It began in the 1970s with a discovery that people living on the island of Crete in the Mediterranean Sea had some of the lowest cholesterol levels in the world. In fact, while more than 40 per cent of the daily diet of Cretans traditionally came from foods rich in fat, death rates on the Greek island were 57 times lower than in countries like Finland, Holland and the US.
Researchers began unravelling the ancient Cretan diet and discovered that, throughout the Mediterranean, there are key elements to this style of eating.
All the fats eaten are healthy fats from foods like oily fish, olive oil and avocado, and diets are also high in fresh vegetables, fruits and whole grains. Meats are lean and limited to a couple of times a week and desserts, pastries and highly processed foods are rarely indulged in.
And the evidence supporting the healthy impacts of the 'Mediterranean diet' continues to build. From helping to fight frailty as we age and reducing the risk of heart disease to lowering the risk of vision loss and helping to manage depression, the benefits of Mediterranean eating are many.
"It's not a low-fat diet but it's about good quality fats, plenty of fruits, vegetables and whole grains and it's an ideal way of eating for people of all ages," says Marisa Nastasi, an accredited practising dietitian at Baker Heart and Diabetes Institute. "You can very easily bring elements of the Mediterranean diet into your daily eating plan."
Mediterranean-style eating can feed the body and the brain. Researchers in Scotland found older adults who eat plenty of fresh fruit, veg and olive oil have less brain shrinkage as they age than men and women who eat more meat and dairy.
"As we age, the brain shrinks and we lose brain cells, which can affect learning and memory," says researcher Dr Michelle Luciano. "This study adds to the evidence that suggests the Mediterranean diet has a positive impact on brain health."
Research suggests the diet can halve the volume of brain loss that comes with ageing. "The higher consumption of fish provides a high level of omega-3 fats, which are important for brain function and grey matter," says Nastasi.
Boosting the number of people eating a Mediterranean diet may help reduce deaths from cardiovascular disease each year.
The University of Cambridge found men and women who closely follow Mediterranean-type eating have a six to 16 per cent lower risk of disease. More than 19,000 deaths in the UK due to cardiovascular disease could be prevented each year with Mediterranean-style eating and less red and processed meats, ice creams, soft drinks, sugary desserts, sweet biscuits and commercially baked cakes.
"A Mediterranean eating pattern is low in saturated fats – the fats that have a negative impact on cholesterol and the development of heart disease," says Nastasi.
"But unsaturated fats like nuts, seeds and olive oil have a protective effect on the heart. They reduce cholesterol in the blood and this reduces cardiovascular disease."
Age-related macular degeneration (AMD) is the most common cause of vision loss in Kiwi adults.
Around one in seven adults over 50 experience the disease that begins with gradual loss of central vision. But Mediterranean foods, particularly a diet that includes at least 150g of fruit a day, helps reduce the risk of AMD.
Eating more foods rich in antioxidants, such as beta-carotene and vitamins C and E, was also protective, say researchers from the University of Coimbra in Portugal.
"The fruits and vegetables, particularly dark leafy green vegetables with plenty of antioxidants and polyphenols, help fight the nasties in our body," agrees Nastasi. "The evidence is not yet 100 per cent, but there are definite signs of improvement in this area of eye health."
Women who use IVF treatment may improve their chances of conceiving by following a Mediterranean diet before treatment. Researchers at the University of Athens found women who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil – and who ate less red meat – had a 65 to 68 per cent greater chance of becoming pregnant than women who didn't eat these foods.
"Women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may help increase the chances of successful pregnancy and delivering a live baby," says Professor Nikos Yiannakouris.
He adds it's important for men to follow a similar diet to improve sperm quality.
At the Food and Mood Centre at Deakin University in Melbourne, researchers are uncovering links between diet and depression and, yet again, eating the Mediterranean way scores major points.
Researchers placed adults who'd been diagnosed with depression in two groups – one followed a Mediterranean diet and the second group ate their regular, more Westernised diet and received weekly visits from researchers as social support. After three months, one third of people in the Mediterranean diet group reported significant improvements in their mood and symptoms of depression.
Dr Sarah Dash of Deakin University says researchers are interested in how the different types of bacteria living in the gut may play a role in diet and better managing or reducing the risk of depression. Gut bacteria help make serotonin, one of the natural chemicals in our body that improve mood."There are lots of pathways leading to the brain that might originate in the gut. For example, when fibre is broken down in the gut it can have anti-inflammatory effects and that's good for mental health because inflammation is a risk factor for depression and chronic disease," explains Dash.
"Omega-3s are also good for brain health and are found in whole grains, legumes and healthy fats. The Mediterranean style of eating is protective against ageing on the brain and memory loss, too. There are a lot of factors about our health that we can't control, such as genetic predisposition, but our diet is within our control."
Almost two in three adults in New Zealand are overweight or obese, as are a third of Kiwi children. And the link to excess weight and increased risk of cardiovascular disease, type 2 diabetes and some cancers has long been established. If you want to maintain a healthy weight, the Mediterranean diet is a useful and sensible way of eating beyond fad low-fat or high-fat diets - think the ketogenic diet.
A five-year study found people lost more weight with a Mediterranean diet rich in healthy fats like extra virgin olive oil, dried fruit and nuts compared to a low-fat diet. "Calories are derived from good fats but there's a balance of whole grains that are not processed and vegetables and salad," says Nastasi. "People do better with these foods because fat and whole grains can be filling. So people don't eat as much and their waistline reduces. That's important because we know when people carry a lot of weight around their waist, major organs are cushioned with fat and don't work as well. That can lead to chronic disease."
A diet full of plant-based foods and low to moderate amounts of fish, lean chicken and wine can boost your chances of staying stronger in older age. A four-year study of elderly people found those who ate a diet typically found in Greece and Southern Italy were less than half as likely to become frail. Those who stayed strongest also ate minimal amounts of saturated fat and sugar.
"Nutrition is thought to play a crucial role in developing frailty and we found the Mediterranean diet may help older individuals maintain muscle strength, activity, weight and energy levels," says Dr Kate Walters of University College London.
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