The Mediterranean diet is really the poster child for mainstream healthy eating right now, and even though it’s not exactly Paleo, the research on it is pretty interesting.
The diet of actual people living around the Mediterranean sea obviously varies, but the “Mediterranean diet” in most studies focuses on whole grains, legumes, low-fat dairy, nuts, fish, fruits, vegetables, and olive oil, and discourages red meat, refined flour, refined sugar, animal fat, and processed foods.
It’s pretty well-proven that the diet improves most people’s overall health, and from a Paleo perspective, that’s not surprising. Parts of it are very healthy (the fish and the vegetables), and even the parts that aren’t ideal (like the grains) are better than the typical American diet.
But the research on the Mediterranean diet is more interesting than just “lentil soup is better than Twinkies, no kidding, news at 11.” Here are 5 things Paleo eaters should know about the Mediterranean diet – how it strikes another blow against low-fat dogma, how it can work as a low-carb, high-fat diet, and how it might be a step towards more Paleo-friendly advice even in the Dietary Guidelines.
1. The Mediterranean Diet Consistently Beats Low-Fat Diets
The Mediterranean diet is low in fat by Paleo standards (around 35% fat, depending a little on who’s running the study, and obviously the ketogenic versions are higher). But that’s at the high end of the typical government nutrition guidelines, and more importantly, the Mediterranean diet is focused much more on getting high-quality fat than on reducing fat as much as possible. The focus is much more on quality than quantity.
And the Mediterranean approach seems to work. In the real world, advice to eat a Mediterranean diet consistently produces better results than advice to eat a low-fat diet. Whether it’s risk of death from heart disease, risk of diabetes, or weight loss, the Mediterranean diet pattern wins.
This is a huge argument for diet quality over diet quantity – and also for a diet with a recognizably delicious cuisine, a diet that doesn’t conjure up images of bland and gross food, and a diet focused on fresh meals rather than processed food.
2. The Mediterranean Diet Rivals Low-Carb for Weight Loss.
The Mediterranean diet is constantly praised as a sustainable or healthy way to lose weight. But guess what other diet does just as well?
This review looked at studies comparing the Mediterranean diet to other dietary patterns for weight loss in people with obesity. The Mediterranean diet smashed low-fat diets (no surprise there) but Mediterranean and low-carb did about equally well.
That’s obviously a victory for the low-carb crowd: their diet works as well as the current “golden child” of dietary advice. But you could also take it the other way: a moderate-carb diet works just as well as a low-carb diet, as long as that moderate-carb diet is focused on quality of food and not just calorie-counting.
But wait…why not combine the two for a double whammy of weight-loss success? Well, actually, that’s been done!
3. There’s a Very Low-Carb/Ketogenic Mediterranean Diet (and it’s Really Impressive)
A ketogenic diet is a very low-carb, very high-fat diet (usually less than 5% calories from carbs, with around 80% from fat). Paleo doesn’t have to be a ketogenic diet, but it can be, and a lot of people find that a ketogenic Paleo diet is a very impressive tool for weight loss and general health.
Ketogenic Mediterranean diets take out all the bread and legumes, and replace them with more olive oil, low-carb vegetables, fatty fish, and nuts. The benefits include…
- Improvements in metabolic syndrome and nonalcoholic fatty liver disease (NAFLD)
- Improvements in cardiovascular health
- Weight loss and improvements in inflammatory markers
This research suggests that those “heart-healthy whole grains” aren’t actually necessary for the health benefits of the Mediterranean diet; most of these diets were basically Paleo with some low-fat dairy thrown in. For Paleo eaters who find the Mediterranean diet concept interesting but don’t want to venture into the land of whole wheat and chickpeas, this might be a good place to start. (And if you’re not huge on the full ketogenic thing, you could add carbs with potatoes and/or sweet potatoes as you like.)
Take those first three points all together, and it looks like the Mediterranean diet is making a pretty strong case against low-fat diets or the need for “healthy whole grains.” Mediterranean-style emphasis on healthy fats outperforms low-fat diets, and you can get Mediterranean diet benefits with almost no carbs or grains at all.
4. The Diet Alone Isn’t Magic
The original promoter of the Mediterranean Diet was Ancel Keys (yes, the same Ancel Keys better-known for unjustifiably demonizing saturated fat and cholesterol as the “causes” of heart disease). Keys traveled to the island of Crete, off the coast of Greece, and observed that traditional Cretan dietary patterns were associated with low rates of heart disease. And the “Mediterranean diet” was born.
But even people eating the Mediterranean diet in studies don't end up as healthy as the Cretans, and this review points out one possible reason why. The people living in Crete and southern Italy at the time also enjoyed “a relaxing psychosocial environment, mild climate, preservation of the extended family structure, and even a siesta, as well as regular activity, mainly through walking.” Think about the lessons of Roseto, PA: strong social connections can dramatically reduce rates of heart disease even when the people are eating huge piles of refined flour and everyone smokes. Or think about the importance of sleep and stress, or the benefits of walking.
The history of the Mediterranean diet is one more point in favor of considering all these things as part your health environment: it's not just the food you put in your mouth.
5. It Might be Changing the Dietary Guidelines in a Paleo-Friendly Direction.
Maybe the most exciting thing about the Mediterranean Diet is the politics.
The Mediterranean Diet is the fat-is-not-evil wedge that’s slowly filtering into mainstream dietary advice. It’s the poster child for “good fat,” for unprocessed foods, and for focusing on overall diet patterns instead of picking on just one nutrient. And as it filters into the public consciousness that olive oil is actually good for you, we might be getting a welcome dose of fat-friendly, whole-foods nutrition coming along for the ride.
The latest version of the Dietary Guidelines for Americans even touts the Mediterranean diet as a suggested dietary pattern. Who knows: maybe next they’ll actually get tough on sugar!