The truth about the Mediterranean diet | ZOE Dailies with Christopher Gardner

Hello and welcome to Zoe, Science and Nutrition and our special daily

diet

series. Each day this week we're examining one of the world's most popular

diet

s, putting the latest scientific evidence under the microscope, we'll discover that these diets have a real impact on your health. I'm your host Jonathan Wolf and I'll be joined throughout this series by Professor Christopher Gardner. Hello Christopher, it's a pleasure to be here. Jonathan Christopher is a professor of medicine at Stanford University and director of nutrition studies at the prestigious Stanford Prevention Research Center. He is one of the world's leading researchers and how our diet affects our health, so what's on our plate today?

Christopher in episode 6 Jonathan, we're taking a trip to the Mediterranean for lunch Christopher, I definitely know you're talking about the Mediterranean diet. right, yes, we recently had Professor Walter Willet from Harvard on the show, and I think he's widely hailed as sort of the Godfather of modern nutrition and he's been talking about the benefits of the Mediterranean diet for decades, but what is it? Exactly the Mediterranean diet? Mediterranean diet and I like to ask all Americans this because I feel like I visited a lot of places in the Mediterranean and they seem to eat very different food if you're in Spain or Italy or you know somewhere like Morocco.

I think this is a great question to ask and the answer is olive oil, it's just olive oil, eat whatever you want during the day and at night put some olive oil next to your bed, drink it and in the morning you can claim your Mediterranean. I feel like maybe there's a little more to this Hello, I'm delighted you're here to find out if eating Mediterranean style can improve your heart health if you haven't already hit the subscribe button and the bell to turn on notifications so you can. know. Every time a new episode arrives, this will really help us continue our mission of improving the health of millions.

I don't think the average person can describe the Mediterranean diet to you. In fact, we have several ratings of the Mediterranean diet and you should eat more vegetables, more fruits. more beans, more whole grains, they have a controversial one where they say you should have a little alcohol, not none or much, but they actually criticize you for not having any, which is pretty controversial right now, you get a point for eat moderately, but you're supposed to Reduce meat and dairy consumption, but even the dairy part is controversial, so when I find and look at this, I see that some of the scores count dairy against it, while some say the Yogurt is Mediterranean, so what's the general idea of ​​this?

I guess it's a little bit in the name, but help me understand what the Mediterranean diet type of concept is. It really is a whole plant-based flexitarian diet, so from all the names you could give it it sounds Mediterranean. something sexy ah oh I love the temperate climate and I love all the foods from all those different cultures uh it certainly includes fish uh and it probably includes modest amounts of meat but actually some of my favorite descriptions of the Mediterranean diet are the lifestyle that goes with that, which is often not discussed, which is why in some of the older data it is recognized that people who followed, quote, the Mediterranean diet had better health outcomes, they were shepherds who walked miles every day caring for their flocks and took a nap every afternoon. for three hours it was hot Nap every afternoon I want a three hour nap every day settle for 30 minutes Christopher so really if you come back uh some of the original data was from the people of Creit who did this and you know how the At the same time, it is one of the few diet patterns that actually has data.

They actually randomly assigned thousands of people to this and tracked them for years and years and saw that it saved lives, it saved hospital bills, so that's amazing because it's very rare in nutrition science, right, that there are studies. that really intervene to get people to change what they eat and study this long enough that you can see long-term effects on ultimate health conditions like having a heart to address stroke because it's very, very difficult, but in In this case you're saying there's actually really hard data and I have an underlying reason for this, so it's fun, it's tasty, it's not low fat, it's got avocados, fatty fish, nuts and seeds.

I can imagine randomly assigning people to eat their usual diet or switch to this Mediterranean diet that a lot of restaurants serve and it sounds good, as opposed to I need you to eat vegan or keto or some other restrictive diet where people aren't willing. to enroll in that or if they are, they can follow it for a short period of time and you've made an excellent point that there is a difference in these studies as to whether we're studying long-term health outcomes or short-term impacts. on risk factors, which is actually what I do for a living.

I study blood cholesterol, blood pressure, blood glucose and insulin. These are all things you can change in your diet in weeks or months, but what we're really interested in is what we're really interested in. It's about long-term health and to study it you have to follow it for years and years and years and years because you want to know if people live many more healthy years, so I guess, by definition, you have to wait years to find out if that What would happen if you lowered your cholesterol but died of misery or boredom or something? It's like, I lowered my cholesterol but I hate life, so the Mediterranean is kind of forgiving if you think about the things that come from cultures that practice this. meditate say but you're right.

I'm sure it's different in Morocco, France, Italy and Greece. It's not a diet, but it has this theme: it's a whole food, plant-based diet, so I think people listening will be Okay, that sounds really interesting. I'm still completely confused about what it is. Maybe you could contrast it, for example, with the typical American or British diet, which are quite similar. What's the difference between that if you switched to a Mediterranean diet? What would you be? What would you be doing? In fact, I think the best contrast is with this low-fat diet that's been so ubiquitous for so long, the Mediterranean diet, when you get to the fatty fish, the avocados, and the nuts. and the seeds and olive oil poured generously over the entire salad are 40% fat or more, okay, so there's quite a bit of fat in that diet, quite a bit of fat, and in fact, we did this study on the ketogenic diet. versus the Mediterranean and it was a It was a lot of fun, we actually increased the Mediterranean diet up to about 50% fat and the fat feels good in your mouth, it tastes good, but it's unsaturated fat, so when we go back to that type of misunderstanding the low-fat message that we always try to understand.

The low saturated fat Mediterranean diet is a diet low in saturated fat and high in plant-based unsaturated whole foods, so there is not a lot of meat in the Mediterranean diet, yes, when you look at the Mediterranean diet scores, you They criticize meat and livestock and um processed. meats and things like that, yeah, so again, it's not necessarily, as I understand it, completely excluding meat. You could eat a Mediterranean diet with some meat, but somehow this is once a week or something instead of three times a day or it would be a smaller portion so it's not a steak or a pork chop or roast beef in the center of the plate with some vegetables and starch on the side so that it is like a Mediterranean salad with Greek cheese or it is an eggplant moussaka or I just great names that sound wonderful and therefore are likely to meet several times a week, but it's like a side instead of a big piece of meat with a little bit, it's one of the ingredients here, so you've added a little bit of fish or you've added a small amount of lamb or you've added so, what?

What else would be the difference when going from this low-fat diet to a Mediterranean diet? Really, the main focus for me is Whole Foods, okay, I know the whole thing. the food doesn't make any sense, so really what we mean is that yes, in those bakeries you would have bread where you would go to the bakery every day and you wouldn't get this white Wonderbread that will last forever on the market because it would spoil. They, in a sense, took out all the things that would have perished on the shelf, so they will remain there forever.

No, no, this has some oils, it has some nuts and whole grains, yes, that would spoil and the bugs. You would eat them if you left them on the shelf because we hope you buy this food and eat it soon. It's cooler. It is perishable. Yes, and it really is that these cultures that you know for centuries had those types of foods. built on thousands of years of wisdom and they taste great and they sound great and you talked about a kind of whole grain. Could you help people understand a little? I think you've explained the fat side of this, what would that mean for kind of the type of carbs on your plate, yeah, especially in the US, in the case of grains, we eat mostly wheat and refined wheat, so, What about millet, quinoa, barley and farro?

There are many cereals with which you can make a cereal-based salad or a grain-based dish, put vegetables, nuts and seeds and maybe a little fish or yogurt so that the whole grain is not the flow that is all pulverized , would be the one that grew while cultivating this crop and harvesting it. the whole grain before being pulverized and ground into pulp, is interesting. I was in Athens earlier this year, where my co-founder George is from, and a couple of things stood out to me, obviously it's definitely a Heartland. of the Mediterranean, the first thing is the amount of beans they eat as part of their traditional dishes, something that in the United States and the United Kingdom we are not used to and have left aside. and the other thing is the enormous amount of olive oil that they put on everything, yes, yes, very generously, they put olive oil and other oils, so I don't want to exaggerate the olive oil.

I think most oils are fine, as long as you not only drink them well, but cook with them and season beans with them. I would love to take advantage of the fact that beans are so underrated in the US that many cultures have a diet based on grains and beans because they are their storage. their capacity is really excellent, you dry grains and beans, they are full of nutrients, they are full of fiber, they are economical as a whole, so they are really good for feeding populations that may not have all the resources for fancy foods , so Beans are very underrated and there are many types of beans, kidneys, chickpeas, lentils and legumes, as if the general name is legumes.

I don't know in the UK, but in the US no one says legume like they do, no one says leg, I mean honestly, I have no idea what a legume is, but legume is a general name that covers soybeans, peas, lentils, legumes and chickpeas, which technically botanically are all different subcategories of legumes, so Christopher, what happens to your body if you switch from this traditional US or UK United? Diet to the Mediterranean diet and why you have seen those benefits in your heart, for example, as a result. Well, I think the biggest issue, which honestly doesn't get played much, but was in the study we did on Keto versus Mediterranean.

In fact, we call it the Mediterranean diet plus. Our main emphasis was to get rid of added sugars and refined grains well, and that in the US makes up 40% of our calories, so here are some calculations that I would love to share on this question, so imagine that the 60% of your calories are a combination of three types of mono and polysaturated fats, let's say 10 each and then you get 10% of your calories, like they do in yes, from good carbohydrates and 10 or so from each animal protein and vegetable that adds. up to 60 and the remaining 40 are added sugars and refined grains. 40% of people's caloric intake comes from added sugar, just junk added on top of something else, it's junk, so this is like ultra-processed, so as soon as you remove that 40%. of calories that a low-carb diet would be because it was made up exclusively of carbohydrates, refined grains, and added sugars, so this is the way I would love to frame it.

And if you replaced all that with beans, vegetables and plants, you would have a very low-fat diet? diet because you replaced bad carbs with good carbs. Don't know. Most people can't eat that many calories from beans and vegetables. It's very bulky, so you got the low carb content. People would say, "Oh, all that should have been fat, please move." all 40% is due to fatty things and thatIt's also pretty difficult unless you're going to eat meat, which would be a lot of avocados, a lot of nuts and seeds, a lot of fatty fish, and then what happens inside your body when you make that change that actually provides these health benefits, so I still think our main problem is that too many simple carbohydrates get into the bloodstream too quickly, causing an excessive rise in insulin, so this is like a blood sugar jump in your Monitor Sugar Level in the blood now with the continuous glucose monitors that I know Zoe has based on a lot of her studies, it's fascinating that we're learning about the temporal sequence of what you're absorbing from your diet that goes into your blood and gets left out and this Mediterranean diet because it has less added sugars and refined grains and fewer total carbs because you have more fat is really going to slow all of that down, so what are the potential challenges for someone who says well, that's the first one.

Christopher You seem to think about what the possible challenges are in trying to adapt. Adopt this diet to be a whole foods diet.and it requires some cooking uh I know a lot of people don't cook they don't shop order I will say there are a lot of people doing this if you want to go out and find the Mediterranean there are certainly a lot restaurants and lots of food. food delivery services that provide this it takes more time to cook so at home it's easier to cook at home in some of these other ways the downside of the Mediterranean is that it has enough flexibility that some people get confused if it's this Mediterranean or No, I'm not sure if I'm doing the right thing.

I read this recipe, so I don't think it has many downsides other than focusing too much on the olive oil or just not being sure what exactly fits that category. One of the things that we see with the thousands of people who are starting the um as members of Zoe and starting their program each week is that for many of them it is difficult to understand how to move on from who they are. eat now because people eat in many different ways, right? If we were to talk to everyone listening right now, there is an extraordinary diversity in the way we are all accustomed to eating, understanding how to change and take steps so that you can get to something much healthier is much more difficult with what you just described, which I think for most people is pretty close to um uh, you know the basics that they're probably going to end up with that just saying you know eliminates all fat or eliminates all carbs correctly, that is counting your calories, it's very simple, whereas what you're describing I think is more complicated, so I think there's a real challenge for people and it's one of the reasons I've been doing this podcast for a long time to help people. people to understand more about how they might adapt.

You know many aspects of your life to improve your health. It is very consistent with a separate article we wrote for the ketogenic versus Mediterranean diet study. adherence, like how we measure adherence and we had constructed the Mediterranean diet to be similar to what a normal score would be plus less added sugar and refined grains, so we actually called it Mediterranean plus and ketogenic, we had a well-formulated ketogenic diet and so on. On some of these scores, the Mediterranean people were not doing as well as the Keto people and when we looked at this more closely, they said ah Keto was just eating low carb.

They got a lot of points for eating low carb Mediterranean. They were supposed to achieve a higher fat content. uh, more legumes, more whole grains, and very quickly we realized that there were many categories that were supposed to be achieved every day to follow this Mediterranean diet and much more, to your point, yes, there are many more goals and objectives to achieve. once so while you're transitioning yes I nailed the beans one oh I forgot the whole grains yes I nailed the olive oil but I left this one out it would take time which is fine.

I think listeners should cut themselves some slack here. and I say I'm learning about olive oil I'm learning about beans I'm learning about whole grains I don't have to do it all at once I enjoy this I enjoy that I'm going to give myself months to figure out what this is and I'm going to appreciate all the different options that I have and now I feel more comfortable with the whole package. It's not something easy that you can solve for tomorrow. I totally agree and think I would do it. just add that we were talking about this um you know right before we record that it can be very difficult if you go shopping, you know, to the supermarket, to understand what to buy because a lot of the food that we have today has all these labels that these big manufacturers they're putting it on and you know they're basically misleading, like you, they say in big letters, you know, low fat and they don't mention all the things that they've done to this food or, you know, a lot of the food that's in on the shelves is actually very processed, ultra-processed, but that's not very visible, so I think it's quite difficult for something like this diet that you're describing to understand well.

Well, is this the kind of highly added ultra-processed sugars that you're describing Christopher or is it actually whole grain because, unfortunately, there are a lot of things that pretend to be healthier than they are true? Yes, and I know buyers want something simple. They would like to be able to go to the store and say it on the label. I saw that sign, that symbol and it meets my criteria. We do not have the symbol of the Mediterranean diet because there are many different ways to comply with it. and I'm very sorry, it's not that easy to identify until you adapt it, adopt it and enjoy it well, it's definitely something that I want us to be able to solve in the future, but I think we should recognize one of the challenges, that is the challenge, So Christopher, what's your verdict on the Mediterranean diet?

Double thumbs up and again you might misinterpret it and think it's just olive oil, but get over that and go ahead and take that afternoon nap if you get the chance and go out and walk your flock of sheep, but if you can't do it, go for a walk because it's part of the Mediterranean lifestyle, it's like going outside, getting some exercise, getting enough sleep and eating well. Whole-grain foods. Plant based diet with enough room for some animal foods that you could include or exclude great, well I'm excited to be able to put this all together tomorrow in our normal long form.

I'm excited too, thanks Christopher, okay, thanks Christopher for our journey through the Mediterranean diet. part of our special series of daily episodes about diets and our health. I'm Jonathan Wolf and Christopher Gardner. Join us tomorrow for our full weekly Zoe Science and Nutrition episode, where we'll complete our diet analysis. and providing our verdict on the healthiest diet to follow, as always, Zoe's Science and Nutrition Podcast is not medical advice, it is for general informational purposes only, until next time.