What makes a diet the “best overall?” Why does the Mediterranean Diet come out on top? In this blog article, I’ll a look at the “best diets” according to the US News and World Reports 2019 list and discover what unites the winners in the “best diet overall” category. Then I’ll take you on a different journey to explain why the Mediterranean region is associated with health and longevity. And trust me, it is not because just because of the food. Let’s get started.
How easy the diet is to follow
The diet’s ability to produce short-term and long-term weight loss
Nutritional completeness of the diet
Safety of the diet
Potential for preventing and managing diabetes
Potential for preventing and managing heart disease
After evaluation, the diets receive their “best” status in a variety of categories such as best diet for weight loss, heart healthy, plant based etc. I am only interested in the best overall category.
Here’s how winning best diets break down
The Mediterranean Diet received the best overall diet award, followed in second and third place by The Dash Diet and the Flexitarian Diet. Only 2 points separated first place Mediterranean Diet from third place Flexitarian Diet in this best overall category. The Flexitarian Diet had a four-point lead over The Mediterranean Diet in the weight loss category however.
The Mediterranean Diet focuses on fruit, vegetables, whole grains, beans, nuts, legumes, olive oil, herbs and spices with a recommendation for fish and seafood a minimum of twice a week. Poultry, eggs, cheese and yogurt are included “in moderation.” Sweets, red meat and red wine are reserved for “special occasions.” More on that later!
The Dash Diet also emphasizes fruit, vegetables, whole grains, lean protein and low-fat dairy. The diet veers away from food high in saturated fat, to include fatty meats, whole-fat dairy and “tropical oils,” such as coconut, palm kernel or palm oil. The lower saturated fat recommendation is inline with this diet’s alignment with heart health.
The Flexitarian Diet is “more plants and less meat” – so pseudo vegetarian with a meat fix thrown in when the urge demands it. Again, the focus is on fruit, vegetables, legumes and whole grains. The protein choice slants towards plant protein over animal. Unlike the Mediterranean Diet and Dash Diet, the Flexitarian plan includes calorie recommendations based on an average of 1500 a day distributed over meals and snacks during the course of the day. The calorie parameters align this diet with a weight loss strategy, hence its highest overall score for weight loss.
What are the differences?
At first glance, all three diets appear very similar. Each diet emphasizes fruit and vegetables but does not distinguish between the types. Obvious differences are the emphasis on herbs, spices, seafood and a glass of red wine in the Mediterranean Diet. Notice there is no guidance on the type of fat or maligning saturated fat either. The Dash Diet is also plant-centric, but differentiates on its advocacy for low-fat dairy and animal protein. It also emphasizes lower overall sodium to align with its heart health focus. The Flexitarian Diet is equally plant-heavy, providing caloric guidance which is not an emphasis of the Mediterranean or Dash Diet.
Why The Mediterranean Itself Is Best
I grew up in Europe, living more than half my life there. I have seen a lot of Western Europe from trains, on the back of my bike, by foot and on skis, where mountains permit! The Mediterranean is as much about life as it is about food. The two are deeply intertwined.
Rather than unpacking the Mediterranean by food group and pointing out the health value of this food, I’d like to take you on a journey to the Mediterranean to explain why this region, food traditions and lifestyle qualify it to be among the world’s best for your health. I’ll start with food.
Greece and the Peloponnese
Herbs and spices (usually hot peppers in Greece) are ubiquitous across the Mediterranean. In 2016 I visited a friend who is a Naturopath in Athens. We traveled to the town of Sparta where she grew up. Sparta, in the Peloponnese region of Greece, is known for its splendid olives and houses the Museum of the Olive and Greek Olive Oil. We went for a walk into the hills with a local guide. We were supposed to be learning about the history of Sparta, but the conversation quickly diverted to an explanation of the different flora and fauna and how they are used in local dishes and even herbal medicines. We tasted and appreciated.
The next day my colleague was up early and at the local market. She greeted me at my hotel with armfuls of the very plants we had seen and tasted the day before. You see local people make a living foraging for and selling these robust plants which have been a part of traditional cuisine in Greece for centuries. They go into the fields, hills and mountains where they live and forage these plants. Some land on their plates. Others make their way to the markets. The remainder may be formulated into local teas and herbals products, completing the cycle of life.
While it is not a secret to the locals in many regions across the Mediterranean, these native wild plants are the “secret” to the health of this vast region. From Southern Italy, across the Greek Islands to Croatia and Western Turkey, wild plants are a means to make an income and a way to grace the plate. These wild plants which include thyme, fennel and chives among many others, contain large concentrations of bioactives. These bioactives can activate genes whose protein products that soothe inflammation in the body, or act as powerful antioxidants.
Most disease finds its roots in inflammation. Across the Mediterranean, native plants incorporated into simple meals, naturally help soothe the fires of inflammation. If you prevent inflammation, you can prevent heart disease and diabetes among other chronic diseases. No heart disease, no diabetes = a long life.
And the Mediterranean is known for its healthy long-living people. Think about that.
Read more about bioactives and the Mediterranean here.
The Pyrenees Mountains
In 2003 I was hiking high in the Pyrenees Mountains bordering France and Spain. It was early November and the villages were largely shuttered because people were taking a break between the demands of the summer tourist season and the onslaught of the Winter ski season. Taking a break and respecting your mind and body is an essential part of Mediterranean life. It provides time to downshift and recuperate.
While in the mountains, I came across a lone shepherd working with his dog to bring sheep down to lower pastures before the snow began. The sheep provide milk for the famous cheeses of this part of the world. Whole milk, aged cheese with a robust flavor. Plenty of saturated fat, but eaten in small chunks and often, usually not adorning pizza. Sheep join goats and cows in providing the milk for some of the world’s best, yet less familiar cheeses. And climbing mountains is hard work, so adding calories, versus counting them is more important!
Read more about some of these cheeses here.
And on the subject of cheese, each Mediterranean country has its specialties. The Mediterranean people are not afraid of cheese and its calories. Cheese vary by animal and the grass of the season. They are celebrated by region and frequently paired with a wine and fruit from the same locality.
I am an avid cyclist. My preferred vacation is cycling. You learn a lot from the back of a bike and you get to places a car never will, particularly on the tiny back roads of Europe.
In the Fall of 2011 I cycled the “white villages of Andalusia” in Southern Spain. Tiny roads. Hefty mountain climbs. From my bike I saw small fields of seasonal vegetables, Winter squash, broccoli, cabbage. Each night came with different lodging, yet the daily table always included: jamon serrano, Manchego and local bread. Evening meals offered local meat, often pork, venison or rabbit.
Even though I could often see the ocean from my bike, unless I was next to the ocean, seafood was rarely on the plate. You see we think that the people of the Mediterranean eat a lot seafood. They don’t unless they live next to the ocean. They eat what the land provides and has for centuries. Herein lies the difference. The land provides the foundation for cultivating food, raising animals, and a landscape for foraging to nourish. Animals foraging naturally on the land provide humans with the essential sources of omega-3 fats as seafood does.
The Mediterranean diet is not about seafood twice a week. It’s about high quality naturally-raised animal or seafood proteins served with the greens and wild herbs I talked about.
The First Secret of the Mediterranean is Food from the Wild
Herbs, flowers, olives and fruit grow naturally in the wild across the Mediterranean region. In my opinion they are the answer to why the Mediterranean Diet ranks highest among “diets” around the world.
The Mediterranean Diet has nothing to do with low fat, eating seafood twice a week or counting calories. It has everything to do with the local and traditional foods that provide the diversity of bioactives and nutrients which activate and support genes that are instrumental to our health.
The Second Secret of the Mediterranean is Life not Diet
I am frequently in Europe. It is my original home and the geographical origin of my DNA. I like to go “home” on occasion to connect with my roots. One of the roots of European society is the local café or bar. Depending on the country this is a brasserie, café, taverna, trattoria, osteria, Gasthaus, Stube, pub.
In Italy, Aperitivo signals the end of the day. It may involve a tiny snack and a glass of prosecco or an Aperol Spritzer. Food ALWAYS pairs with alcohol. Aperitivo is never enjoyed in isolation. Almost always in familiar surroundings. Always involves a chat.
Community Places are Meeting Places
Regardless of the Mediterranean country of origin, community spaces are meeting places. People come together to communicate. Maybe they lean on a counter and drink a beer (UK) or an espresso (Italy). Maybe they grab a newspaper and chat (France). Sit outside to compare note and observe the locals (Greece). All this to say that people come together as humans. Sure smartphones are there, but in so many places the phone screen is secondary to the simple art of being human and acknowledging presence. Neighbors meet and neighbors greet.
Across the Mediterranean, a region so famous for its diet, life and the local community is as important to health as food itself. Human connectivity is as essential to health as the food that fuels it. And yes, our genes respond to it. Listen in to this Ted Talk to learn which determinants are the most important to health and longevity. The answer may surprise you. And for the pursuers of science among you, delve into this important work on Human Social Genomics and its impact on health.
What you can do now
In truth there is no one “best” diet. Genomic science tells us that while humans share essentially the same genes, the tiny variants in them (single nucleotide polymorphisms), determine how we respond to the food we eat and the life we live. People who live long lives, many of which live in the Mediterranean region, may have a gene variants that help them efficiently manage the type of food they eat.
While most of us don’t know what our gene blueprint looks like, we can rely on the body of science that shows how important components of food support our master genes. This field of science is called nutrigenomics. Read more about nutrigenomics here. Certain foods, particularly herbs, spices, berries, citrus fruit and cruciferous vegetables contain bioactives that work in harmony with many of our genes. Coincidentally, these are some of the same foods that are foundations of the Mediterranean plate.
At the Genomic Kitchen, we created an Ingredient Toolbox that contains many of these important foods. By including these ingredients on your grocery list and putting them on your plate, you provide your body with critical information to optimize your health. Sign up to receive our Quick Start Guide to this toolbox here.
And if you are interested in exploring the traditional foods of the Mediterranean, consider joining us in Athens and The Peloponnese region of Greece in October of this year. Learn more about this program here.
Wild Edible Plants and their Value for Health
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Kaloteraki C, Velivasaki, M, Tsourdalaki, E. Comparison of wild greens and herbs consumption between residents of urban and rural areas of Crete. Clinical Nutrition. ESPEN. Volume 13, e61.
Sansanelli S, Tassoni A. Wild food plants traditionally consumed in the area of Bologna (Emilia Romagna region, Italy). J Ethnobiol Ethnomed. 2014;10:69.
Tan A, Adanacioglu, N, Karabak S, Aykas, L, Lerzan, Tas, N, Taylan, T. Biodiversity for food and nutrition: edible wild plant species of Aegean region of Turkey. J of AARI. 2017;27(2): 1-8[MSS1] .
Human Social Genomics
Cole SW. Human social genomics. PLoS Genet. 2014;10(8):e1004601.