The most famous Mediterranean Diet study in recent years is the PREDIMED Study, a randomized control trial from Spain of 7,447 citizens, funded by the Spanish government’s Instituto de Salud Carlos III and others. This study was designed to verify observational data that following a Mediterranean Diet is linked with a lower risk of heart disease.
Results of this study were so conclusive that the study authors stopped the study early, thinking it was unfair (healthwise) to the control group to not be on the Mediterranean diet. The result was that among persons at high cardiovascular risk, a Mediterranean diet with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events by 30%. Despite the imperfections of the original PREDIMED study, its results continue to withstand scrutiny. The republished analysis, which excludes 1,588 of the original 7,447 participants due to randomization protocol, comes to the same ﬁndings as the original PREDIMED study, with an approximately 30% lower risk of major cardiovascular events.
This result begs the question: What were these Spanish participants eating? In Spain, following the Mediterranean Diet is something that families have done for years, based on the ingredients at hand, and many years of history including the Arab occupation and the introduction of foods from the New World (green and red peppers, tomatoes, beans, potatoes, corn, and chocolate, among others).
Spanish cookbook authors focus on this same point, the importance of the ingredients at hand. Penelope Casas, author of many cookbooks including The Food and Wines of Spain, writes:
“Spanish tastes in foods have been molded over the centuries by availability of ingredients. Although Spain’s mountainous terrain is generally poor dairy country and not spacious enough for cattle to graze, it is ideal for growing olive trees and grape vines and raising small animals, so the Spanish have naturally developed a taste for eggs, lamb and veal, using olive oil as a cooking base and wine as an accompaniment to all meals.”
Elisabeth Luard’s writing in The Food of Spain and Portugal describes a similar pattern:
“The strength in Spanish cooking lies in good raw materials simply and skillfully prepared. The best and freshest in the market is prepared quite simply, but in harmony with the three most important ingredients of the Spanish kitchen: the pure juice of the olive, healthiest of oils; wine, purest of all ﬂavoring broths; and garlic, most aromatic of garden herbs. From the hot plains of Castile to the cold uplands of the Basque country, the orange groves of Seville to the granite uplands of Galicia, each region has its own specialties.”
Although each region has its own distinct expression of Spanish cooking, there are dishes that translate countrywide, and can be found on menus in restaurants all over Spain.
Gazpacho and Salmorejo Gazpacho or Salmorejo are cold soups, both from the hot, southern region of Andalusia. Gazpacho was mentioned in Greek and Roman literature, but today’s version features tomatoes and peppers, foods brought to Spain by explorers from the New World in the 16th century. Gazpacho and Salmorejo are similar, although Salmorejo has a tomato base, while Gazpacho’s is pepper and onion. There are other versions of Gazpacho, notably Ajo Blanco, traditionally made with almonds.
Tortilla Espanola Ask a Spaniard his or her favorite foods, and odds are they will say eggs and potatoes. Penelope Casas wrote, “if a Spaniard were exiled to a far-oﬀ island allowed only one food, I have little doubt that he would choose eggs.” Similarly, she said, “potatoes, of course, are in a class by themselves and ever since they were introduced from South America in the sixteenth century, they have been a staple of the Spanish diet.” A classic Spanish dish found on every restaurant is Tortilla Espanola, the potato omelet! This is a very familiar dish seen at tapas bars (more about tapas below) around the country.
Paella Traditionally from Valencia or Catalonia, paella is both a dish and a cooking pan. Food writer Elisabeth Luard explains, “Paella, as all the world knows, is no more than the Catalan or Valencian name for a frying pan. The ingredients were whatever was at hand…..It was many years before it occurred to the resource citizen-restaurateurs of Valencia to add seafood to the mix.” Longtime friend of Oldways and a master at paella, Chef Norberto Jorge serves many delicious versions of paella (traditional Valencian or negro with squid ink) at his Madrid Restaurant, Casa Benigna, in a specially designed and patented cooking pan that he calls La Patella. Chef Norberto charmed us with his paella and his guitar playing at the Oldways Culinaria in Madrid.
Jamon Serrano and Croquetas It goes without saying that Spaniards love their ham, and Jamon Serrano is just one, although most common, of a number of splendid versions. It is a dry-cured ham, made from large white pigs. The ham is ﬁrmer than other dry-cured hams, such as Prosciutto di Parma. Jamon Serrano is served a number of ways, including by itself, sliced very thinly and served as tapas with wine or sherry, or prepared inside a croqueta, which Elisabeth Luard describes as a “crunchy jacket enclosing an exquisitely melting heart.” The trick is in the frying. A thick bechamel sauce is mixed with the Jamon Serrano (or whatever you choose), and once cooled and ﬁrm, it is made into little balls or logs and coated with egg and bread crumbs, and then fried in extra virgin olive oil. The croquetas are served hot, often as a tapas.
Tapas The Spanish tradition of tapas is a custom to have a glass of wine or beer and small bites to eat. The word tapa means cover or lid and originally referred to the plate of appetizers that bars (tascas) placed on the top of a glass of wine or beer. There is a wide range of tapas, some that can serve as a ﬁrst course in any Spanish dinner. In countryside tascas, the oﬀerings are most likely smaller, as compared to the tapas in large cities like Madrid, Barcelona and Seville, where people go from tasca to tasca, sampling small dishes and glasses of wine, beer, sangria or dry sherry. Tapas can also be enjoyed at home, as you can read in this description of a Sunday lunch party in Madrid.
It’s easy to see the elements of the Spanish Mediterranean Diet, just by following the Mediterranean Diet Pyramid.
Extra virgin olive oil Spain produces more olive oil than any other country in the world. In 2019, the Olive Oil Timesreported Spain made up 75 percent of the European Union’s olive production and 50 percent of the global production.
Fruit Dessert in Spain is often fresh fruit served simply.
Vegetables Olive Oil and vegetables go hand in hand, along with salads, and tapas featuring vegetables.
Whole grain bread A Spanish breakfast often features toasted or grilled bread, dressed with extra virgin olive oil. A particular Catalan specialty enjoyed throughout the country is Pa’ amb Tomaquet, which is toasted whole grain bread rubbed with raw garlic and tomato, topped with extra virgin olive oil and sea salt.
Fish and Seafood No matter where you go in Spain, ﬁsh and seafood are plentiful, whether fresh, dried, or canned.
Beans and other Legumes Beans are a staple in Spain and are often served with rice.
Nuts and Peanuts Nuts are enjoyed in sweets and also in savory dishes. There is also a famous Spanish sauce— Romesco— that is made from roasted tomatoes and peppers and is thickened with almonds or other nuts or peanuts. It’s perfect for dressing ﬁsh, meat, and vegetables.
Activity As you see on the Mediterranean Diet Pyramid, activity is important. In Spain, as in Italy, there is a tradition of leisurely walks in the evening, often in city centers. This walk is called El Paseo in Spain.
Wine Spain has plenty of wonderful red, white, rose and sparkling wines from almost all regions of the country. Sherry is traditionally produced in the southern region of Andalusia. Wine and sherry are enjoyed with food, whether it is tapas or a meal.
Despite all these wonderful foods and iconic dishes, one discouraging note cannot be ignored. As highly processed and fast food take hold in more and more countries, the adherence to the Mediterranean Diet has decreased in Mediterranean countries, along with an accompanying rise in obesity. Spain is no stranger to this phenomenon.
The Organisation for Economic Co-operation and Development (OECD), an international organization that works to build better policies for better lives, reports two out of 3 men are overweight and 1 in 6 people are obese in Spain. The proportion of adults who are overweight is projected to rise a further 10% during the next 10 years. Childhood obesity is also a big problem.
However, there is a ray of hope for Spanish children. As reported in London’s Independent:
“A chef dubbed the Spanish Jamie Oliver has won an international gastronomic prize for teaching healthy eating to school children as the country struggles to contain rising levels of child obesity. In spite of its Mediterranean diet, Spain’s rate of childhood obesity is the second highest in Europe, with 40 per cent of children either overweight or obese, according to the World Health Organisation.
Xanty Elías, 40, won the 100,000 euro Basque Culinary World Prize for his programme, which has reduced obesity among children in one of the poorest corners of Spain by 35 per cent in three years.
I go into schools and teach them about maths, chemistry and the history around food. So, take gazpacho, a typical Andalusia dish. It is made from tomatoes – but what was the history of the tomato? It was brought from the Americas by Columbus,” Mr Elias told the reporter. The chemistry involves the interaction between chemicals during cooking like using yeast to make bread rise, and in making gazpacho.”
Chef Elías’ sample lunch menu says it all — it’s The Spanish Mediterranean Diet!
- Lentils, black beans or chickpeas cooked with meat
- Fish with rice
- Fresh or dried fruit
To enjoy the Spanish Mediterranean Diet in your home, try the recipes in the Fresh Friday email and check out the Oldways recipe page. Also, look for any one of these excellent cookbooks about Spanish food and cooking.
The Food of Spain by Claudia Roden
The Food of Spain and Portugal by Elisabeth Luard
The Foods and Wines of Spain (among others) by Penelope Casas
A Taste of Spain in America by Jose Andres
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