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Crete: Decline And Fall Of The Mediterranean Diet

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#1 chorianos



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Posted 07 July 2010 - 05:10 AM

By Margot Krijnen, Maastricht University

About 45 years ago, the incidence of cardiovascular diseases and cancer was very low in Crete: until recently, in the valley of Messara, only one third of the national Greek level and much, much lower than in the Netherlands. Today, these diseases occur almost as often in rural Crete as in the rest of the country. No wonder the Cretan people became concerned. Media coverage about this strange increase of diseases led to a public outcry for thorough investigation. What was going on? Did it have to do with environmental factors, pollution? Was there a factor that could and should be controlled? The Cretan prefecture commissioned a study. Dr. Constantine Vardavas conducted the research and earned his PhD on the subject at Maastricht University.

What exactly was the famous Mediterranean diet?
“It consisted of bread, fruit, vegetables, wild greens, olive oil, some fish, few dairy products and hardly any red meat,” says Constantine Vardavas. “In fact, only seasonal products from the region that the people harvested from their own open air cultivation. That required hard physical work on the land. The key aspect of the diet was olive oil, which accounted for up to 40% of the daily calorie intake. Moreover, their Orthodox Christian religion prescribed almost 200 annual days of fasting, when they were not allowed to eat foods of animal origin, dairy products, and fish. So, part of the year the Cretans consumed an almost vegetarian diet.”

How did you approach the study?
“We recruited 662 farmers, aged between 18 and 79, took blood and fat samples and submitted them to a thorough clinical examination. Moreover, we asked them to write down exactly what they ate every day and how much physical exercise they had. In other words, we performed a complete clinical, dietetic and lifestyle assessment on each of them. The results were stunning. We found that the famous Mediterranean diet no longer existed. Over the past 45 years, the consumption of fruits and vegetables had dropped from 655 grams per day to 400 grams per day, while the meat intake jumped from 35 grams per day to 124 grams per day. We could monitor this alteration in dietary habits by comparing adipose ‘fat’ composition among farmers in 1962 and in 2005. This comparison indicated a decrease in mono-unsaturated fatty acids and an increase in saturated fatty acids in the human fat. Just as you can tell a tree’s age from looking at its rings, looking at the fat composition in the human body gives you clear insight in the person’s dietary habits.”

How did this happen? What made the Cretans change the diet they had adhered to for centuries?
“The changes were brought along by a combination of factors. There was the tourist industry boom in Crete in the seventies, the introduction of mass super markets with imported food, and the fact that the Cretans were no longer as strict about fasting. Whereas in the 1960’s farmers cultivated and consumed their own produce, they now grow commercially profitable foods and spend less time cultivating their own fruit and greens. They found out that it is much easier to go to the supermarket and buy food rather than actively cultivate the produce they need to sustain an entire family. So, their lifestyle has become much more sedentary. In the sixties, the farmers walked on average 12 kilometres per day to their fields. Now they drive there in their four-wheel drive cars. Even the shepherds, the healthiest people ever on Crete, now use their motorbikes to go their herds.”

Your research has definitely proven the effectiveness of the original Mediterranean diet?
“Adherence to this diet has been shown to have a protective effect on the development of cancer, cardiovascular diseases and overall mortality. It lowers the blood pressure, increases the good cholesterol HDL, and lowers the bad cholesterol LDL. We believe that the magic ingredient with the beneficial effects is the concurrent interaction between all the micronutrients and vitamins. A good example of the power of the Mediterranean diet is the fact that smoking habits never changed on Crete. Already in the sixties, the studied Greek farmers smoked, and they still do. Their diet used to protect them from developing the diseases that come along with smoking, as it counterbalanced the negative effects of smoking on health. Now that the diet no longer exists, the Cretans get the same diseases as the rest of the world.”

How did the participating farmers respond to the results?
“They were, of course, startled when they realized they had let their health to slip through their fingers. They all received a folder with their blood test results and the assessment of their dietetic lifestyle, but also with a proposal on how they could improve their health status by implementing basic personal guidelines. We actually also managed to locate and treat a few developing cancers. For sure, the population got a strong wake-up call!”

What will be done with the conclusions of your research?
“Our findings and those of other studies on the Mediterranean diet were brought forward and a call for action was made in Greece. Consumer knowledge is extremely important and information should be provided from childhood on. In Greece, there are no comprehensive health education lessons in schools. Because of the great increase in obesity, the great lack of physical activity, and the smoking rates, we have had discussions with the Ministers of Health and Education to include health promotion as a core lesson in primary schools and to educate teachers to become proper role models in the schools. Perhaps we can convince the Greek population of the future to go back to the famous en beneficial Mediterranean diet. The diet of great health.”

Constantine Vardavas PhD defended his thesis “Public Health implications of the Mediterranean diet; its interaction with active and passive smoking” at Maastricht University on May 27th. His promotor was prof. Wim Saris, from the Faculty of Health, Medicine and Life Sciences. Contact: [email protected]

#2 Julie


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Posted 21 July 2010 - 05:36 PM

What an interesting study this is - and how sad. Thank you for bringing it to our attention.