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The Mediterranean diet – fiction: time to move on

myfoodistry - traditional cooking and modern inspiration - the Mediterranean diet hoax

My name is Chris and I live in Toronto, Canada. Among other things I am running this food blog.

In my ancestral Greek Mediterranean home we always cooked and ate the produce of that land in the ways of that land. In North America my very mention of “olive oil” or “Greek food” or “Italian food” triggers in others a Pavlov’s Dog response on the health benefits and wonders of “The Mediterranean Diet” – as if people in Florence, Algiers, Ljubljana, Cairo, Marseilles, Tel Aviv, Athens or Izmir are somehow… indistinguishable in how they cook, what they eat and how they eat it.

Curious as to the origins of the confusion and misinformation I came to realize that the “Mediterranean Diet” is a media-driven idea that started becoming a household concept in the early nineties, when “in 1993 the Harvard School of Public Health, Oldways Preservation and Exchange Trust, and the European Office of the World Health Organization (W.H.O.) introduced the Mediterranean Diet Pyramid as a guide to help familiarize people with the most common foods of the region” . (Read on.)

The gist of their story translates to “if you follow the ‘Diet’ practised in ‘The Mediterranean’ you may achieve ‘heart and brain health, cancer prevention, and diabetes prevention and control. By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease.’” 1US News – What is the Mediterranean Diet?

Alas.

There are major problems with the “Mediterranean Diet” story.

The first problem has to do with the blatant injustice the “Mediterranean Diet” story inflicts on the diverse, disparate and delicious cuisines of the +400 million people living around the Mediterranean Sea. The term “Mediterranean Diet” suggests that all the countries and regions bordering the Mediterranean Sea cook and eat in the same way – hence the name. As we shall see the culinary reality of the Mediterranean countries and regions is outright inapplicable to the notion of an implied “Mediterranean Diet”.

The second problem has to do with the real fact that no-one is able to offer a clear, unambiguous definition of the much promoted “Mediterranean Diet”. They call it a “diet” but, in reality, they present “dietary patterns”, “eating patterns” or “eating plans” that are supposedly shared by “the Mediterranean”. As we shall see, these terms, often used loosely in everyday speech, are not interchangeable: a “diet” is not the same as an “eating pattern” when medical/health claims are involved.

The third problem has to do with the credibility of the science supporting the medical/health claims this “eating-pattern-called-diet” of “the Mediterranean” is all about. As we shall see, the statistical correlation of dietary patterns is at best inadequate as a method to supply the necessary link between dietary cause and medical effect that the “Mediterranean Diet” story purports to provide.

In this post/article I am jotting down certain thoughts as to why, in my mind, the much promoted “Mediterranean Diet” story is pure diet-fiction. As I was researching the subject I came to realize that yes, there is truth in some of this; but that truth is not “Mediterranean” at all.

What’s in a name?

The Mediterranean diet - fiction: time to move on | myfoodistry

The “Mediterranean Diet” story suggests that all cultures bordering the Mediterranean Sea constitute a homogeneous region that grows the same produce and cooks and eats food in the same, indistinguishable way. Otherwise… why call it “Mediterranean”?

In actuality the Mediterranean Sea is the geographic nexus of 3 Continents, 24 countries, 12 languages, 4 religions and +400 million people. We will probably be surprised to know that the majority of the population of the Mediterranean is Muslim.

In terms of food and cooking the countries and cultures bordering the Mediterranean could not be more disparate. For example, Crete (Greece, Europe) is about 300 km or 186 miles away from Libya (Africa) on a straight line. This is the same amount of distance separating New York from Boston and less than the distance between Toronto and Ottawa. Regardless of the geographical proximity, the Libyans abhor pork; but the Cretans adore it in every shape and form.

The same level of disparity characterizes the food and cooking of Florence and Algiers, Izmir and Tel-Aviv and Ljubljana (Slovenia) and Cairo – among others. To better illustrate the point let’s compare a popular Slovenian dish (Bograč) to a popular Egyptian dish (Koshari)

You will probably agree with me that, metaphorically speaking, these two represent the two sides of the Moon. That is no surprise when one takes into account the lands, or terroirs, these two recipes come from.

myfoodistry - the Mediterranean diet fiction
Slovenia
myfoodistry - the Mediterranean diet fiction
Egypt

Yes, Slovenia and Egypt are both on the Mediterranean Sea.

So, what do you think? Does it look like the respective diets of where these two dishes come from, namely Egypt and Slovenia, can “differ slightly” as Harvard says they do? (Read on.)

The list of the cultural and dietary differences comprising the Mediterranean basin is long. Some of the most significant include the following:

  • The minority of the Mediterranean peoples (Christians) eat pork and drink alcohol.
  • The majority of the Mediterranean peoples (Muslims) abhor pork and alcohol.
  • The Jewish people of the Mediterranean do not eat pork, do not mix meat and dairy, do not eat seafood but do drink alcohol.
  • The Muslims of the Mediterranean do not eat pork, eat seafood and they mix meat and dairy.
  • The Christians of the Mediterranean eat pork and seafood, drink alcohol and also mix meat with dairy.
  • The Muslims of the Mediterranean follow the Ramadan (a 30-day period of consuming neither food nor drink from sunrise to sunset).
  • The Christian Catholics fast on Ash Wednesday and Good Friday and abstain from meat on all Fridays during their 40-day Lent and all Fridays through the year are fish-only but there are no dietary restrictions on meat-based sauces and gravies or animal fat.
  • The Greek Orthodox Christians fast at regular intervals from 95 to +120 days per year. During the fasts and Lents they abstain from any and all animal products, including eggs and fish, but not seafood. For the rest of the year they drink alcohol in moderation and eat red meat, white meat and fish roughly once a week or 72 times per year (total including all three categories).

Religious dietary differences may not present themselves as significant to the modern reader. However, they were very significant at the time of initial research, namely in the 1950s and 1960s because people back then did observe dietary stipulations imposed by religion.

So far, we established differences among the culinary cultures of the Mediterranean. Are there any similarities that can actually justify the suggestion of a “Mediterranean Diet”?

Um… actually, no.

When it comes to food,

The Mediterranean countries have one thing in common: they border the Mediterranean Sea. Apart from that, they vary in religion, culture, ethnicity, economy, political status, and food supply. Consequently, the diet varies from place to place and country to country. It has been difficult to find a common denominator for all the countries, but several of them seem to have in common the use of locally produced foodstuffs, like vegetables and olive oil.” 2Kiple, K. E., & Ornelas, K. C. (Eds.). (2000)
The history and culture of food and drink in Europe
Cambridge World History of Food (Vol. 1, pp. 1193–1203). Cambridge, UK
Cambridge University Press

It seems that the much-promoted idea of the “Mediterranean Diet” has very little to do with the Mediterranean itself.

Well, in fact, it is not even a diet.

What is “The Mediterranean Diet”?

The Mediterranean diet - fiction: time to move on | myfoodistry

I ran a web search on “Mediterranean Diet, definition”. Alas. Instead of a definition, all I ended up with is the consistent lack of definition. Here are some of the results. Emphasis is mine.

Time Magazine

There’s no one book or website to follow if you want to learn about the Mediterranean diet, and there’s no one way to structure a meal plan around it. …/… The Mediterranean diet also includes alcohol in moderation—traditionally, wine with meals —and encourages sitting down to meals as a family or a group, rather than rushing through them on-the-go.

Mayo Clinic

…/… While there is no single definition of the Mediterranean diet, …/… Other important elements of the Mediterranean diet are sharing meals with family and friends, enjoying a glass of red wine and being physically active.

UNESCO

The Mediterranean diet as a nutritional recommendation is different from the cultural practices that UNESCOlisted in 2010 under the heading “Mediterranean diet” on the Representative List of the Intangible Cultural Heritage of Humanity: “a set of skills, knowledge, rituals, symbols and traditions concerning crops, harvesting, fishing, animal husbandry, conservation, processing, cooking, and particularly the sharing and consumption of food”, not as a particular set of foods. Its sponsors include Italy,  Spain,  Portugal,  Morocco, Greece, Cyprus, and Croatia.

US News

The Mediterranean Diet may offer a host of health benefits, including weight loss, heart and brain health, cancer prevention, and diabetes prevention and control. By following the Mediterranean Diet, you could also keep that weight off while avoiding chronic disease. There isn’t “a” Mediterranean diet. Greeks eat differently from Italians, who eat differently from the French and Spanish. But they share many of the same principles.

American Heart Association

There’s no one “Mediterranean” diet. At least 16 countries border the Mediterranean Sea. Diets vary between these countries and also between regions within a country. Many differences in culture, ethnic background, religion, economy and agricultural production result in different diets. But the common Mediterranean dietary pattern has these characteristics:

  • high consumption of fruits, vegetables, bread and other cereals, potatoes, beans, nuts and seeds
  • olive oil is an important monounsaturated fat source
  • dairy products, fish and poultry are consumed in low to moderate amounts, and little red meat is eaten
  • eggs are consumed zero to four times a week
  • wine is consumed in low to moderate amounts

Harvard School of Public Health

The traditional diets of countries bordering the Mediterranean Sea differ slightly so there are different versions of the Mediterranean diet. However, in 1993 the Harvard School of Public Health, Oldways Preservation and Exchange Trust, and the European Office of the World Health Organization introduced the Mediterranean Diet Pyramid as a guide to help familiarize people with the most common foods of the region.

More of an eating pattern than a strictly regimented diet plan, the pyramid emphasized certain foods based on the dietary traditions of Crete, Greece, and southern Italy during the mid-20th century. [1,2] At that time, these countries displayed low rates of chronic disease and higher than average adult life expectancy despite having limited access to healthcare. It was believed that the diet—mainly fruits and vegetables, beans, nuts, whole grains, fish, olive oil, small amounts of dairy, and red wine—contributed to their health benefits. The pyramid also highlighted daily exercise and the beneficial social aspects of eating meals together.

There are additional points that make this eating plan [Mediterranean Diet] unique:

  • An emphasis on healthy fats. Olive oil is recommended as the primary added fat, replacing other oils and fats (butter, margarine). Other foods naturally containing healthful fats are highlighted, such as avocados, nuts, and oily fish like salmon and sardines; among these, walnuts and fish are high in omega-3 fatty acids.
  • Choosing fish as the preferred animal protein at least twice weekly and other animal proteins of poultry, eggs, and dairy (cheese or yogurt) in smaller portions either daily or a few times a week. Red meat is limited to a few times per month.
  • Stressing daily physical activity through enjoyable activities.

Basta. Enough.

Confusion reigns supreme

The Mediterranean diet - fiction: time to move on | myfoodistry

Do I really need a PhD to figure out that confusion reigns supreme, here?

  • From the 24 countries around the Mediterranean Sea only 6 endorse the idea of a “Mediterranean Diet”. The 7th country endorsing it, namely Portugal, does not even border the Mediterranean. It is situated entirely on the Atlantic Ocean.
    • If we are to include Portugal in the Mediterranean what prevents us from including Austria in the list? After all, Austria’s border is only 90 km or 56 miles away from the Mediterranean coast. Portugal’s border is more than 200 km or 124 miles away from the Med.
  • The majority of the sources consider the (24) Mediterranean countries as having “common (dietary) principles”.
    • Well… as we already saw, they don’t. The only things they share is vegetables and olive oil – much in the same sense that East Asia shares vegetables and soy sauce. Is this enough to support the idea of “common dietary principles” in the Mediterranean? (Nope.)
  • UNESCO again (by way of Wikipedia) considers “The Mediterranean Diet” to be a set of skills, knowledge, etc. instead of a particular set of foods.
    • This definition of the “Mediterranean Diet” does not even involve… food!
  • Harvard, (yes, Harvard) recommends… avocados and salmon as ingredients of the “Mediterranean Diet eating plan”.
    • Well, avocados and salmon are neither indigenous to the Mediterranean, nor are they – or have ever been – a food staple of the Mediterranean.
  • The same Harvard suggests that the “Mediterranean Diet” has “different versions” because the countries bordering the Mediterranean “differ slightly”.
    • We did compare a popular Slovenian dish to a popular Egyptian dish. We also saw pictures of the lands they respectively come from. Do they “differ slightly”? A common mortal like myself would not dare suggest that the dietary differences between Ljubljana (Slovenia) and Cairo (Egypt), or between pork-adoring Barcelona and pork-abhorring Algiers, or between meat-and-dairy loving Izmir and meat-and-dairy detesting Tel-Aviv is… “slight”. But Harvard can.
  • Further on to Harvard’s description of “the Mediterranean Diet” we read that it is “More of an eating pattern than a strictly regimented diet plan”.
    • If it’s an eating pattern why do they call it a diet? If it’s a diet, why do they call it an eating pattern? As we shall see these terms are not interchangeable when medical/health claims are involved.
  • And, here’s the best part: all but one (UNESCO) of the aforementioned sources accept moderate amounts of alcohol, mostly red wine, as an integral part of the “Mediterranean Diet”.
    • Well, more than half (that is: +200 million) of the Mediterranean population is Muslim: alcohol is Haram (forbidden) to them by religion – particularly so in the cultural context of the 1950’s – 1960’s when initial research took place. So, what are they talking about?

All in all, no one here is in position to offer a single, unambiguous definition of the alleged diet of the Mediterranean.

At the same time, almost all of them are quite busy describing the magnificent health benefits of the “pattern” or “principles” of a diet that has no single, unambiguous and clear definition.

Marvellous.

So, why and how on earth did the “Mediterranean Diet” fiction become a household concept?

The timeline

The Mediterranean diet - fiction: time to move on | myfoodistry

As the story goes…

After World War II the Greek government was concerned about the living conditions of the population and saw the need to improve these conditions. They invited the Rockefeller Foundation to carry out a major epidemiological survey on the island of Crete to find out how best to raise the standard of living for the population. The epidemiologist Allbaugh (1953) carried out an investigation into the life of the population in Crete. Included in this study was a survey of the dietary characteristics of the members of one out of every 150 households on the island.

The survey of the dietary characteristics showed that the population had a mainly vegetarian diet, with a lot of cereals, vegetables, fruits, and nuts and only small amounts of milk, meat, and fish. Olive oil and bread were part of every meal, and wine was consumed in moderate amounts. Wild herbs were also gathered and used.

Although Allbaugh and the Rockefeller Foundation were the first to record the diet in Crete, Keys was the person who first showed an interest in the diets in southern Italy and Crete and possible health effects. He noticed the very low rates of heart disease in the regions, and together with colleagues, he started a series of investigations in seven countries into diet and other factors that could cause coronary disease.3From Greece To Norway With Useful Knowledge.

From then on…

The concept of a Mediterranean diet was developed to reflect “food patterns typical of Crete, much of the rest of Greece, and Italy in the early 1960s”. Although it was first publicized in 1975 by the American biologist Ancel Keys and chemist Margaret Keys the Mediterranean diet failed to gain widespread recognition until the 1990s. Objective data showing that Mediterranean diet is healthful originated from results of epidemiological studies in Naples and Madrid, confirmed later by the Seven Countries Study, first published in 1970, and a book-length report in 1980.4Wikipedia: https://en.wikipedia.org/wiki/Mediterranean_diet#cite_note-1

Finally…

…/… in 1993 the Harvard School of Public Health, Oldways Preservation and Exchange Trust, and the European Office of the World Health Organization introduced the Mediterranean Diet Pyramid as a guide to help familiarize people with the most common foods of the region. 5The Nutrition Source, Harvard School of Public Health.

In short:

  • Leland G. Allbaugh researched the diet of the Cretan Greeks between 1949 and 1951, and published a study called “Crete: A Case Study of an Underdeveloped Area” in 1953. He found that although the diet of the Cretan Greeks of that time was scarce, their health was excellent.
  • Inspired by Allbaugh’s study, Ancel Keys et al. embarked on their famous (or infamous) “Seven Countries Study”. Although said study did include… Japan, it was accepted as the scientific base for the medical/ health attributes of the “Mediterranean Diet” idea.
  • Many years after that, in 1993, the Harvard School of Public Health, Oldways Preservation and Exchange Trust, and the European Office of the World Health Organization published their “Mediterranean Diet Food Pyramid” – thus cementing and promoting the idea of a “Diet” of the “Mediterranean”. The media – and others – took it from there.

As we can clearly see, the entire “Mediterranean Diet” discourse sprang from Allbaugh’s research in Crete, Greece c.1950.

What did Allbaugh find in Crete, Greece, between 1949 and 1951?

Allbaugh, Crete and the missing attribute

The Mediterranean diet - fiction: time to move on | myfoodistry

Leland G. Allbaugh was an epidemiologist and an Assistant Director in the Social Sciences department of the Rockefeller Foundation. Shortly after WWII the Rockefeller Foundation accepted the Greek Government’s invitation to conduct an epidemiological survey on the island of Crete citing, among other things, that:

Crete has been almost untouched by the industrial revolution or by the technological changes in agriculture which have accompanied the development of modern science. Its population, for the most part, is descended from families that have inhabited the land for generations, and the manner of living has not essentially changed for centuries. Over 80 per cent of the people live in rural areas, giving their major effort to the raising of food.” 6Rockefeller Foundation, Annual Report, 1949, p.41.

Starting in 1949, Allbaugh’s team researched the diet and way of life of the Cretans for two years. Much to their astonishment, they found the opposite of the famine and malnutrition they assumed to expect.

In Crete, expecting to find widespread malnutrition, Allbaugh’s researchers instead discovered the local diet to be “surprisingly good” and noted that the Cretans had an exceedingly low rate of chronic Western diseases. They suffered about a third as many heart disease-related deaths as Americans at the time and had barely any incidence of cancer. No matter how underdeveloped Crete might have been in terms of roads, plumbing and other typical markers of “progress,” it seemed they were far ahead of the U.S. when it came to eating well. 7Eating Well

Unfortunately, the one thing Allbaugh did not mention in his study was that the diet of the Cretan Greeks c.1950 was dictated by the strictly regimented Greek Orthodox dietary code.

In reverse, given that the place was Crete, Greece and the time period was 1949-1951, Allbaugh could not have researched or studied something other than the daily life application of the Greek Orthodox dietary code – practised by the overwhelming majority of the Cretan Greeks in their daily lives back then.

The Greek Orthodox dietary code calls for Lents and fasting at regular intervals for a total number of days ranging from 95 to +120 days per year. The major Lents and fasts of the Greek Orthodox are spread out in three main periods: 40 days before Christmas, 40 to 48 days before Easter and 15 days before August 15. The strongly devout also follow other minor fasts and Lents among these three periods, increasing the total number of Lent and fast days to approx. 200 days per year.

During their Lents and fasts the Greek Orthodox abstain from any and all animal products, including eggs and fish – with the exception of seafood.

During the regular, non-Lent, periods the Greek Orthodox go vegetarian for 4 days per week and drink alcohol only in moderation. They eat red meat, white meat and fish roughly once a week per category. The result is something like 24 fish dishes, 24 white meat dishes and 24 red meat dishes… per year.

This was the diet (as opposed to “eating pattern”) whose results Allbaugh’s study observed as beneficial to the health of the Cretan Greeks c.1950.

I suggest that the results of Allbaugh’s research c.1950 were subsequently generalized by others, namely Ancel Keys et al., to apply to other countries or regions bordering the Mediterranean Sea.

Ancel Keys et al.

The Mediterranean diet - fiction: time to move on | myfoodistry

Ancel Keys was an American physiologist known for the creation of the ready-to-eat portable meals known as K-rations that were used by the American army during World War II. He also conducted landmark research on the causes of heart disease and promoted the Mediterranean diet, which emphasized fruits, vegetables, and olive oil. 8https://www.britannica.com/biography/Ancel-Keys

Ancel Keys et al. reached scientific fame (or infamy) with their Seven Countries Study. Here’s a section from the abstract:

Ancel Keys and his Italian colleague Flaminio Fidanza and their SCS colleagues were central to the modern recognition, definition, and promotion of the eating pattern they found in Italy and Greece in the 1950s and ’60s, now popularly called “The Mediterranean Diet.” They showed together with their colleagues that dietary patterns in the Mediterranean and in Japan in the 1960s were associated with low rates of coronary heart disease and all-cause mortality.”

What we learned from the Seven Countries Study

The number of Mediterranean countries Keys et al. included in the Study was only three: Greece, Italy and two regions (now countries) of former Yugoslavia: Croatia and Serbia. It is worth mentioning that Serbia is landlocked – it does not extend to the Mediterranean Sea. 9Serbia is Greek Orthodox but during the time of the Seven Countries Study Serbia was a part of Communist Yugoslavia. Communist rule actively discouraged and suppressed expression of religion in Serbia during that time. But let us choose to forego this “detail” and carry on.

The medical/health nature of the claims attributed to the Seven Countries Study’s “Mediterranean” eating/dietary patterns and/or principles (e.g. reduced heart disease and all-cause mortality etc.) suggest a proven and unambiguous link between dietary cause and medical effect. As many have since pointed out, this may not have been the case.

Effectively, Ancel Keys et al. linked the medical/health attributes of the religious dietary code of the Greek Orthodox Cretan Greeks to “eating patterns” or “dietary patterns” found elsewhere in the Mediterranean by way of… correlating mortality statistics and F.A.O. balance sheets. 10The Truth About Ancel Keys: We’ve Got It All Wrong

What Every Doctor Should Know About Ancel Key’s Experiments

Can statistical correlation link dietary cause to medical effect?

Um… no, it can’t.

Statistical correlation is unable to prove causation.

For example, if “the consumption of ice cream and the number of murders in New York are positively correlated (i.e. both rising) then as the amount of ice cream sold per person increases, the number of murders increases”. The statement is statistically correct. But can you seriously suggest that the number of murders in New York increases because people in New York began eating more ice cream?11How Statistical Correlation and Causation Are Different

In plain language, Ancel Keys et al. statistically correlated apples to bananas suggesting that “eating patterns” found elsewhere in “the Mediterranean” (bananas) can be linked to the good health stemming from the religious dietary code of the Cretan Greeks c.1950 (apples).

Their method and results left a lot to be desired. E.g. among other regions they also included Greece’s Crete and Corfu in the Seven Countries Study.

…/… However, the diets of these two islands, Crete and Corfu differed from each other rather markedly with an appreciably higher fat content in Crete. Moreover, the available evidence on the Greek diet in the 1960s is limited to only two specific and possibly atypical and unrepresentative island sites, so it would be unwise to extrapolate the diets of either of these islands to the main-land as only 5 and 1% of the Greek population lives in Crete and Corfu.12The high-fat Greek diet: a recipe for all?
European Journal of Clinical Nutrition (2002)

If this is how two regions of the same country compare, what would an all-out comparison of the multitude of countries, regions, cultures and religions bordering the entire Mediterranean Sea be like, I wonder?

Anyhow, the scientific community of the time had few good things to say about the conclusions of the Seven Countries Study. But, at any rate, Ancel and Margaret Keys captured North American imagination by publishing two diet books revolving around their study – Eat Well and Stay Well in 1959 and How to eat well and stay well. The Mediterranean way in 1975. Their books became best-sellers and the rest is history.

But why and how did Keys brand his science in a manner that implies a single “diet” that is purporting to be characteristic of “the Mediterranean”?

I cannot be certain as to why. But there can be an explanation as to how. Let us now examine the wonders of reverse causality.

Reverse Causality and the Mediterranean diet – fiction

The Mediterranean diet - fiction: time to move on | myfoodistry

According to Katz (2006) 13What is Reverse Causality?

… identifying reverse causality is sometimes a matter of “common sense.” For example, a study might find that brown spots on the skin and sunbathing are linked. While it is plausible that sunbathing can cause brown skin spots, it’s highly unlikely that the brown spots cause sunbathing.

This gives us a handle to better understand how Allbaugh’s Cretan Greek brown skin spots came to cause… Mediterranean sunbathing. To better illustrate the point let’s employ a few direct yet equally absurd analogies.

The Lake Ontario Diet

You research the diet of the Torontonians and you somehow find that it results in less heart disease compared to “eating patterns” found elsewhere around Lake Ontario. Alright. Would you name the diet of the Torontonians “The Lake Ontario Diet”? (Nope.)

The Great Lakes Diet

Had Detroit, Michigan followed a diet somehow leading to less heart disease compared to “eating patterns” found elsewhere around the Great Lakes… would you name the diet of Detroit “The Great Lakes Diet”? (Nope.)

The East China Sea Diet

The Seven Countries Study also associates the diet of Japan to low rates of coronary heart disease and all-cause mortality.

Splendid.

China, Korea and Japan share the East China Sea. In fact they share soy sauce and vegetables much in the same way that Greece, Italy and Egypt share vegetables and olive oil.

Would you name the diet of Japan “The East China Sea Diet”?

Nope.

If the suggestion of an East China Sea Diet is unacceptable, how is the suggestion of a Mediterranean (Sea) Diet reasonable?

Why not, then, also equate “Astronomy” with “Astrology”? After all, they both have the word “Astro” in common.

The bottom line here is that, in light of the information above, plain common sense is able to dismiss the idea of a “diet” of the “Mediterranean” as the obvious, perhaps preposterous, by-product of reverse causality.

Nevertheless, Harvard, the Oldways Preservation and Exchange Trust and the European Office of the W.H.O. were indeed able to propose and promote such reverse a causality with their “Mediterranean Diet Pyramid”, summa cum laude.

Wondrous, isn’t it?

The Mediterranean diet – fiction : concluding remarks

myfoodistry - traditional cooking and modern inspiration - the Mediterranean diet fiction

Have you ever walked away from a medical doctor’s office holding in your hand a piece of paper listing “patterns of medication”? If you have, chances are that your region’s medical board would like to know about it. But you haven’t. You walk away with a prescription, dictating how much of what you should be taking when and for how long to achieve a certain health goal.

It is the same with diets. You consult a dietitian because there’s a medical/health goal you want or need to achieve. You don’t walk away from her/his office waving “eating patterns”. You go away with clear instructions as to how much of what to eat when and for how long. In my mind that’s what the word diet means (or ought to mean) when medical/health claims are involved.

As such, plain common sense is telling me that if I am hoping to imbibe “weight loss, heart and brain health, cancer prevention, diabetes prevention and control, etc.” chances are that following “no one way of structuring a meal” around “eating patterns” portrayed to represent a “diet” that is supposedly shared by a so disparate and heterogeneous a region as “the Mediterranean”… will not get me very far.

On the other hand, following a regimented diet may give me a better chance of staying healthy through cooking and eating, as shown by the Cretan Greeks’ centuries-old Orthodox diet, all the way up to the 1950’s.

After all, this is what Allbaugh studied in Crete c.1950s and this is what other scientists are discovering today when researching the health effects of diets born of scarcity no matter where they come from. 14Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete.

Does the periodic vegetarianism of Greek Orthodox Christians benefit blood pressure?

A critical review of current evidence, perspectives and research implications of diet-related traditions of the Eastern Christian Orthodox Church on dietary intakes and health consequences.

Unravelling the metabolic health benefits of fasting related to religious beliefs: A narrative review

Health Benefits of Islamic Intermittent Fasting

Is Ramadan fasting related to health outcomes? A review on the related evidence,
Islamic Fast and Health

Effects of Intermittent Fasting on Health, Aging, and Disease

Religious Fasting in Hinduism

Ramadan, Lent and other fasting periods have benefits for body and mind

The impact of religious fasting on human health

Fasting for Health and Longevity: Nobel Prize Winning Research on Cell Aging

A week of Danjiki (Buddhist fasting ritual) on cardiometabolic health: a case report

As this point I feel totally comfortable to freely and summarily dismiss the “Mediterranean Diet” idea as pure diet-fiction. It ran its course. It is now time to move on; embrace applied, shared human wisdom and eat happily ever after.

Be well,
Chris G

Written for myfoodistry – traditional cooking and modern inspiration
All rights reserved.

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