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Mediterranean Diet or Mediterranean Lifestyle?

May 22, 2015 09:49AM ● By Cate Reynolds
Much has been written about the health benefits of a Mediterranean diet—a menu packed with olive oil, nuts, beans, fish, fruits, and vegetables. A major study, first published on the New England Journal of Medicine’s website in February of 2013, asserted that approximately 30 percent of heart attacks, strokes, and death from heart disease can be prevented in people at high risk if they adopt the diet.

Additionally, according to the Mayo Clinic, “An analysis of more than 1.5 million healthy adults demonstrated that following a Mediterranean diet was associated with a reduced risk of death from heart disease and cancer, as well as a reduced incidence of Parkinson’s and Alzheimer’s diseases.”

Mayo Clinic experts continue by listing the key components of the Mediterranean diet:

  • Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts.
  • Replacing butter with healthy fats, such as olive oil.
  • Using herbs and spices instead of salt to flavor foods.
  • Limiting red meat to no more than a few times a month.
  • Eating fish and poultry at least twice a week.
  • Drinking red wine in moderation (optional).

Mayo concludes their advice: “The diet also recognizes the importance of being physically active, and enjoying meals with family and friends.” Which brings us to our “aha moment.”

A recent Rick Steves travelogue on PBS (isn’t he great, by the way?) showed a dinner scene in an utterly charming taverna or trattoria somewhere in Spain, Italy or Greece—not sure where, but there was lots of fish, fresh produce, wine, and hugging. What a relaxed and friendly bunch. These fathers, mothers, grandparents and offspring all welcomed Rick with open arms, joyful music, and good humor. It was a full evening of fun, not rushed or stressful. Surely, we thought, the leisurely, loving way the meal was consumed, and with whom, might be just as important for our health as the food that was eaten.

Turns out, that once upon a time there was a perfect sociological experiment to illustrate our supposition.

Welcome to Roseto, Pennsylvania circa 1961—a hilly little town of about 1,700 souls 80 miles northwest of New York City, and supported by a slate quarry which employed the predominately Italian-American residents. This off-the-beaten-path place caught the attention of Dr. Stewart Wolf (then head of the Department of Medicine at the University of Oklahoma) when a colleague, who had practiced in Roseto, told him that he had never seen anyone under the age of 55 with heart trouble.

Wolf and his research team proceeded to study the population, eventually interviewing and examining 86 percent of them, while also looking at death records, hospital information, and the lifestyles of their families. He told People magazine in 1980 that “we were surprised to find the usually accepted risk factors no different in Roseto than elsewhere. They probably ate more animal fat than most people. Smoking was about the same as elsewhere, and they were more obese. They didn’t exercise more. But they had a lower death rate from heart attack. It was lower than among Italian-Americans at large, and close to that in rural Italy.”

Dr. Wolf concluded that the one variable was the low stress level. “The community was cohesive. There was no keeping up with the Joneses. Houses were very close together, and everyone lived more or less alike.” He further explained in the People interview that families were run by strong father figures, housewives were highly respected, and grandparents revered. Also, in 1961 this was an area untouched by fast food—TV dinners hadn’t taken a foothold yet. Meals were cooked from scratch, no need for preservatives. That was true for much of America. But, Roseto was an insular, self-supporting community—the very embodiment of the “It Takes a Village” philosophy. It might be accurate to say that Roseto residents had less heart trouble because their hearts were already too full of good things.
So, enamored, Dr. Wolf ended up moving to Pennsylvania, just a few miles from Roseto. He kept tabs on the people. The end of this tale, however, may have been inevitable. Ultimately, he saw change. Roseto caught up to the rest of America. The older generation passed away, children went off to college never to return, or came back with new influences. The future came to Roseto—and so did heart disease.

“We predicted in 1963 that if the social values these people had began to erode, they would lose their relative immunity to heart disease,” he said in 1980. “That’s what happened. They weren’t going to the Marconi Social Club anymore. Cars changed from Chevys and Fords to Cadillacs and Mercedes, and even one Rolls Royce. Swimming pools and fancy houses sprouted.”

Dr. Wolf based his final report on 1975 findings. By that time, Roseto’s heart attack rate had more than doubled…and had caught up to the national average. It seems cooking with olive oil isn’t the only answer. Social and psychological stresses may play even more of a part.

Dr. Wolf apparently lived the lessons he had learned from Roseto, however. He passed away in 2005 at the age of 91.

—Sarah Hagerty