The People's Perspective on Medicine

Will a Mediterranean Diet Benefit Your Brain?

To get the Mediterranean diet benefit for cognitive and cardiovascular health, stick with mostly plants, use olive oil and stay away from processed food.

The Mediterranean diet has earned a reputation for promoting heart health, as we discuss below. Now a Harvard study suggests it can also be good for the brain, especially for people with type 2 diabetes (Diabetes Care, online May 23, 2019). How did researchers measure the Mediterranean diet benefit?

The Study on Cognitive Effects of the Mediterranean Diet:

The investigators collected information on the eating habits, blood sugar control and cognitive function from over 900 volunteers during the two-year study. The volunteers were part of a multi-ethnic study, the Boston Puerto Rican Health Study. Two-fifths of the participants had type 2 diabetes. The scientists scored the dietary information according to how closely it resembled a Mediterranean style diet. They also considered the Healthy Eating Index, the Alternate Healthy Eating Index and the score for Dietary Approaches to Stop Hypertension (the DASH diet).

People without diabetes scored higher on memory tests when they followed a more Mediterranean diet. The real rewards were to people with type 2 diabetes. Those who followed diets that most resembled Mediterranean standards scored better on a range of cognitive function tests. Only the Mediterranean diet scores correlated to cognitive outcomes, however. In addition, the Mediterranean benefit was apparent only for those who maintained good blood sugar control.

How Can a Mediterranean Diet Benefit Your Heart Health?

Previous randomized controlled trials, such as the Lyon Diet Heart Study and the PREDIMED study were conducted in Mediterranean countries. Dietary habits are different in the US. Is it possible for Americans to benefit by following a Mediterranean-style eating pattern?

Results from the Women’s Health Study published in JAMA Network Open show that American women who emphasize veggies and fruits, nuts and fish and downplay meats and sweets get a significant cardiovascular edge (JAMA Network Open, Dec. 7, 2018). The study included nearly 26,000 women over 45 years old. They answered detailed questionnaires about their diets and gave blood to be analyzed for cholesterol and other markers.

Harvard researchers scored the dietary data on a scale from one to nine for adherence to a Mediterranean style eating pattern. The categories included vegetables, fruits, nuts, whole grains, legumes, fish and olive oil, as well as moderate alcohol intake. Over about two decades, women with scores in the upper third were 28 percent less likely than those in the lowest third to suffer cardiovascular complications. These included heart attack, stroke, hospitalization for a coronary or death from cardiovascular causes.

How Would a Mediterranean Diet Protect Your Heart?

Following a more Mediterranean eating plan might not work by lowering cholesterol. Oddly, women following diets closest to the Mediterranean pattern had higher total cholesterol overall than those in the lower group. However, their markers for inflammation were lower. They also had lower glucose levels and less insulin resistance. Although this was not a randomized controlled trial, it strongly suggests that American women can help their hearts with a Mediterranean eating style.

The Many Benefits of a Mediterranean Diet:

Earlier studies already indicated that people who eat more vegetables, fruits, fish and olive reap health benefits. An analysis of 56 studies of the Mediterranean diet found that people following this eating pattern have a lower likelihood of developing diabetes, heart attacks, strokes and breast cancer (Annals of Internal Medicine, Oct. 4, 2016). To be included in the research, a study had to have at least 100 participants. Each study lasted at least a year. Volunteers needed to adhere to at least two of the following seven components:

  • more monounsaturated fat (usually from olive oil or nuts, with little if any animal fat like butter);
  • lots of vegetables and fruits;
  • plenty of legumes such as peas, beans and lentils;
  • mostly whole grains;
  • moderate amounts of red wine;
  • limited dairy products;
  • and reduced consumption of meat, with fish as a substitute.

Importantly, the diets were not restricted in fat. Many physicians and nutrition experts have thought that avoiding red meat and dairy products would be beneficial primarily because people eat less fat. That was not necessarily true for these study diets.

The Envelope:

The research can’t demonstrate cause and effect. But by now the consensus is that you can get a Mediterranean diet benefit for the heart, the brain and various other organs. Significantly, that seems to be true even for a relatively high-fat diet. People following a Mediterranean pattern lowered their chance of a heart attack or stroke by 29 percent. They were 57 percent less likely to be diagnosed with breast cancer. The risk of diabetes was 30 percent lower. The scientists didn’t detect any difference in overall death rate, however.

Myths About the Mediterranean Diet:

With more than 700 entries in the PubMed index regarding Mediterranean diet benefit, we should consider some myths that can be confusing (Nutrients, Nov. 8, 2017). Although the Mediterranean diet is plant-based, it is not a strictly vegetarian diet. Even more important, pizza is not a food that fits well in the Mediterranean dietary framework. Third, although this traditional dietary pattern includes moderate amounts of wine, people are drink it at meals, in the presence of friends and family. They do not consume any appreciable amount of other spirits. Avocado, soy and oils such as corn, peanut or sunflower oil do not belong in the Mediterranean diet, whether or not we consider them healthful. Perhaps most challenging for Americans, following a traditional Mediterranean diet means cutting out processed foods, fast foods, soda pop and sweet desserts, at least for the most part.

Do Try This at Home:

You might try to get your Mediterranean diet benefit at home by using olive oil rather than other fats and focusing on plant foods, especially vegetables, beans and seeds. Mediterranean-style menus from Italy, Spain, France, Turkey, Lebanon and Israel are delicious, so adopting such a plan shouldn’t mean sacrificing flavor. If you would like guidance on following a Mediterranean diet, you will find it in our book, The People’s Pharmacy Quick & Handy Home Remedies.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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  • Mattei J et al, "The Mediterranean diet and 2-year change in cognitive function by status of type 2 diabetes and glycemic control." Diabetes Care, May 2019.
  • Ahmad S et al, "Assessment of risk factors and biomarkers associated with risk of cardiovascular disease among women consuming a Mediterranean diet." JAMA Network Open, Dec. 7, 2018. doi:10.1001/jamanetworkopen.2018.5708
  • Bloomfield HE et al, "Effects on health outcomes of a Mediterranean diet with no restriction on fat intake: A systematic review and meta-analysis." Annals of Internal Medicine, Oct. 4, 2016. DOI: 10.7326/M16-0361
  • Martínez-González MA et al, "Transferability of the Mediterranean diet to non-Mediterranean countries. What is and what is not the Mediterranean diet." Nutrients, Nov. 8, 2017. doi: 10.3390/nu9111226
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I do not cook much and would like to know why processed meals are so frowned on. I guess this is referring to frozen dinners (better then my cooking!) and packaged mashed potatoes, prepared pasta dinners, etc? I want to know if at age 85, excellent health, no meds except 2-4 Tylenols a day (arthritic knees) do I need to worry???

Dot, the problems with processed foods include low fiber, high sodium, etc. Lots of processed foods, like potato chips or cookies, are high in calories and low in nutritional value. It sounds like you are utilizing a slightly different approach.
I would say that if what you are doing is working for you at 85, keep it up.

Looking at the diets of France, Spain, Italy, Turkey, Lebanon, Israel, as suggested, can anyone tell me what whole grains are typical in those diets? I think of baguette, croissant, pasta, risotto, couscous. None of it is usually whole grain in my experience.

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