Mediterranean Diet and cardio-vascular health: an historical perspective

Abstract

Abstract The first investigation of dietary intake in the Mediterranean region was undertaken at the initiative of the government of Greece in 1948. Plant foods (cereals, pulses, nuts, potatoes, vegetables and fruits) accounted for 61% of total energy intake (TEI), animal foods (meat, eggs, fish, and dairy products) for 7% of TEI, and olive oil was the main oil used. In 1950s, Ancel Keys undertook studies in USA, Italy, Spain, England, Japan, Australia, Canada leading him to hypothesize that a link could exist between diet, plasma cholesterol and coronary heart disease (CHD). Between 1958 and 1964, Keys and co-workers carried out the Seven Countries Study, which enrolled men aged 40-59 years in one of 16 cohorts from seven countries (Finland, Greece, Italy, Yugoslavia, Japan, USA and Italy), After 15-y, 25-y and 50-y follow up, a strong positive relation was observed between saturated fat intake and CHD mortality, and a negative one with Mediterranean Dietary Index. In 1975, Keys and his wife published a book intitled: “How to eat well and stay well. The Mediterranean way”, which popularized Mediterranean Diet (MedDiet). After 45-y follow-up longevity without CHD death was 12.9 years higher in Crete than in Finland. Protecting effect of MedDiet towards CHD incidence and risk is now confirmed by PREDIMED Study and by cohorts’ studies gathered in several recent meta-analysis. MedDiet is sustainable and recognized by UNESCO as an Intangible Cultural Heritage, which is the most beautiful homage that can be paid to Ancel Keys and all his co-workers.