Mediterranean diet, lifestyle may lower death and cancer risk


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What is a Mediterranean lifestyle, and why might it help to lower death and cancer risk? Image credit: Paul Phillips/Stocksy.
  • A Mediterranean diet is not just a good idea for people living near the Mediterranean Sea, says a new study.
  • The study documents the health benefits of the Mediterranean diet, analyzing data from participants living in the United Kingdom.
  • Besides following a Mediterranean diet, a ‘Mediterranean’ attitude toward food and eating was even more important.

Numerous studies of people living in the Mediterranean area have demonstrated the health benefits of the Mediterranean diet — a largely plant-based diet, in which animal proteins play a smaller role than in Western diets.

A new study looks at the value of the Mediterranean diet — and the Mediterranean lifestyle — for people living elsewhere, in this case, the United Kingdom.

The study finds that higher adherence to the Mediterranean diet and lifestyle is associated with a 29% lower risk of all-cause mortality and a 28% lower risk of cancer compared to people who least follow the diet and lifestyle.

Using the questionnaire-based MEDLIFE index, the authors of the study analyzed the diet, habits, and health of 110,799 participants in the UK Biobank cohort.

The participants lived in England, Wales, and Scotland. Individuals were between 40 and 75 years old at the start of their involvement with the study — between 2009 and 2012 — and free of cardiovascular disease and cancer. They were followed until 2021.

The researchers measured people’s adherence to a Mediterranean lifestyle according to three “blocks”:

  1. consumption of foods typical of a Mediterranean diet
  2. following Mediterranean eating habits
  3. having adequate physical activity, rest, social contact, and conviviality associated with Mediterranean cultures.

All three of the above, individually, resulted in a reduction of mortality risk. The strongest reduction of cancer and all-cause mortality was associated with block three.

The study is published in Mayo Clinic Proceedings.

The block the study found brought the greatest health benefit was block three. This suggests that the Mediterranean diet is as much about one’s lifestyle and attitude toward eating as it is about its list of recommended foods.

Block three was the only block associated with a reduced risk of cardiovascular disease.

Certified nutritionist Conner Middelmann, who was not involved in the study, told Medical News Today: “That was actually my favorite finding! Many nutrition studies analyze the foods people eat, but the Mediterranean lifestyle is about so much more than food! Following a Mediterranean lifestyle isn’t just about eating hummus, a nutty granola bar, or a salad once in a while.”

The study’s corresponding author, Dr. Mercedes Sotos Prieto, explained more about what following a Mediterranean lifestyle means.

“Conviviality relates [to] the context of eating ‘how’ we eat rather than ‘what’,” she noted.

Middelmann expanded on this notion:

“It’s just as much about slowing down, enjoying life, spending time — including meals — with other people, managing your stress by taking breaks and playing, and being physically active in joyful ways like walking, dancing, gardening, fishing, swimming in a creek, etc.“

Cardiology dietician Michelle Routhenstein — also not involved in the study — explained why rest, relaxation, and leisurely socialization are so beneficial to overall health.

“When sleep, physical activity, and social connection are prioritized, these can cause a decrease in stress hormones like cortisol levels, which can improve dietary choices and metabolic functioning,” she told us.

Routhenstein said it is important to acknowledge the importance of such lifestyle behaviors on metabolic functioning, and cardiovascular health.

The Mediterranean way of eating

In addition to exercising and getting enough sleep, Middelmann cited a 2008 study which found that, when asked about eating, American and British respondents focused on the presence of nutrients such as “protein,” “carbohydrates,” or “fat”, while Italian and French respondents most often responded with the emotions that eating inspired in them, such as “pleasure” or “joy.”

That same study described the Mediterranean way of eating:

“Three meals a day at fixed hours, modest portion sizes, table manners (no phones, no TV), snacking between meals (discouraged), second helpings (frowned upon), dietary variety (essential), eating environments (tables, eating off ‘real’ dishes, not in cars, at desks or while walking).”

None of this is to minimize the health benefits of the Mediterranean diet itself.

“The mechanisms underlying the health benefits of the Mediterranean diet for heart disease include the antioxidant and anti-inflammatory properties of the foods included in the Mediterranean diet, namely fruits, vegetables, legumes, nuts, or olive oil that contain vitamins, minerals, polyphenols, [and] fiber,” explained Dr. Sotos Prieto.

The Mediterranean diet leaves a great deal of room for individual preferences. The general idea is to eat:

  • fruits, vegetables, and legumes — Middelmann recommends eating fruits and vegetables that are in season
  • nutritious, minimally processed healthy fats, such as extra virgin olive oil, nuts and seeds and their butters, and avocados
  • high-quality, whole-grain carbohydrates — Middelmann pointed out that while white bread, pasta, and rice often make their way to Mediterranean tables, their glycemic effect is offset by fiber-rich vegetables, fats, and proteins
  • aromatic herbs and spices.

It is equally important to reduce one’s consumption of:

  • dairy
  • large portions of meat
  • alcohol.

One does not need to eat foods grown in the Mediterranean to follow a Mediterranean diet.

Routhenstein described a Mediterranean-style dinner of “4 ounces of salmon — seasoned with paprika, garlic, and lemon — with a large side of asparagus and a regular baked potato.”

Middelmann also suggested an alternative that chimes with Western appetites: “A more typically ‘American’ dish might be roast chicken with [fresh and minimally unprocessed] roasted mixed vegetables (carrots, celery, onion, leeks, potatoes, green beans) and an old-fashioned, simple chocolate pudding, which can be made with nut milk to make it even more ‘Mediterranean’.”

It is also the case, said Middelmann, that contemporary supermarkets provide a wide range of ready-washed vegetables and fruits that can form the basis of a delicious Mediterranean dish.

“Whenever people eat out,” said Middelmann, “I suggest they choose restaurants whose food is both nutritious and delicious.”

She added that “[t]here are casual dining restaurants opening up all over the place these days that serve significantly more nutritious meals than old-style ‘fast food’ outlets.”

She also noted that by ordering thoughtfully, one can eat according to a Mediterranean diet at a wide range of international restaurants, including Thai, Chinese, Mexican, Italian, and Japanese eateries.



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