The high-fat Greek diet: a recipe for all?

Abstract

Objective: To examine critically the published results of dietary surveys on the fat content of the Greek diet, and to assess its evolution and its relationship to the health of the Greeks. To consider the implications of these findings for current views on the nature and health implications of the traditional Mediterranean diet and how best to define it for use in modern policy making. Design: A systematic review of the literature on food consumption in Greece. Setting: Greece. Results: The first fully published data on the fat content of the Greek diet -the Seven Countries Survey -relates only to a small number of adult males in Crete and Corfu; the legitimacy of extrapolating these results to the rest of Greece is questioned. Earlier studies and chemical validation of intakes point to a lower fat content of the traditional diet than that inferred for Crete. Nearly all later surveys relate only to urban groups in Athens (mostly case -control hospital-based samples) and a variety of nonrepresentative Cretan groups. Only two studies are larger and more representative, but one uses FAO food balance-sheets to reflect the national diet, and the other surveyed school-age children in three out of the 52 Greek counties. Unfortunately recent dietary studies have proved unreliable, given the continuing lack of national food composition tables with survey methods which proved inaccurate for dietary fat content. A progressive upward trend in total and saturated fat intake appears to have occurred with all health indicators in relation to fat indicating remarkable increases in adult and childhood obesity with attendant progressive deterioration in cardiovascular mortality and its risk factors, ie hypertension and diabetes. These data emphasise the need to alter current nutritional advice in Greece, particularly when it focuses on the promotion of olive oil and a high-fat diet. Conclusions: The findings reaffirm low -moderate fat policies for optimum health, within which olive oil can be an important component of the diet.

Adherence to a Mediterranean dietary pattern and weight gain in a follow-up study: the SUN cohort

“…Although its benefits on health have been largely tested, the composition of this Mediterranean component (100% fat) has led to some criticism about recommending virgin olive oil consumption to protect from cardiovascular disease because it is presumed to increase the risk of overweight/obesity. Furthermore, Ferro-Luzzi et al 22 criticized the current nutritional advice applied in Greece and based in the Mediterranean Diet Pyramid. 23 A crucial discussion matter was that the high Mediterranean dietary pattern and weight gain A Sánchez-Villegas et al prevalence of weight gain associated with excessive energy intake and physical inactivity observed in the Mediterranean area in the last 30 years is a strong reason for concern regarding the threating obesity epidemic.…”

“…The high fat content based on olive oil consumption of the Greek diet (one of the most typical Mediterranean diets) could have increased since the 1950s, leading to substantial weight gain in this Mediterranean region and, thus, increasing obesity prevalence and, consequently, the risk of cardiovascular disease, hypertension and diabetes. 22 However, the presumption that olive oil increases the risk of obesity in Mediterranean populations is not supported by any reliable evidence. 24,25 Recently, our group did not find a significant association between olive oil consumption and the risk of obesity or weight gain in the SUN cohort (M BesRastrollo et al -unpublished data).…”

Food patterns and Mediterranean diet in western and eastern Mediterranean islands

“…The MDP can be defined as a dietary pattern with a high intake of vegetables, legumes, fruits and nuts, cereals (largely unrefined in the past), a high intake of olive oil but a low intake of saturated lipids, a moderately high intake of fish (depending on proximity to the sea), a low-to-moderate intake of dairy products (mostly in the form of cheese or yoghurt), a low intake of meat and poultry, and a regular but moderate intake of ethanol, primarily in the form of wine and generally during meals (2)(3)(4) . Latest indicators show that the Mediterranean diet is tending to disappear in the Mediterranean area; the Western diet is progressively being implanted instead of the Mediterranean diet; and the nutrition transition, which reflects a progressive alteration in traditional eating and physical activity practices that is associated with the changing demographic and economic profile of countries, is a growing trend in the dietary intake of the Mediterranean countries (5)(6)(7)(8)(9)(10)(11)(12) . The nutrition transition has progressed over lengthy time frames, and focused on subtle shifts in diet and activity patterns, from a starchy, low-variety, low-fat, high-fibrefood diet and labour-intensive work and leisure physical activities to a high-saturated-fat, high-sugar, refined-andprocessed foods and low-fibre diet and low physical work and leisure physical activities, which is often termed the 'Western diet' (13) .…”

The Third International Symposium on Obesity and Hypertension ISOH'03: ‘Genetics and Molecular Mechanisms’ (October 23–25, 2003, Berlin Germany)

“…60 Anthony Kafatos (University of Crete School of Medicine, Heraklion, Crete, Greece) described the significant changes in Cretan diet and lifestyle in recent decades F notably in terms of fat intake F and how these are currently evidenced in rising obesity rates among both adults and children. 61 The most impressive change in the Cretan diet is the increase in the saturated fatty acid intake, from 8% of total energy intake in the 60s to 15-16% in adolescents at present. In contrast, monounsaturated fat intake, mostly derived from olive oil, has been decreased.…”