03 January 2011

The Mediterranean Diet - our edible cultural heritage

Last year the Mediterranean Diet was designated by UNESCO as an Intangible Cultural Heritage of Spain, Greece, Italy and Morocco.  It is characterised by a daily intake of olive oil, cereals, pulses, fruit and vegetables, with a moderate amount of fish, dairy produce, eggs and meat, accompanied by wine or infusions.  The Cultural Heritage bit also applies to the skills and traditions associated with the production, preparation and consumption of these foods:
... the Mediterranean diet (from the Greek work diaita (δίαιτα), or way of life) encompasses more than just food. It promotes social interaction since communal meals are the cornerstone of social customs and festive events. The system is rooted in respect for the territory and biodiversity. It ensures the conservation and development of traditional activities and crafts linked to fishing and farming in the Mediterranean communities ... Women particularly play a vital role in the transmission of expertise, as well as knowledge of rituals, traditional gestures, celebrations and the safeguarding of techniques.
(Inscribed in 2010 on the Representative List of the Intangible Cultural Heritage of Humanity)
The health benefits of this way of eating were first confirmed by Ancel Keys, director of the Laboratory of Physiological Hygiene at the University of Minnesota, in the 1940s.  He noticed that well-fed American businessmen had high rates of heart disease, whereas in postwar Europe rates fell sharply in the wake of reduced food supplies.  This prompted him to launch the Seven Countries Study.  For more than ten years  his team studied the diet, lifestyle and incidence of  heart disease among 12,763 randomly selected middle-aged men in the United States, Japan, Italy, Greece, the Netherlands, Finland and Yugoslavia.

The research revealed that in Greece, Japan and southern Italy, where vegetables, grains, fruits, beans and fish formed the main part of their diet, heart disease was rare. But in those countries where people ate large amounts of red meat, cheese and other foods high in saturated fat, such as in the US and Finland, the rates were much higher.  In Crete, where subjects consumed up to 40% of their calorie intake as unsaturated fats - mainly from olive oil and fish - they found the lowest rate of heart disease and the highest average life expectancy (along with Japan).  This led to the distinction between saturated and unsaturated fats that we are all familiar with today.

Keys also observed that Mediterranean and Asian peoples were physically active, family ties were strong, and the pace of life was leisurely. He concluded that although diet was the single most important factor, it was a combination of dietary and lifestyle factors that were responsible for the remarkably low rates of heart disease in Mediterranean and Asian regions.  In 1975 he retired to a fishing village in Southern Italy, where he continued to study the link between diet and health in the local population - and lived to be 100.

In the mid-1990s the concept of the "Mediterranean Diet Pyramid" was popularised by Walter Willett of Harvard University School of Public Health, in conjunction with the World Health Organization and the Oldways Trust.  (Interestingly, the International Olive Oil Council, a Madrid-based trade association of countries that produce olive oil, was a major sponsor of Oldways conferences.) They recommended that up to 40% of calories should come from unsaturated fat (mainly olive oil), going against US government dietary advice which recommended no more than 30% of calories should come from fats of any kind.  Unfortunately most consumers just took this as a licence to eat more fat, drowning their salads with olive-oil dressings or eating more fried food, without making all the other recommended dietary changes.

By the turn of the millennium however, with obesity levels soaring, we were being told that eating fat was bad. Low-fat or fat-free products flooded the supermarket shelves and olive oil became a naughty treat. Then in 2006 the results of an eight-year study of nearly 50,0000 women found that low-fat diets did not protect against heart attacks, strokes, breast cancer or colon cancer, as had previously been claimed.  Subsequent research has shown that a low-carbohydrate, Atkins-style diet is more effective for weight loss and has more health benefits than a low-fat diet.

So the olive oil is back on the table, the fruit bowl and vegetable rack are full and the wine is flowing.  In our household we have been following the Mediterranean diet pretty faithfully ever since moving here - without even thinking about it.  With all that lovely fresh produce, who would want to eat any other way?

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