How exactly is the US interpretation of “the Mediterranean diet” misinformed? In an epic-fail kind of way.
For decades, beginning with its inspiration of the USDA’s first Dietary Guidelines, we’ve been led to believe in a model of this allegedly health-promoting “Mediterranean diet” that is largely plant-based, rich in whole grains, low in fat, saturated fat, salt, and animal protein and fat.
This mainstream concept and faith in it persists despite several gaping holes in the science that underlies it.
The Gaping Holes in “the Mediterranean Diet”
I’ve observed four main holes in the logic behind the popular unquestioned concept of “the Mediterranean diet.” The current concept of the Mediterranean diet neglects
(1) changes in standard dietary practices since the introduction of Western and industrial foods to Mediterranean regions. 1, 2, 3 (This will come as a shock to many: the USDA’s low-fat, grain-and-cereal-focused food recommendations (the old Food Pyramid and new MyPlate) have never been tested for health benefits.)
(2) that traditional Mediterranean diets varied and vary greatly by region (the Mediterranean covers a huge hunk of land!).
(3) that traditional Mediterranean diets have not included as many grains as they have unprocessed animal-products, fats (usually animal-sourced), and oils.
(4) that cuisines in many regions actually include about 40 percent more sodium than the USDA tells us to eat (think of all those sodium-rich foods like olives, sardines, anchovies, prosciutto, parmesan, etc.).4, 5
Not surprisingly, the USDA’s first Dietary Guidelines, set forth in 1980, and which have remained in effect for more than thirty years—and which Americans have tried their darndest to follow—were written by political staffers, as opposed to scientists, nutritionists, and dietitians. Who woulda thunk?
It should come as no surprise then that since 1980, the number of obese people in America has more than doubled, and the number of those with type-2 diabetes has tripled. 6, 7
The Experts Weigh In on Low-fat Diets
Dr. Janet King, Chairwoman of the 2005 Dietary Guidelines Advisory Committee:
“[E]vidence has begun to accumulate suggesting that a lower intake of carbohydrate may be better for cardiovascular health [than a low-fat diet].”
The Institute of Medicine’s 2005 Dietary Reference Intakes Report:
“…lowfat, high-carbohydrate diets may modify the metabolic profile in ways that are considered to be unfavorable with respect to chronic diseases such as coronary heart disease and diabetes.”
The 2010 report, penned by six highly-credentialed authors, “In the face of contradictory evidence: Report of the Dietary Guidelines for Americans Committee” unearths research that demonstrates a lack of
“sufficient evidence to conclude that increases in whole grain and fiber and decreases in dietary saturated fat, salt, and animal protein will lead to positive health outcomes.”8
John P. Salerno, MD, board certified family physician:
“Low-fat patients are my most unhealthy patients….The reason we are spiraling into diabetes and obesity is because of the low-fat concept developed by the U.S government decades ago. Low-fat diets have a low nutrient base, and phytonutrients in vegetables cannot be properly absorbed without fat.”9
Basically, fat is mega important for good health, and since we’ve been nixing fat, including animal-sourced fats (what with our exaltation of “the Mediterranean diet”), we’ve been replacing it with things that aren’t good for us.10
People Don’t Actually Lose Much Weight on a Low-fat Diet
What is the supposed logic behind low-fat diet recommendations for weight-loss?
Fat has 9 calories per gram, in comparison to carbohydrate’s and protein’s 4 calories per gram—factoids we’ve taken to mean that if you eat less fat, you’ll by default eat less calories and lose weight.
While that logic looks alright on paper, it doesn’t hold up so well in clinical tests.
Take for example the $100-million Women’s Health Initiative (WHI), a rigorously-controlled clinical trial in which the 50,000 women who enrolled were thoroughly counseled to eat lots of grains, fruits and veggies, with no more than 20 percent of their daily calories from fat.
According to the WHI, after three years of this extremely low-fat diet, the women lost an average of one kilogram each—a little over two pounds.
Two pounds in three years! Talk about epic fail.
In general, according to Gary Taubes, expert on the dietary fat and cholesterol controversy, “the results of well-controlled clinical trials are consistent: people on low-fat diets initially lose a couple of kilograms, as they would on any diet, and then the weight tends to return. After 1 to 2 years, little has been achieved.”
So why exactly are low-fat diets so ineffective for weight loss, and how do they increase your chances of heart disease and diabetes?
To answer this question, we have to ask another: what nutrient replaces fat in a low-fat diet (aka “the Mediterranean diet”)? Usually carbohydrates (as seen in the WHI study). Herein lies the problem.
Too Much Fat Isn’t The Problem, Too Many (and Poorly-sourced) Carbohydrates Are the Problem
There are three kinds of carbs: sugar, starch, and fiber. Fiber isn’t digestible, can help your body eliminate waste, and doesn’t spike blood sugar—fiber is cool.
On the other hand, starch eventually breaks down into sugar in the body. As sugar and starch consumption increase, the body makes more insulin to collect sugar from the blood, and tells your body to store fat (exactly the opposite of what you want!), laying the foundation for weight-gain, diabetes, and heart disease.
So even if you count every gram of fat that enters your mouth, throw out the yolks of your eggs, and avoid butter as if it was that ebola-monkey from the movie Outbreak, you’re not helping matters when it comes to weight loss. Frustrating much!
To make things worse, low-fat diets are hard to maintain because they tend to lack flavor and don’t satisfy. Meals made up of mostly carbohydrate and very little fat are digested quickly, leading to blood sugar highs and lows that can make you seem like a cranky PMS-ing monster for no apparent reason, or an insomniac zombie in the office at 2:00pm.
Unless you’re looking to not enjoy meals and walk around hungry and out of sorts, low-fat diets, including “the Mediterranean diet,” basically make for an unsustainable lifestyle.
Research Demonstrates the Opposite of a Low-fat Diet is Better for Your Health
On the other hand, the opposite diet—higher fat and lower carb—has actually been shown to reduce the risk of diabetes (by decreasing fasting blood sugar and improving insulin sensitivity), as well as heart disease (by improving cholesterol and triglyceride values, and lowering inflammation).
Read more about the myriad health benefits of not just fat, but saturated fat in my two-part series Why Is Saturated Fat Good For You?
And learn more about how important it is to source protein from animal foods, despite what “the Mediterranean diet” espouses, in my article Protein Myths: DEBUNKED! (Animal vs Plant Protein).
Why then do some people swear by a low-fat diet? Most likely because when people keep tabs on fat, they also become more conscious of their eating habits on the whole, thereby nixing processed food or at least excessive amounts of it.
That said, while some people may stay on track with weight management by paying attention to numbers, health hackers are not interested in nit-picky calorie-counting.
If you simply can’t resist the urge to number-crunch labels (you know who you are), check out the grams of sugar per serving. Doing so will give you an idea of how truly “fattening” your food choices are.
The Bad Guy that Ends Up On Your Hips and Thighs
See, sugar is the bad guy that ends up on your hips and thighs. And while it is true that not just sugar, but also excess starchy carbohydrates can do the same thing, sugar is more addictive and leads to overeating by tweaking insulin levels in funky ways.
Even the nutritionally conservative American Heart Association recommends a maximum intake of 25 grams of added sugar per day (though this message gets little media attention).
Yikes! That’s just 6 teaspoons of sugar or 2/3 of a 12oz can of soda. Sweet crap adds up quickly!
One thing remains clear though: the body responds to different macronutrients in different ways when it comes to storing their associated calories as fat.
So a new question arises: are calories even a reliable tool of measurement for weight management?
While calories are clearly one way to quantify energy provided by food nutrients, research indicates human biology responds to calories from different sources, well, differently. (Read more about this in article: 6 Reasons Why You Should Stop Counting Calories to Lose Weight.)
The Dangers of a Low-fat Diet
Still not convinced about the dangers of a low-fat diet, as exalted in “the Mediterranean diet?” If you just can’t seem to shake your fat-fearing mindset, consider the following things a low-fat diet might predispose you to:
• infertility and menstrual disorders
• heart disease
• lowered immunity.
In fact, researchers have never been able find a culture in the history of the world that was able to continue its line on a diet devoid of fat-rich animal foods (I talk about this in my book). There’s a simple, obvious reason: your body needs fat.
Don’t Buy Into All That Non-fat Greek Yogurt Hype
And don’t let all the non-fat Greek yogurt that flies off grocery store shelves fool you: traditionally, cultures (Greek, Icelandic, etc.) removed fat from yogurt not in an attempt to avoid fat, but in an effort to eat it in/as other foods, like butter. The non-fat yogurt was just a byproduct, and unlike our modern practices in the US, traditional cultures didn’t let much food go to waste.
In fact, in some Scandinavian countries, it was recommended people eat what most Americans would consider to be ghastly amounts of butter per week during the frigid winter months. Such recommendations certainly weren’t made because fat was considered unhealthy.
Nope, fat was and is a prized giver of health. On the other hand, the American interpretation of “the Mediterranean diet,” is not.
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1 Vareiro, D., et al. “Availability of mediterranean and non-mediterranean foods during the last four decades: comparison of several geographical areas.” Public Health Nutrition 12(9A), 2009: pp. 1667-1675. http://www.ncbi.nlm.nih.gov/ pubmed/19689838
2 Romaquera, D., et al. “Food patterns and mediterranean diet in western and eastern mediterranean islands.” Public Health Nutrition 12(8), 2009: pp. 17741781. http://www.ncbi.nlm.nih.gov/pubmed/18838026
3 Fallon-Morell, S. and M. Enig. “The Mediterranean Diet: Pasta or Pastrami?” Wise Traditions. Spring 2000. http://www.westonaprice.org/ traditional-diets/mediterranean-diet
4 Satin, M. “Press Conference: Critique of 2010 Dietary Guidelines.” Video of lecture. Weston A. Price Foundation. 14 February 2011. http://www. westonaprice.org/press/press-conference-critique-of-the-2010-dietary-guidelines
5 Taubes, Gary. “The Soft Science of Dietary Fat.” Science 291(5513), 2001: pp. 2536-2545. http://www.ncbi.nlm.nih.gov/pubmed/11286266 “
6 Hite, A., et al. “In the Face of Contradictory Evidence: Report of the Dietary Guidelines for Americans Committee.” Nutrition 26(10), 2001: pp. 915-924. http://www.ncbi.nlm.nih.gov/pubmed/20888548
8 Hite. “Whole Foods Promotes Militant Vegetarian Agenda: Has the Upscale Market Outlived Its Usefulness?”
10 Hite, et al. “In the Face of Contradictory Evidence: Report of the Dietary Guidelines for Americans Committee.