weight. Three months after the experiment ended, Keys
found that none of the subjects had regained their
weight or physical capacity. He learned that renutrition
following starvation requires several months of above-
average calorie intake, that vitamin supplements are
needed, and that the proportion ofproteinin the diet
must be increased. He wrote a booklet with this infor-
mation for use by relief agencies after the war ended.
In the process of studying the effects of starvation
in European men who survived the war, however,
Keys noticed that the rate of heart attacks among
them dropped markedly as food supplies decreased.
He wondered whether dietary factors might be
involved in heart disease. A study of Minnesota busi-
nessmen and professors in the mid-1950s showed him
that the fat content of food—particularly the satu-
ratedfatsfound in the meat and dairy products con-
sumed in large amounts by Midwesterners—was
indeed a factor. After that experiment, Keys began to
think in terms of diet as preventive medicine. He first
encountered Mediterranean diets during visits to Italy
and Spain to conduct research for the World Health
Organization. His studies of food consumption pat-
terns in those countries eventually led to the Seven
Countries Study, which was a systematic comparison
of diet, risk factors for heart disease, and disease expe-
rience in men between the ages of 40 and 59 in eighteen
rural areas of Japan, Finland, Greece, Italy, the for-
mer Yugoslavia, the Netherlands, and the UnitedStates from 1958 to 1970. (Women were not included
as subjects because of the rarity of heart attacks
among them at that time and because the physical
examinations were fairly invasive). In addition to ask-
ing the subjects to keep records of their food intake,
the researchers performed chemical analyses of the
foods the subjects ate. It was found that the men living
on the island of Crete—the location of Leland All-
baugh’s 1953 study—had the lowest rate of heart
attacks of any group of subjects in the study.
Subsequent studies of Mediterranean diets have
been conducted in subjects who have already suffered
heart attacks and in women subjects. One consistent
finding of recent research, however, is that subjects are
less healthy in the early twenty-first century than the
participants of the late 1950s because the traditional
diets of the Mediterranean region have been increas-
ingly abandoned in favor of fast foods and higher
consumption of fatty meat products and sweets, as
well as other staples of American and Northern Euro-
pean diets that are high in trans-fatty acids. In addi-
tion, changing agricultural practices around the
Mediterranean have resulted in poultry and meat with
higher fat content than was the case in the 1960s. As a
result of concern about these trends, an association for
the advancement of the Mediterranean diet was formed
in Spain in 1995 and later funded the Foundation
for the Advancement of the Mediterranean Diet,
which is presently headquartered in Barcelona. TheMediterranean dietFrequency Food Tips
Monthly Red meats No more than a few times month
Weekly Sweets Opt instead for naturally sweet fresh fruit
Eggs Less than 4 per week, including those in processed foods
Poultry A few times a week. Take the skin off and choose white meat to lower fat intake
Fish A few times a week
Daily Cheese and yogurt Cheese and yogurt are good sources of calcium. Choose low-fat varieties
Olive oil The beneficial health effects of olive oil are due to its high content of monounsaturated fats and antioxidants. Olive oil is
high in calories, consume in moderation to reduce calorie intake
Fruits At least a serving at every meal. A serving of fruit is a healthy option for snacks
Vegetables At least a serving at every meal. Choose a variety of colors
Beans, legumes, nuts Beans are a healthy source of protein, and are loaded with soluble fiber, which has been shown to lower blood cholesterol
levels by five percent or more. Most nuts contain monounsaturated (heart-healthy) fat. A handful of nuts is a healthy
option for snacks
Whole grains, including A grain is considered whole when all three parts—bran, germ and endosperm—are present. Substitute whole wheat for
breads, pasta, rice, white bread, brown rice for white rice and whole-wheat flour when baking. Mix pasta, rice, couscous, polenta and
couscous, and polenta potatoes with vegetables and legumes
Water At least 6 glasses daily
Wine (in moderation) The U.S. Department of Agriculture defines moderation as no more than a five-ounce glass of wine daily for women
and up to 2 glasses (10 ounces) daily for men
Physical activity Thirty minutes of cardiovascular activity a day is recommended to get in shape, burn calories and boost the metabolismBased on the Mediterranean diet pyramid.(Illustration by GGS Information Services/Thomson Gale.)Mediterranean diet