The problem with the Mediterranean diet we need to talk about


You are probably familiar with the Mediterranean diet. It’s consistently ranked as the healthiest diet, and numerous studies have linked it to a lower risk of chronic diseases such as heart disease and type 2 diabetes, as well as a lower risk of premature death (1).

But while there’s a lot to celebrate about the Mediterranean diet, there’s also a big problem that we don’t talk about enough.

The diet is based on the traditional eating habits of European Mediterranean countries, but it excludes the traditional cuisines of many other countries bordering the Mediterranean.

Additionally, the current interpretation of the diet is not as flexible or accessible as claimed, as it relies heavily on foods that are out of reach for many.

This article explores in more detail how we can make the Mediterranean diet more inclusive, regardless of cultural heritage and preferred foods, and some of the issues with the initial research.

There are 21 countries touching the Mediterranean Sea: Albania, Algeria, Bosnia and Herzegovina, Croatia, Cyprus, Egypt, France, Greece, Israel, Italy, Lebanon, Libya, Malta, Monaco, Montenegro, Morocco, Slovenia, Spain, Syria , Tunisia and Turkey.

However, the Mediterranean diet is based mainly on the traditional cuisines of Italy, Greece, Spain and southern France, excluding those of Eastern European countries, the Middle East and African region.

The reason for this can be attributed to the study of the seven countries. From 1952 to 1957, the American researcher Ancel Keys carried out informal exploratory studies in seven countries: Italy, Greece, Yugoslavia, the Netherlands, Finland, Japan and the United States.

Researchers studied dietary habits in each of these countries and measured rates of heart disease, diabetes and risk factors such as high cholesterol, high blood pressure and smoking (2).

Ultimately, Keys and his team concluded that dietary habits in Italy and Greece were associated with lower rates of heart disease and all-cause mortality in those countries. So, Keys started promoting this way of eating for better health and lower risk of disease (2).

Today, experts are quick to criticize Keys’ research methods. A recent article published in the Journal of Critical Dietetics points out that the study only collected data from men and that, with the exception of Japan, it only included predominantly white populations (3).

The reason non-European cuisines aren’t part of the Mediterranean diet isn’t that they’re less nutritious, but that those countries weren’t included in early research (3).

Overall, experts agree that the Mediterranean diet is nutritious. It emphasizes whole, plant-based foods (fruits, vegetables, nuts, seeds, legumes, and whole grains), lean proteins, and unsaturated fats. This is similar to what the Dietary Guidelines for Americans recommend (4).

But calling the cuisines of Italy, Greece, Spain, and France specifically isn’t necessarily helpful, and many Mediterranean diet food lists lack cultural diversity.

“To say that one region (and indeed, three or four countries) eats healthy implies that other countries and their cultural foods are unhealthy, which can be stigmatizing,” says Shana Spence, MS, RDN, registered dietician At New York. .

The true Mediterranean diet extends far beyond European staples like fish and olive oil.

“Each country and/or cultural group in the Mediterranean region has its own culture and food preferences,” says dietician Alice Figueroa, MPH, RDN. “We must not only highlight European countries but also African and Middle Eastern countries.”

Expanding our idea of ​​what the Mediterranean diet looks like can also make it more sustainable and realistic for people, Spence says. “If someone doesn’t have a taste for seafood or olives, this way of eating would not be sustainable.”

Likewise, if someone can’t afford to eat these Mediterranean staples all the time, they may become discouraged and feel like healthy eating is out of reach.

On the other hand, focusing on the general patterns of the Mediterranean diet, like eating lots of plant-based foods and choosing unsaturated fats over saturated fats, makes it more flexible and customizable.

“Every culture eats vegetables, fruits and grains,” Spence says. “Add more of these foods [to your diet] is great, and there are ways to do it without thinking your particular heritage is incorrect because it’s not celebrated in the mainstream media.

Figueroa also notes that many non-European cultures incorporate similar foods: vegetable curries are a mainstay of Indian cuisine, stir-fries are a staple in Southeast Asia, Guatemalan stews are made with lots of vegetables and some meat, and Ethiopian food relies heavily on legumes.

While these dishes aren’t necessarily the ones you’ll find in Mediterranean diet cookbooks, they contain many of the same foods and nutrients.

Ultimately, staple ingredients in Greece, Italy, and Spain may not be accessible or enjoyable for everyone.

But just because you don’t eat fish and olive oil every night doesn’t mean your eating habits aren’t nutritious or that you can’t reap the benefits of the Mediterranean diet.

The Mediterranean diet is indeed nutritious and health-promoting, but its emphasis on European cuisines excludes many other cultural foods that are equally nutritious.

Instead of trying to follow the Mediterranean diet all the way, try adopting its general patterns, such as eating lots of plant-based foods and choosing unsaturated fats over saturated fats.


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