Mediterranean diet: Importance of individual components

The Mediterranean diet is associated with lower overall mortality, but the relative importance of the various components of the diet is unknown. A study in Greece has provided some pointers.

The study included 23,349 men and women. After an average follow-up of 8.5 years, mortality was 652/12,694 among people with a Mediterranean diet score of 0–4 and 423/10,655 among people with a score of 5 or more. After controlling for confounders, the Mediterranean diet was associated with a significant reduction in mortality of 14% per 2-unit increase in score. Moderate consumption of alcohol contributed 23.5% to this reduction; low consumption of meat and meat products, 16.6%; high consumption of vegetables, 16.2%; high consumption of fruit and nuts, 11.2%; high monounsaturated: saturated fat ratio, 10.6%; and high consumption of legumes, 9.7%. High intake of fish and seafood was associated with a non-significant increase in mortality. High consumption of cereals and low con­sumption of dairy products had little effect.

The most protective components of the Mediterranean diet are moderate alcohol intake, low intake of meat and meat products, and high intakes of vegetables, fruits, nuts, olive oil and legumes.

Trichopoulou A, et al. Anatomy of health effects of Mediterranean diet: Greek EPIC prospective cohort study. BMJ 2009;339:26–29.