with a pooled sample of more than 700,000 female participants, has found that, by adhering closely to a Mediterranean diet, women reduced their risk of CVD by 24%, and their risk of death from any cause by 23%.

According to Dr. Laird, “[w]omen are also much more likely to stick with the diet compared to men, which could explain why we see more of the health benefits in women.”

The meta-analysis seems to confirm the findings of previous research. For example, in 2015, another meta-analysisTrusted Source had found that the Mediterranean diet could be a major factor in preventing CVD.

And it was the complete diet, rather than any particular aspect, that seemed to have this effect, as Dr. Joanna Hodges, an assistant teaching professor of nutritional sciences at Pennsylvania State University, told MNT.

“[The study] concludes that no specific component of the Mediterranean diet has been shown to be as beneficial as the whole diet [in CVD prevention],” she told us.

Mediterranean diet and cognitive health

There is also increasing evidence that the diet may enhance cognitive function. A study published in MarchTrusted Source 2023 that used UK Biobank data has just reported that individuals with a higher adherence to a Mediterranean diet had up to 23% lower risk for dementia compared with those who had lower adherence to a Mediterranean diet.

The study, which used data from more than 60,000 people, concluded that the Mediterranean diet lowered dementia risk even in those with a genetic predisposition for dementia.

The authors conclude that adopting a diet high in healthy, plant-based foods may be a strategy for reducing dementia risk.

Another study, also published in March 2023, which looked at postmortem Alzheimer’s pathology, found that those who had followed a Mediterranean or MIND diet, particularly one rich in leafy greens, had a much lower beta-amyloid load.

Beta-amyloidTrusted Source is thought to be responsible for many of the symptoms of Alzheimer’s disease.

The diet may also be beneficial for people with multiple sclerosis (MS). A preliminary study to be presented at the American Academy of Neurology’s 75th Annual Meeting in April 2023, found that people with MS who followed a Mediterranean diet had a 20% lower risk of cognitive impairment than those who followed it the least.

Mediterranean diet and cancer

The diet has been found to both reduce the risk of some cancers and improve the efficacy of some cancer treatments.

A 2019 reviewTrusted Source found that high adherence to the Mediterranean diet was associated with a lower rate of several cancers, including breast, colorectal, and prostate cancers.

This study concluded that the antioxidant and anti-inflammatory properties of components of the diet “prevent and counteract DNA damages and slow down the development of various forms of cancer.”

For prostate cancer, recent research has shown that eating a diet high in colorful fruits and vegetables both reduces the risk of developing prostate cancer and speeds recoveryTrusted Source in those who undergo radiation therapy for the disease.

The studies, from South Australia, found that diets high in lycopeneTrusted Source and seleniumTrusted Source reduced the risk.

Tomatoes, melons, papayas, grapes, peaches, watermelons, and cranberries are rich in lycopene, and white meat, fish, shellfish, eggs, and nuts contain high concentrations of selenium. All of these are recommended in the Mediterranean diet.

And it is not only prostate cancer patients whose treatment may be more effective on a Mediterranean diet.

A recent study presented at UEG Week 2022 found that the diet was significantly associated with an improved response to immunotherapy drugs in people with advanced melanoma.

How it works

Although the exact mechanism by which the Mediterranean diet benefits health is unclear, there is increasing evidence that the diet can have five main effectsTrusted Source:

  • lowering lipids

  • protecting against oxidative stress, inflammation, and platelet aggregation

  • modifying hormones and growth factors involved in cancer pathogenesis

  • restricting specific amino acids

  • influencing the gut microbiome to produce metabolites that benefit metabolic health.

Dr. Laird explained to MNT how some components of the diet benefit health:

“Omega-3 fatty acids, phytosterols, resveratrolTrusted Source, vitamins, and polyphenolsmay contribute to lower levels of inflammation (CRPTrusted Source, inflammatory cytokinesTrusted Source), and may improve endothelialTrusted Sourcefunction. By reducing levels of inflammation, improving blood flow, improving insulin sensitivity, and improving lipid metabolism, by default you are also reducing some of the major risk factors for CVD, cognitive decline, cancers, and diabetes.”

Studies have found that it is best to take in these nutrients in their natural form as part of a healthy diet, such as the Mediterranean diet.

Although they can be obtained through supplements, there may be side effects to taking excessive amounts.


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Small changes will make a difference

The Mediterranean diet is just one of many diets that have health benefits. Others include the MIND, Nordic, and DASH diets.

“The common thread throughout all the [healthy] diets is a heavy influence of plant foods, which we see […] has numerous benefits in increasing dietary fiber, antioxidants, phytonutrients, vitamins, and minerals,” said Kate Cohen, a registered dietitian at the Ellison Clinic at Saint John’s, part of the Ellison Institute for Transformative Medicine and Providence Saint John’s Health Center in Santa Monica, CA.

So, key to any healthy diet is incorporating plenty of vegetables, whole grains, and healthy fats. Most importantly, any dietary changes made should be long-term and sustainable to give health benefits.

“Long term it [the Mediterranean diet] may be difficult to follow in its true form, particularly to those accustomed to processed food diets. A good approach would be to slowly integrate components into your current diet and to build slowly — again variety is the spice of life and we should have a varied and diverse diet and not rely solely on one dietary pattern to meet all our needs and requirements and tastes — food is to be enjoyed too!”– Dr. Eamon Laird

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