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Recent studies contribute to growing evidence that a Mediterranean-stylediet—rich in fruits, vegetables, grains, and olive oil—isassociated with reductions in metabolic syndrome, cardiovascular risks, andmortality.
According to an analysis of the Healthy Aging: A Longitudinal study inEurope (HALE) population, reported in the September 22, 2004, issue of theJournal of the American Medical Association (JAMA), elderly peoplewho adhered to a Mediterranean diet and a healthful lifestyle had a more than50 percent lower rate ofmortality.1
Epidemiologist and lead author Kim T.B. Knoops, MSc, of WageningenUniversity in the Netherlands, and colleagues studied 2,339 apparently healthymen and women, aged 70 to 90 years, for a period of 10 years.
Analysis of the follow-up data revealed that longevity was associated withfour protective factors: moderate alcohol consumption, physical activity,nonsmoking, and a Mediterraneandiet.
Subjects whose lifestyles included at least two of these factors were atmuch lower risk of dying from illnesses such as heart disease and cancer. Infact, subjects whose lifestyles included all four factors had a mortality rateabout one-third that of those with none or only onefactor.
MORE BENEFITS
A second study reported in the same issue of JAMA examined theeffect of a Mediterranean-style diet on markers of vascular inflammation andthe metabolic syndrome—a syndrome researchers say includes abdominalobesity, elevated blood pressure, and insulinresistance.2
Katherine Esposito, MD, of Italy's Naples University, and colleaguesstudied the effect of the diet among 180 patients in a randomized,single-blind study. Those in the intervention group were instructed to followa Mediterranean-style diet and received detailed advice on how to increasetheir daily consumption of whole grains, fruits, vegetables, and nuts.Patients in the control group, however, were told to follow a "prudentdiet" made up of 50%–60% carbohydrates, 15%–20% proteins,and <30% fats.
After 2 years, those who followed the Mediterranean diet lost more weightthan control subjects. Even after controlling for the effects of weight loss,the researchers found that subjects following the Mediterranean diet hadgreater reductions in insulin resistance and significantly lower levels ofC-reactive protein and interleukin-18, markers of cardiovascular risk.
At the end of the study period, 40 of the 90 patients who followed theMediterranean diet still had features of the metabolic syndrome, compared with78 of the 90 patients who did not follow the diet.
EXPERTS AGREE
Experts praised both studies for contributing to the body of evidenceshowing that a healthful diet can help reduce risks associated withcardiovascular disease and metabolic syndrome.
"The articles sort of speak for themselves. They'rewell-written," says Roger S. Blumenthal, MD, director of the JohnsHopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore."There's a wealth of data supporting the Mediterranean diet as probablythe healthiest approach."
"Even for those people who are eating a bad diet and may already havediabetes, if you change towards this Mediterranean diet, what the data seem tosay is that you're going to do yourself a favor," says William Evans,PhD, of the University of Arkansas for Medical Sciences in Little Rock."What you may be able to do is prevent some of the terrible symptoms orconsequences of diabetes." 
FYI: THE MEDITERRANEAN DIET AT A GLANCE
The term "Mediterranean diet" is something of a misnomer. Thereis no single Mediterranean diet. With at least 16 countries bordering theMediterranean Sea, a wide diversity of cultures and diets exists among peoplethroughout the region.
As popularly used, the Mediterranean-style diet features the following:
Mediterranean-style diets are close to American Heart Association dietaryguidelines, although the diets contain a relatively high percentage ofcalories from fat.
More than half the fat calories in a Mediterranean diet come frommonounsaturated fat—mainly from olive oil—which doesn't raiseblood cholesterol levels the way saturated fat does.
Source: American Heart Association,www.americanheart.org.
References
2. Esposito K, Marfella R, Ciotola M, et al.: Effect of aMediterranean-style diet on endothelial dysfunction and markers of vascularinflammation in the metabolic syndrome. JAMA 292: 1440–1446, 2004.
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