Crete: decline and fall of the Mediterranean diet

In Body
Written by  Margot Krijnen Sunday, 03 October 2010 00:00

For decades, the Greek island of Crete was renowned as one of the healthiest areas in the world, where cardiovascular diseases or cancer hardly occurred. The ‘Seven Countries Study’, a large-scale international health study in the sixties, showed that the inhabitants of Crete owed their excellent health to their Mediterranean diet. But times have changed and Crete’s golden health has disappeared. Dr. Constantine Vardavas found out why.

Public outcry

About 45 years ago, the incidence of cardiovascular diseases and cancer was very low in Crete: until recently, in the valley of Messara, these incidences were only one third of the national Greek level and much, much lower than in the Netherlands. Today, these diseases occur almost as often in rural Crete as in the rest of the country. No wonder the Cretan people have become concerned. Media coverage about this strange increase of diseases led to a public outcry for thorough investigation. What was going on? Did it have to do with environmental factors or pollution? Was there a factor that could and should be controlled? The Cretan prefecture commissioned a study with Dr. Constantine Vardavas, who earned his PhD while conducting his research.

What exactly was the famous Mediterranean diet? “It consisted of bread, fruit, vegetables, wild greens, olive oil, some fish, few dairy products and hardly any red meat,” says Constantine Vardavas. “In fact, only seasonal products from the region that people harvested from their own open air cultivation. That required hard physical work on the land. The key aspect of the diet was olive oil, which accounted for up to 40% of the daily calorie intake. Moreover, their Orthodox Christian religion prescribed almost 200 annual days of fasting, when they were not allowed to eat foods of animal origin, dairy products, and fish. So, part of the year the Cretans consumed an almost vegetarian diet.”

Stunning results

Vardavas: “We recruited 662 farmers, aged between 18 and 79, took blood and fat samples and submitted them to a thorough clinical examination. Moreover, we asked them to write down exactly what they ate every day and how much physical exercise they had. So, we performed a complete clinical, dietetic and lifestyle assessment on each of them. The results were stunning. We found that the famous Mediterranean diet no longer existed. Over the past 45 years, the consumption of fruits and vegetables had dropped from 655 grams per day to 400 grams per day, while the meat intake jumped from 35 grams per day to 124 grams per day.”

How did this happen? “The changes were brought along by a combination of factors. There was the tourist industry boom in Crete in the seventies, the introduction of mass supermarkets with imported food, and the fact that the Cretans were no longer as strict about fasting. Whereas in the 1960’s farmers cultivated and consumed their own produce, they now grow commercially profitable foods and spend less time cultivating their own fruit and greens. They found out that it is much easier to go to the supermarket and buy food rather than actively cultivate the produce they need to sustain an entire family. So, their lifestyle has become much more sedentary. In the sixties, the farmers walked on average 12 kilometres per day to their fields. Now they drive there in their four-wheel drive cars. Even the shepherds, the healthiest people ever on Crete, now use their motorbikes to go to their herds.”

Power of the diet

Has your research definitely proven the effectiveness of the original Mediterranean diet? “Adherence to this diet has been shown to have a protective effect on the development of cancer, cardiovascular diseases and overall mortality. It lowers the blood pressure, increases the good cholesterol HDL, and lowers the bad cholesterol LDL. A good example of the power of the Mediterranean diet is the fact that smoking habits never changed on Crete. Already in the sixties, we observed that Greek farmers smoked, and they still do. Their diet used to protect them from developing the diseases that come along with smoking, as it counterbalanced the negative effects of smoking on health. Now that the diet no longer exists, the Cretans get the same diseases as the rest of the world.”

What will be done with the conclusions of your research? “Our findings and those of other studies on the Mediterranean diet were the result of a call for action made in Greece. In Greece, there are no comprehensive health education lessons in schools. Because of the great increase in obesity, the great lack of physical activity, and the smoking rates, we spoke with the Ministers of Health and Education about health promotion in primary schools. Perhaps we can convince the Greek population of the future to go back to the famous and beneficial Mediterranean diet.”

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