Researchers have long suggested that a Mediterranean diet increases life expectancy but is it really that good?
This idea is now supported by an increasing body of scientific evidence. Findings have associated Mediterranean dietary habits with reduced rates of cardiovascular disease, dementia, and certain cancers. The science behind these benefits has been analyzed, with insights from experts shedding light on the topic.
Over time, various diets have been proposed as means to maintain health or minimize the risk of specific illnesses. However, few have consistently withstood rigorous scientific evaluation.
The Mediterranean diet has emerged as a notable exception. Growing research indicates substantial health benefits tied to adherence to this dietary pattern. It has been shown to lower the risk of cardiovascular disease, support cognitive health, reduce diabetes risk, decrease the likelihood of certain cancers, extends lifespan and even alleviate symptoms associated with multiple sclerosis.
What is The Mediterranean Diet?
The Mediterranean diet represents a broad term encompassing dietary patterns rooted in the traditional eating habits of communities around the Mediterranean Sea.
The American Heart Association identifies this diet as beneficial for cardiovascular health. Its main components include:
- A high intake of vegetables, fruits, whole grains, beans, and legumes.
- Inclusion of low-fat or fat-free dairy products, fish, poultry, non-tropical vegetable oils, and nuts.
- Limited consumption of added sugars, sugary beverages, sodium, highly processed foods, refined carbohydrates, saturated fats, and fatty or processed meats.
Additional insights from the Harvard School of Public Health highlight the value of healthy fats, such as olive oil, avocados, nuts, and oily fish. Red meat is recommended only occasionally, while protein sources like fish or seafood should be prioritized at least twice weekly, along with moderate quantities of poultry, eggs, and dairy on most days.
Water is suggested as the primary beverage, with small amounts of red wine, typically one or two small glasses daily, reflecting traditional Mediterranean dietary customs.
Pairing this nutritional approach with enjoyable daily physical activity is emphasized as an essential complement to a healthy lifestyle.
“Research supports the benefits of adopting healthy lifestyle habits and indicates the critical importance this can play in shaping future individual and collective health. […] Starting with fresh vegetables — particularly green leafy varieties — along with fresh fruits, such as antioxidant-rich berries, is key. Including fish, olive oil, and other foods abundant in brain-healthy omega-3s further enhances the diet’s benefits.”
Dr. Scott Kaiser, a geriatrician and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute
Mediterranean diets have been closely linked to improved cardiovascular health for decades. During the mid-20th century, findings from the Seven Countries study revealed that dietary habits in the Mediterranean region and Japan during the 1960s corresponded to lower rates of coronary heart disease and all-cause mortality.
Subsequent research has demonstrated that this dietary pattern extends its benefits beyond heart health, reducing the risk of various other medical conditions. Recent evidence has further highlighted the extensive advantages associated with adopting a Mediterranean diet. But what specifically contributes to its health-promoting qualities?
“The Mediterranean diet is characterized by high fruit and vegetable intake, high fiber, high levels of ‘good fats,’ moderate intakes of fish and meat, and low amounts of highly processed foods and sugary treat foods.”
“These food components provide significant amounts of fiber, good fats, antioxidants, polyphenols, vitamins, and minerals — such as choline, vitamin C, potassium, B-vitamins, vitamin D from fish, and proteins — which deliver health benefits across multiple organ and tissue systems.”
Dr. Eamon Laird, a visiting research fellow at Trinity College, Dublin, in Ireland.
Mediterranean Diet Against CVD
The relationship between the Mediterranean diet and cardiovascular disease (CVD) has been extensively studied.
A meta-analysis published in March 2023, encompassing data from over 700,000 female participants, revealed that close adherence to a Mediterranean diet reduced the risk of CVD by 24% and the risk of death from any cause by 23%.
“Women are also much more likely to stick with the diet compared to men, which could explain why we see more of the health benefits in women.”
Dr. Eamon Laird
These findings align with earlier research. A 2015 meta-analysis also identified the Mediterranean diet as a significant factor in preventing CVD.
Notably, the overall dietary pattern, rather than any single component, appears to drive these benefits. Dr. Joanna Hodges, an assistant teaching professor of nutritional sciences at Pennsylvania State University, emphasized this point:
“[The study] concludes that no specific component of the Mediterranean diet has been shown to be as beneficial as the whole diet [in CVD prevention].”
Dr. Joanna Hodges
Mediterranean Diet and Cognitive Health
It is increasingly believed that the Mediterranean diet can enhance cognitive function. A recent study, published in March 2023, utilizing UK Biobank data, has revealed that individuals adhering to a Mediterranean diet had up to 23% lower risk of dementia compared to those with lower adherence.
The study, which analyzed data from over 60,000 individuals, concluded that the Mediterranean diet lowered dementia risk even in those genetically predisposed to the condition.
The authors suggest that adopting a diet rich in healthy, plant-based foods may be a strategy for reducing dementia risk.
Another study, published in March 2023, examining postmortem Alzheimer’s pathology, found that individuals who followed a Mediterranean or MIND diet, particularly one rich in leafy greens, had significantly lower beta-amyloid load.
Beta-amyloid is believed to be responsible for many of the symptoms of Alzheimer’s disease.
The diet may also be beneficial for individuals with multiple sclerosis (MS). A preliminary study, to be presented at the American Academy of Neurology’s 75th Annual Meeting in April 2023, found that people with MS who followed a Mediterranean diet had a 20% lower risk of cognitive impairment compared to those with the least adherence.
Mediterranean Diet and Cancer
It has been found that the Mediterranean diet can both reduce the risk of certain cancers and enhance the efficacy of some cancer treatments.
A 2019 review revealed that high adherence to the Mediterranean diet was associated with a lower rate of various cancers, including breast, colorectal, and prostate cancers.
This study concluded that the antioxidant and anti-inflammatory properties of the diet’s components “prevent and counteract DNA damages and slow down the development of various forms of cancer.”
For prostate cancer, recent research has demonstrated that consuming a diet rich in colorful fruits and vegetables both reduces the risk of developing prostate cancer and accelerates recovery in those undergoing radiation therapy for the disease.
The studies, from South Australia, found that diets high in lycopene and selenium reduced the risk.
Tomatoes, melons, papayas, grapes, peaches, watermelons, and cranberries are rich in lycopene, while white meat, fish, shellfish, eggs, and nuts contain high concentrations of selenium. All of these are recommended in the Mediterranean diet.
And it is not only prostate cancer patients whose treatment may be more effective with a Mediterranean diet.
A study presented at UEG Week 2022 found that the diet was significantly associated with an improved response to immunotherapy drugs in individuals with advanced melanoma.
How It Works
While the precise mechanism by which the Mediterranean diet benefits health remains unclear, there is growing evidence suggesting that the diet can exert five primary effects:
- Lowering lipids
- Protecting against oxidative stress, inflammation, and platelet aggregation
- Modifying hormones and growth factors involved in cancer pathogenesis
- Restricting specific amino acids
- Influencing the gut microbiome to produce metabolites that benefit metabolic health
Dr. Laird explained to MNT how certain components of the diet contribute to health benefits:
- “Omega-3 fatty acids, phytosterols, resveratrol, vitamins, and polyphenols may contribute to lower levels of inflammation (CRP, inflammatory cytokines) and may improve endothelial function. By reducing levels of inflammation, improving blood flow, improving insulin sensitivity, and improving lipid metabolism, one can also reduce some of the major risk factors for CVD, cognitive decline, cancers, and diabetes.”
Studies have indicated that it is optimal to consume these nutrients in their natural form as part of a healthy diet, such as the Mediterranean diet.
Although these nutrients can be obtained through supplements, excessive intake may lead to side effects.
Small changes can make a significant difference.
The Mediterranean diet is just one of many diets that offer health benefits. Others include the MIND, Nordic, and DASH diets.
“The common thread throughout all the [healthy] diets is a heavy influence of plant foods, which we see […] has numerous benefits in increasing dietary fiber, antioxidants, phytonutrients, vitamins, and minerals.”
Kate Cohen, a registered dietitian at the Ellison Clinic at Saint John’s, part of the Ellison Institute for Transformative Medicine and Providence Saint John’s Health Center in Santa Monica, CA.
Therefore, incorporating plenty of vegetables, whole grains, and healthy fats is key to any healthy diet. Most importantly, any dietary changes should be long-term and sustainable to achieve health benefits.
“Long term, it [the Mediterranean diet] may be difficult to follow in its true form, particularly for those accustomed to processed food diets. A good approach would be to slowly integrate components into one’s current diet and to build slowly — again, variety is the spice of life and we should have a varied and diverse diet and not rely solely on one dietary pattern to meet all our needs and requirements and tastes — food is to be enjoyed too!”
Dr. Eamon Laird