The Mediterranean diet: Is it the food or the lifestyle?

A team of filmmakers, led by a British cardiologist, contends in a new film that the Mediterranean countries' good health is driven not only by food, but by an array of lifestyle factors

For decades, health authorities have argued that the diet of people living in Mediterranean countries, with its emphasis on olive oil, nuts and fresh produce, is a driving force behind the region's historically low rates of heart disease.

Now, however, a team of filmmakers led by a British cardiologist say the function of the Mediterranean diet might have been oversimplified. They contend in a new film that the region's good health is driven not only by food but an array of lifestyle factors, some of which they claim have been overlooked.

In their new film, they hope to show viewers how these factors come together to promote longevity and to also clarify some misconceptions about the diet itself.

The new film is called the 'Pioppi Protocol', and is set in the small town of Pioppi, Italy, just south of Naples. The filmmakers chose the town because Ancel Keys, the first scientist to champion the health benefits of the Mediterranean diet, lived there for much of the last three decades of his life.

Keys conducted epidemiological research linking saturated fat to heart disease. His work also inspired the widespread adoption of low-fat diets, which might health authorities no longer endorse.

Aseem Malhotra said he was inspired to visit the Mediterranean and spend time learning about the traditional diet in which he believes so strongly that he prescribes olive oil to his patients.

Malhotra, an interventional cardiologist and adviser to the United Kingdom's national obesity forum, said studies show that people who quit smoking see large and immediate reductions in their risk of heart attacks and strokes. But something that his heart disease patients often fail to appreciate, he said, is that changes in diet can have a similarly rapid effect.

"There is a perception among people who have heart attacks and heart disease - and I see this in my patients - that there's already so much damage there's not much they can do," . Malhotra said. "But by changing your diet, you can dramatically reduce your risk of having a heart attack even if you have coronary artery disease. We have data suggesting that the risk reduction can happen within weeks."

Malhotra visited the Mediterranean with a documentary filmmaker, Donal O'Neill. Together they noticed that a healthful diet was one of many factors that seemed to play a role in the longevity of people in Pioppi, where the average person has a life expectancy of about 90.

They were surprised by how the people they encountered enjoyed and savoured their food, turning every meal into an excuse for a social occasion with friends and family. They noticed people spent a lot of time outdoors getting fresh air. Instead of designating daily periods of time to jog or exercise, they engaged in a great deal of leisurely physical activity like walking and riding bicycles. And, they seemed to have low levels of chronic stress.

"We need to redefine the Mediterranean diet," Malhotra said. "The truth is that it's a lifestyle. It's the whole approach. It's the food. It's the social interaction. It's getting the right kind of exercise. It's being outside. It's getting sunlight and sunshine. The question, though, is how can we combine all these lessons from this village with what we know about modern medicine."
©2015 The New York Times News Service