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Healthful eating can be delicious, Mediterranean-diet study shows

Too many people have bought into the myth that healthful foods are bland and boring.

The Mediterranean diet is rich in healthful fat (especially olive oil), vegetables, fruits, legumes and beneficial, or at least less-harmful, animal products.

As food writer Mark Bittman underscores in the New York Times today, a key take-home message from a major new study on the heart-healthy superiority of the Mediterranean diet is “eating well is not deprivational, but delicious.”

That’s an important point. Too many people have bought into the myth that healthful foods are bland and boring.

The study, published earlier this week in the New England Journal of Medicine (NEJM) randomly assigned about 7,500 Spaniards, aged 55 to 80, to either one of two Mediterranean diets (one supplemented daily with four tablespoons of extra-virgin olive oil, the other with an ounce of mixed nuts) or a control diet that was intended to be low in fat. All the participants were at high risk of developing heart disease.

At the end of five years, those people in both Mediterranean-diet groups were 30 percent less likely than those in the control group to have developed stroke and other cardiovascular problems — an effect that is similar to taking cholesterol-lowering drugs, such as statins. (That’s a 30 percent drop in relative risk. Here’s another way of looking at it: For every 1,000 people who adopt the study’s Mediterranean diet, three could be expected to avoid an adverse cardiovascular-related event.)

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The results were so strong that the researchers took the unusual step of stopping the study early so that all the participants could be advised to go on a Mediterranean-styled diet.

Why this is good news

Fortunately, the study also found that the Mediterranean-styled diet was much easier to follow than the low-fat one. Indeed, the people in the low-fat group had trouble sticking to that diet plan, even when they received extra coaching halfway through the study.

And that, as Bittman points out, is why this study is good news for people who want to eat healthful but tasty foods:

The diet that seems so valuable is our old friend the “Mediterranean” diet (not that many Mediterraneans actually eat this way). It’s as straightforward as it is un-American: low in red meat, low in sugar and hyperprocessed carbs, low in junk. [The study’s Mediterranean diet discouraged people from eating “commercial bakery goods, sweets, and pastries.”] High in just about everything else — healthful fat (especially olive oil), vegetables, fruits, legumes and what the people who designed the diet determined to be beneficial, or at least less-harmful, animal products; in this case fish, eggs and low-fat dairy.”

This is real food, delicious food, mostly easy-to-make food. You can eat this way without guilt and be happy and healthy. Unless you’re committed to a diet big on junk and red meat, or you don’t like to cook, there is little downside.

More wine or less soda?

One other observation: A lot of people have joyfully noted that the “recommended” items in the study’s Mediterranean diet include a generous amount of wine: seven or more glasses per week with meals (but only for people who already drink alcohol).

What doesn’t seem to get mentioned, however, is another beverage: soda. Those in the Mediterranean groups, but not in the control group, were told to limit soda drinks to less than one per day.

Other research has shown an association (in other words, a correlation, not a direct causation) between the consumption of sodas and an increased risk of heart disease.

You can read the Spanish study in full on the NEJM’s website. Within the study (Table 1), you’ll also find a summary of what participants in the Mediterranean and control diets were encouraged and discouraged to eat. I have a feeling that sofrito, a tomato-onion-garlic-herb sauce, is about to become much more popular in the U.S.