The Mediterranean Diet

Ancel Keys is a giant in the field of nutritional research.  Born in 1904 he completed two PhD’s in his life, one in Biology and one in Physiology.  Numerous accomplishments are credited to him, the most famous being the development of the K-rations (K for Keys) which became a part of any American soldiers’ daily life – the light-weight nutritional biscuit.  But he was also the lead author and investigator in the Seven Countries Study which began in 1958 and lasted for 40 years, comparing the diets and lifestyles of people in mostly 7 countries and establishing the main cause of dramatically rising heart disease as being saturated fat intake.  He is the authority that was responsible for advocating a lower saturated fat content in the diet, which if correctly implemented would have had a dramatic impact on the epidemic of chronic diseases.  Unfortunately, as can be seen by research, the practices of most people groups around the world did not change much, in spite of the dietary recommendations, and the incidence of heart disease and diabetes has skyrocketed.

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Ancel Keys has received a great deal of criticism in the press and from advocates of the low carb community.  This article deals with some of the myths that have been published about the Mediterranean diet, and Ancel Keys in particular, even by some very reputable organisations and journalists.

He is credited with the recognition and promotion of the Mediterranean diet, which varies between different countries, but has many similar elements.  The countries surrounding the Mediterranean Sea include Greece, Italy, Crete and Spain, Algeria, Libya and Morocco, Lebanon, Syria and Turkey.  Although the area is diverse certain common elements to the diet originally were associated with a remarkably lower incidence of heart disease, cancer and other chronic diseases as well as greater longevity.  Ancel Keys identified the most important elements as

predominantly plant-based diet

fresh ingredients straight from the garden

plenty of legumes

whole-grains

seeds and nuts

most of the fats in the diet from olives

small amount of animal products in the form of chicken and fish, and minimal red meat

small amount of dairy

strong sense of community

regular exercise as part of active daily life

wine in moderation

Of course, the original research was performed many years ago and dietary preferences and practices have changed dramatically over the years in all countries.

In all of those Mediterranean countries the incidence of obesity, diabetes, heart disease and cancer has risen exponentially as in most western countries as people have moved away from traditional lifestyles. 

Interestingly Ancel Keys and his fellow scientist wife were strong proponents of the Mediterranean Diet, and wrote a number of books about how to go “Mediterranean”.   They also practiced what they preached. He died at the age of 100 years, and was still very active up until 2 years before his death – a good example of the advantages of his recommendations.

Nevertheless, hundreds of studies have been done on the “heart-protective” effect of the Mediterranean diet since his original studies and have confirmed most of the elements as mentioned above.  However there are some more recent studies that have shown that the main benefits of the Mediterranean diet have not been the emphasis on olive oil and wine and fish, so much as the strong reliance upon fresh home-grown and abundant fruits and vegetables, whole grains, legumes, exercise and sense of community.  Read this article to get some perspective:

Many people think that olive oil is at the “heart” of the Mediterranean diet.  However, there are so many studies that have shown that a high oil diet increases the risk of high blood pressure, heart disease and diabetes – and that includes olive oil.  It must also be remembered that olive oil has around 18% saturated fats.  Olive oil also interferes with the production of nitric oxide production by endothelial cells – those magic slippery lining cells of the blood vessels which are so essential for blood vessel health and control of blood pressure.

If you want to get a very readable and very comprehensive discussion on the question of olive oil, but also the Mediterranean diet, here is a helpful article, with sound scientific support:

The take home messages of the benefits of the Mediterranean diet and lifestyle:

• Eat plenty of a good variety of fresh fruits and vegetables. If you can grow them yourself all the better – nothing quite like vegetables straight from the garden onto the plate.  These include tomatoes, peppers, egg-plant, green leafy vegetables, squashes, cabbage-family vegetables, onions and garlic, mushrooms and herbs and spices.

• Use whole grains – brown rice, whole-wheat pastas and breads, barley, oats.

• Legumes such as beans, chick-peas and lentils are a staple.

• Some seeds and nuts are beneficial – pistachios, almonds, linseeds, sunflower and pumpkin seeds

• A diet low in saturated fats, as found in dairy, red meat and in fact in all animal-based and processed foods, and rather mono-unsaturated fats as found in olive oil if any oil is used. However the best oil is that found in whole olives, rather than refined oil.

• An active lifestyle

• Good community spirit – strong faith base and social support.

Have a great week seriously considering and adopting the beneficial factors of the Mediterranean diet.

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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