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Mediterranean Diet Shown to Reduce Risk of All-Cause Mortality
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Eat Your Way to a Longer Life

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The Mediterranean diet has long been espoused as promoting great health and longevity. Supporters of the Mediterranean diet point to several factors that contribute to its health benefits:

  • Antioxidant-rich fruits and vegetables
  • Omega-3 rich olive oil, nuts and seeds, and fresh fish
  • Fiber from whole grains and legumes
  • Moderate to low intake of dairy products (often from yogurt and/or cheese)
  • Infrequent intake of meat and/or meat products

Thanks to all these factors, the Mediterranean diet has been shown to prevent a wide variety of health conditions, including cardiovascular disease, type 2 diabetes, and even some types of cancer.[1] So why is any study about the health benefits of the Mediterranean diet news?

Because past studies have focused on varying definitions of the Mediterranean diet, may or may not include olive oil consumption (a hallmark of the Mediterranean diet) or, in the case of one particular study,[2] found that a significant reduction in mortality was only found in six of nine countries studied.

To remedy this, Spanish researchers sought to discover how strict adherence to a Mediterranean diet impacted both all-cause and specific-cause mortality.[3]

What’s in a Mediterranean Diet?

To establish a solid definition of a Mediterranean diet (and thereby avoid any confusion of results), researchers used something called the relative Mediterranean diet score (rMED) to estimate the level of adherence to the diet. It is an 18-point linear scale that measures nine specific elements of the Mediterranean diet.

Six of the nine elements were seen as positives and included:

  • Fruit (includes nuts and seeds)
  • Vegetables (except potatoes)
  • Legumes
  • Fish
  • Olive oil
  • Cereals

These were divided into three levels of intake, from 0 to 2, with 0 being the lowest and 2 being the highest level of intake.

Two of the nine elements were seen as directly opposed to a healthy Mediterranean lifestyle. These included dairy and meat intake. They were also divided into three levels of intake, also from 0 to 2, but 2 represented the lowest level of intake (a good thing) and 0 represented the highest (a bad thing).

The ninth element was alcohol consumption. It was given one of two scores — a 2 for moderate consumption (5-25 grams a day for women and 10-50 grams a day for men). Anything above or below this received a 0 score.

Researchers then applied this score to validated dietary history questionnaires of more than 40,000 participants in the EPIC-Spain cohort study. EPIC is a large, multi-center study that reaches across 10 European countries to study the role of diet, lifestyle, environment and genetic factors.

They then looked at all-cause mortality of this group, starting in 1992-93 until December 2006 and June 2009, noting date and cause of death.

Your Diet Can Predict Your Longevity

Of the 40,622 participants examined, 1,855 died within the time period studied. Of these, 399 died from cardiovascular disease, 913 from cancer, and 425 from other causes.

Researchers found that a high versus low rMED score was associated with a 21 percent reduction in all-cause mortality. Moreover, every 2-point increase in rMED score was associated with a 6 percent decrease in mortality.

When it came to specific-cause mortality, a high versus low rMED score was associated with a significant decrease in “other” causes of mortality, and a whopping 34 percent reduction in risk of death from cardiovascular disease. In fact, every 2-point increase in rMED score reduced risk of death from cardiovascular disease in women by 16 percent and by 11 percent in men.

Interestingly, a high versus low rMED score was not significantly associated with reduced risk of death from cancer. However, when researchers looked at specific cancers that are traditionally associated with diet (esophageal, stomach, intestinal, colorectal, other digestive cancers, pancreatic, breast and prostate cancers), they found a moderate reduction is risk of death.

Researchers hypothesized that this may be due to risk factors for cancer varying significantly depending on the location of the cancer. Additionally, there are often many lifestyle and environmental factors that can influence cancer risk, with diet only being one of these factors.

While researchers note that “no one component was wholly responsible for the observed associations,” of the nine factors detailed in the rMED score, both olive oil consumption and alcohol intake were significantly associated with decreased risk of mortality.

Specifically, high intake of olive oil rendered a 15 percent reduction of risk, with 11 percent for moderate alcohol intake. Conversely, high intake of alcohol resulted in a 17 percent increase of risk for mortality. Researchers suggest that future studies break out the alcohol aspect a bit more, defining alcohol consumption more closely and accounting for abstainers/low intake, moderate and heavy drinkers.

Researchers concluded, “This large prospective study supports the important role that an olive oil-rich [Mediterranean diet] plays on reducing mortality in Mediterranean populations.”

Go Mediterranean

While a trip to Spain or Greece would be nice, you don’t have to actually live in the Mediterranean to take advantage of the benefits of a Mediterranean diet. You can start small and switch all of your oils for olive oil. That includes cooking oils as well as salad dressing. Kiss those vegetable oils goodbye!

Next, limit meat consumption to once or twice a week. Substitute with wild-caught, cold-water fish. Or, better yet, get to know legumes. Experiment with lentils, garbanzo beans and kidney beans to start

You can then aim for four servings of vegetables and two servings of fruit a day. One easy trick is to make a smoothie for breakfast with protein powder, frozen cherries, a scoop of almond butter and a handful of fresh spinach. Add water and ice, blend and enjoy!

Lastly, keep dairy and alcohol consumption to a minimum. Ideally, your dairy should be yogurt and/or cheese a couple of times a week and no more than a glass of red wine daily.

By following these tips, you can bring a bit of the Mediterranean into your life every day.

[1] Sofi, F et al. Accruing evidence about benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr. 2010;92:1,189-96.

[2] Trichopoulou, A et al. Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study. BMJ. 2005;330:991-7.

[3] Buckland, G et al. Adherence to the Mediterranean diet reduces mortality in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Br J Nutr. 2001 May 17:1-11. [Epub ahead of print]

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