Study touts following a Mediterranean diet with roots in life by the sea

The virtues of nuts, fish and olive oil now are more clear than ever thanks to an exhaustive, high-profile study of the “Mediterranean Diet.”

Whether Americans will notice — or care — is another story.

“The devil is in the details in terms of a diet, culturally. Is applying a Mediterranean Diet in Spain the same as applying it here? Probably not,” said Dr. Donald Hensrud, a physician and professor of preventive medicine at nutrition at the Mayo Clinic College of Medicine.

“It’ll probably blow over in a little while,” he said of the media attention the research has gotten. “Is it going to cause wholesale changes? No.”

While praising the study for its depth and the length of time researchers followed their subjects, other scholars say the results were, to some extent, predetermined. The study’s control group was told to follow a low-fat diet, while the Mediterranean groups were given supplies of nuts and olive oil for free.

“This enabled the Mediterranean groups to stick with their diet. The low-fat group got nothing. The control group should’ve received something, a good food, to make it more equal,” said Jean Gutierrez, an assistant professor at George Washington University’s School of Public Health. “Access to food is one of the main factors when it comes to sticking to a diet. … The diet they recommend [in the study], for one, it’s expensive.”

The study out of Spain and published this week in the New England Journal of Medicine once again shows the health benefits of pushing fried food and red meat off the plate in favor of chicken, salads, fresh fruits, vegetables and fish, olive oil and nuts. The research is being heralded as one of the most detailed and thoughtful examinations of Mediterranean eating ever conducted. More than 7,000 people, ages 55 to 80, were separated into three groups and tracked for nearly five years.

The two groups that followed the Mediterranean Diet — one used more olive oil in their cooking, while the other incorporated a fistful of nuts into their daily meals — were at lower risk for heart attacks, strokes and other problems. Those results came in spite of the fact that they ate more calories each day than the control group, which was told to follow a low-fat diet centered on bread, potatoes, pasta and other foods.

The survey results are being heralded as definitive proof that Americans, if we wish to live long, healthy lives, need to emulate our counterparts in Greece and Spain.

While Americans still eat more red meat and less fish than many of their global counterparts, there is evidence that Mediterranean foods are rising in popularity.

Olive oil use, for example, has exploded in recent years. Now, it’s in more than 50 percent of American households, compared to just 30 percent five years ago, according to the North American Olive Oil Association.

“If you just think about the changes in the last 20 years, yes, this [study] can have an impact. Twenty years ago, olive oil was seen as this weird ethnic product. We were criticized and told that Americans will never eat olive oil,” said Sara Baer-Sinnott, president of Oldways, a nonprofit food and nutrition education group that promotes traditional, heritage-based diets. The group introduced a Mediterranean Diet food pyramid in 1992.

“There was a lot of skepticism about this,” Ms. Baer-Sinnott added. “Now if you think about all of the products on the shelves, there are all different kinds of olive oil, Greek yogurt, sun-dried tomatoes” and other foods associated with Mediterranean eating.

Eating more of those foods would be a positive step for average Americans, but other nutritionists argue that stocking up on olive oil and replacing steak with salmon once in awhile may not be enough. American Heart Association President Donna Arnett believes the Spanish study, and its wealth of quality data, should be used to help push a more permanent, fundamental shift in U.S. eating habits.

“Diet is not just eliminating one type of fat or food from the diet. It really is about embracing one type of dietary pattern,” she said. “Fast-food restaurants are not really set up to deliver this kind of diet. The way we organize how food is processed and prepared and made available in a convenient to adhere to [a healthier diet] really would be an important step forward.”

While the study wasn’t focused on weight loss, it had in place limits to protect against overeating, a substantial problem in the U.S. Participants were told to supplement their diet with four tablespoons of olive oil each day.

More importantly, those using nuts were told to eat only a fistful.

“You’re talking about an ounce a day. … It’s a handful, not a can full,” said Maureen Ternus, executive director of the International Tree Nut Council Nutrition Research and Education Foundation.