Analysing the Mediterranean diet’s nutritious and broader health benefits three decades after it entered the food landscape reveals new insights for both athletes and non-athletes.
Often tipped as one of the leading diets to optimise nutrition, researchers and consumers have been aware of the Mediterranean diet (MD) for more than 30 years. As its name suggests, the MD comes from the traditional diets of countries along the Mediterranean Sea. Therefore, there is more than one exact version of the MD, which differs based on the country it comes from.
In 1993, the World Health Organisation’s (WHO) European Office and the Harvard School of Public Health, Oldways Preservation and Exchange Trust, introduced the MD Pyramid to serve as a guide and provide insights on the most common foods from the Mediterranean region and therefore those that feature in the MD.
Now, over 30 years on, we explore what role the MD plays in providing athletes and non-athletes with a nutritional diet and how it can support wider health.
What is the MD?
The MD diet features plenty of fruits, vegetables, cereals, olive oil, legumes, and tree nuts, a moderate amount of fish and seafood, and limited amounts of sugar-sweetened foods, carbonated beverages, and red and processed meat.
The MD primarily consists of plant-based foods with healthy fats, emphasising wholesome, colourful and natural foods. The MD diet notably differs from the Western diet, which relies heavily on high-glycemic and low-quality processed foods.
“Interestingly, the traditional MD includes a small-to-moderate intake of alcohol alongside meals, especially red wine, an excellent source of resveratrol and anthocyanins,” Silvia Barbaresi, Co-founder and CSO at Minutia.AI, a research and gut microbiota testing company for sports and longevity, told IFIS Publishing.
Recent research reveals a link to wider health benefits
A study on the MD published in July 2024 in the Journal of Nutrition and Health also suggests that following an MD rather than the traditional Western diet may have perceived stress-related benefits.
Researchers from Binghamton University explored the effects of Mediterranean and Western dietary patterns on perceived stress and mental distress. The study’s findings indicate that adhering to a MD may reduce individuals’ perception of their stress tolerance.
“Stress is recognised to be a precursor to mental distress, and research, including our own, has demonstrated that the MD lowers mental distress,” said Lina Begdache, Associate Professor of Health and Wellness Studies at the University. “Thus, one element of the puzzle may be explained by the fact that the MD may be associated with a decrease in the negative components of perceived stress and an improvement in its positive attributes,” Begdache adds.
Despite the diet’s well-known benefits for mental and physical health, the study was based on the idea that little is known about the impact of the MD on perceived stress, which refers to the stress level an individual experiences at a given moment.
Researchers surveyed over 1,500 people, asking participants about their food choices and evaluating their perceived stress levels. Their findings revealed that adhering to a MD was linked to lower levels of perceived stress and mental distress, whereas consuming Western diet components were associated with higher levels of perceived stress and mental distress.
Lead researcher Begdache noted that these findings fill a significant gap in research, as most studies on the relationship between diet and stress have concentrated on how stress impacts food choices and quality.
Furthermore, a 2019 study published in the Journal of Environmental Research and Public Health, explored the MD from an environment-driven food culture to an emerging medical prescription. Since the MD emerged 30 years ago, it has captured medical professionals’ attention by providing extended health benefits.
The researchers’ study details several large-scale clinical studies that confirmed the first of these wider health benefits as cardiovascular protection. One was the Ancel Keys’ Seven Countries Study, which showed a marked decrease in atherosclerotic clinical events in populations eating an MD diet. Further trials confirmed MD had a positive impact on metabolic syndrome risk, obesity, type 2 diabetes mellitus, cancer and neurodegenerative diseases.
However, the researchers found that while medical experts widely acknowledge the MD’s health benefits, there are significant challenges in adopting this protective dietary pattern in other geographic and cultural regions. In addition, there are also difficulties in maintaining its prevalence in traditional Mediterranean territories, which unhealthy eating habits have influenced.
Athletes adopting a MD
“Controversies are always present regarding the best dietary regime for athletes, and the urge to personalise any nutritional regime is quite comprehensible,” said Barbaresi. Yet, the MD offers an effective option for athletes alongside their training to provide adequate nutrition. “We can try to encourage a healthy diet and lifestyle for the general population following the principles of the MD,” adds Barbaresi.
The MD provides approximately 43% energy from carbohydrates, 37% from fat and 15% from protein. Following the key principles of an MD, or individual foods and nutritional compounds readily available in this dietary pattern, a 2021 research study indicates there is potential to manage oxidative stress and inflammation, reduce the risk of injury and illness, and improve vascular and cognitive function, which could lead to positive effects on both health and performance. For athletes, appropriate macronutrient intake is an important consideration.
The MD meets the dietary requirements of many athletes because it contains a good balance of lean proteins, complex carbohydrates and unsaturated fats. “However, a personalised approach is always recommended within the MD guidelines since we believe in the principle that ‘one does not fit all’,” Barbaresi states.
“Overall, it is a dietary regime rich in foods that cope with high energy demands of athletes combined with a low inflammatory index that elicits a good recovery,” Barbaresi adds. The low inflammatory index mainly derives from the abundant omega-3 fatty acid content, antioxidants (flavonoids, polyphenols, and phytosterols), seasonal fruits and vegetables, and low animal-derived saturated fats.
Athletes who adhere to the MD have reported improved aerobic and anaerobic performance. These findings suggest that this diet can enhance power and endurance training, improving body composition and peak performance. In a 2023 research study, findings revealed that the MD offers a wide variety of foods, making it easier for athletes to stick to compared to other diets. Thus “making it an optimal choice for athletes who want a variety of nutritional options in their daily routine”, Barbaresi shares.
Read more:
> Large-scale precision nutrition study explores role of personalisation
Editorial notes
Source: Interview with Silvia Barbaresi Co-founder and CSO at Minutia.AI- Research and Gut Microbiota testing for Sports and Longevity
Author interviews conducted and blog post originally written August 2024
Photo 1 by Jez Timms on Unsplash
