The Mediterranean Diet gets lots of buzz, but do you know what it really means to eat like a Mediterranean? In a meta-analysis of 27 studies, researchers estimate that every 2-point increase in Mediterranean Diet Score (0-9 scale) is related to an 11% lower risk of heart disease. Additionally, the researchers also analyzed the consistency between Mediterranean Diet Scores in different studies, and clarified the importance of using a standard definition of a Mediterranean diet, which emphasizes “vegetables, fruits, nuts, legumes, and mainly unrefined, minimally processed cereals; an abundant fat intake from virgin olive oil… a moderate consumption of fish and shellfish, a low consumption of meat… the consumption of wine during meals… and fermented dairy products.” In order to successfully transfer Mediterranean diets outside of the Mediterranean, the researchers also note the importance of following the Mediterranean Diet eating patterns (such as drinking a moderate amount of wine with meals throughout the week, rather than binge drinking on weekends) and choosing traditional foods (such as olive oil and beans) rather than untraditional foods (such as margarine and tofu).
Nutrients. 2017 Nov 8;9(11). (Martinez-Gonalez et al.)

Fish is well recognized for its role in a heart-healthy diet. To learn more about how fish eating relates to heart disease risk in a Mediterranean population, scientists analyzed the eating patterns and health outcomes of nearly 21,000 Italian adults. Those eating fish at least 4 times per week were 40% less likely to develop coronary heart disease than those eating fish fewer than 2 times per week. This relationship is primarily driven by fatty fish, like salmon, trout, herring, mackerel, and canned fish. Strokes were also studied, but the trend toward lower stroke risk in frequent fish eaters was not statistically significant.
Nutrition, Metabolism, and Cardiovascular Diseases. 2017 Aug 23. pii: S0939-4753(17)30198-9. (Bonaccio M et al.)

“Everything in moderation” is a favorite mantra of nutrition professionals around the world, and research helps explain why. Scientists from the University of Southern Denmark analyzed data from more than 70,000 Danish adults who were surveyed about their health and drinking habits throughout a 5-year period. The lowest type 2 diabetes risk (43% lower risk) was observed in men who drink 14 drinks per week, and in women (58% lower risk) who drink 9 drinks per week, compared with people who avoid alcohol. The frequency of drinks mattered too. Researchers found that drinking alcohol is linked with lower risk of diabetes for those drinking 3-4 days per week, even after adjusting for weekly alcohol consumption.
Diabetologia, 2017 July 27. (Holst C et al.) [Epub ahead of print]

In order to clear up confusion about how different dietary fats relate to heart health, the American Heart Association published a Presidential Advisory on Dietary Fats and Cardiovascular Disease. In this paper, the researchers reviewed randomized controlled trials (the gold standard of nutrition research) as well as prospective observational studies (following large groups of people over long periods of time and noting their health outcomes). After reviewing all of the evidence, they concluded that replacing saturated fat (the types of fats found in red meat, butter, and milk) with polyunsaturated fat (found in fish, nuts, and seeds) can lower the risk of heart disease by 30%, which is on par with what cholesterol lowering medications can achieve. Similarly, they found that eating more monounsaturated fat (found in avocados, olive oil, and canola oil), more polyunsaturated fat, and less saturated fat is linked with lower rates of heart disease. Saturated fat is also linked with higher rates of “bad cholesterol” (LDL), which is thought to build up in artery walls and pose a risk for heart disease. These findings are in line with healthy dietary patterns around the world, including the Mediterranean diet.
Circulation. 2017 Jun 15. [Epub ahead of print.] (Sacks FM et al.)

Even if you don’t live in the Mediterranean, you can still follow a Mediterranean diet pattern emphasizing healthy foods like fish, whole grains, legumes, and olive oil. In a study of 1,194 Puerto Rican adults in the U.S., researchers analyzed their diets using several different health scores and also collected health measurements from the participants to look for relationships between diet and cardiometabolic health. Those whose diets most closely aligned with a Mediterranean diet were significantly more likely to have smaller waist sizes, a lower BMI, lower levels of inflammation (as measured by C-reactive protein), and lower levels of insulin resistance. The DASH Diet score and Healthy Eating Index 2005 score were not significantly associated with any health measurement, while the Alternative Healthy Eating Index was only weakly associated with some positive health markers.
The Journal of Nutrition. 2017 Apr;147(4):661-669. doi: 10.3945/jn.116.245431. Epub 2017 Mar 8. (Mattei J et al.)