Did you ever wonder why European women always look so slim and beautiful? I spent the last year traveling in Europe studying the different cultures, especially the French, Spanish, Italians, and Greeks.   They all have something in common - they never diet!  But how do they stay in shape?  For one thing, the food that they eat.  The Mediterranean Diet, which is common to these regions, emphasizes a high consumption of fruits and vegetables, bread, wheat and other whole grain cereals, olive oil, fish, seafood, and red wine. The Mediterranean diet is often touted as being beneficial because it is low in saturated fat and high in monounsaturated fat and dietary fiber.  Studies have shown that this diet provides protection against chronic diseases such as heart disease and diabetes. In addition, a meal is an event.  The families come together, and meals may take several hours during which they "nibble and sip".  The Europeans don't eat the huge portions that Americans have become used to.  And, they don't race through any meal.  Food is to be savored and shared with friends and loved ones.  I attended many lunches and dinners that lasted anywhere from 4 to 5 hours.  Europeans also tend to walk and bicycle rather than driving a car everywhere.  In the United States, I know people (you know who you are) who drive their cars to the grocery store only 3 blocks away, instead of walking.  Europeans get much more exercise, but of course neighborhoods there tend to be more self contained than many neighborhoods in the United States.  In any case, exercise is a big part of their lives, and walking a mile or more to purchase groceries or other items is a pleasure, and another reason that obesity is not at the levels that we find in the U.S.  Many families take a walk after meals as a daily routine, and in all kinds of weather. So, how can this help you?  A recent study has once again confirmed that people who closely follow the Mediterranean Diet live longer, overall.  Once again, here are the characteristics of the Mediterranean Diet: High consumption of fruits, vegetables, potatoes, beans, nuts, seeds, bread and other cereals Olive oil used for cooking and salad dressings Moderate amounts of fish but little red meat Low to moderate amounts of full fat cheese and yogurt Moderate consumption of wine, usually with meals Reliance on local, seasonal, fresh produce An active lifestyle The Main Components Research statistics indicate that Mediterranean populations live longer than other Europeans, so scientists have been trying to determine which factors of the Mediterranean diet are responsible for its considerable benefits. Here are some of the candidates so far... Olive oil Olive oil is usually the first choice for investigation since it is used almost exclusively in Mediterranean cooking instead of butter, margarine or other fats. Olive oil is a rich source of monounsaturated fat, which we know protects against heart disease, possibly because it displaces saturated fat from the diet. Olive oil is also an excellent source of antioxidants including vitamin E. In the Mediterranean regions, olive oil is used to prepare vegetable dishes, tomato sauces, salads and to fry fish. Fruits and vegetables High consumption of fresh fruits and vegetables have been shown to protect against both heart disease and cancer; probably because of the antioxidants they contain. Tomatoes are of particular interest since they feature so heavily in Mediterranean food. Tomatoes tend to be a major source of antioxidants.  Cooking tomatoes, for example in tomato sauces, is recommended as it increases the availability of lycopene, one of the main antioxidants in tomatoes. Oily fish Oily fish such as sardines have important health benefits.  They are a beneficial source of omega-3 polyunsaturated fats and the complex long chain derivatives of these fats appear to be particularly beneficial to heart health because of their anti-inflammatory and vasodilatory properties, which keeps blood flowing smoothly. Wine in moderate consumption Throughout the Mediterranean regions wine is drunk in moderation and usually always taken with meals. Normally, for men moderation is two glasses per day, for women one glass per day. Wine, especially red wines, contains a vast array of plant compounds with health-promoting qualities called phytonutrients. Phytonutrients, such as polyphenols, are powerful antioxidants, protecting against LDL oxidation and other pathologic sequelae of the oxidative process. Other phytonutrients play a role in the inhibition of platelet aggregation, vasodilation,etc. The combined effect Studies reveal that individual components or food groups of the Mediterranean diet do not provide any significant protection. It is more likely that it is a combination of all the different ingredients of the diet that make it so healthy. In additiona, other factors such as a more relaxed attitude to eating, plenty of sunshine and more physical activity are likely to be contributing to the overall healthy lifestyle in this region.     References Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. (2003) Adherence to a Mediterranean diet and survival in a Greek population. New England Journal of Medicine 348:2599-2608 Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, Trichopoulos D. (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995 Jun;61(6 Suppl):1402S-1406S. Review. WHO/FAO (2003) Diet nutrition and the prevention of chronic diseases. Geneva, Switzerland. Available at www.who.int Hu FB, Willett WC. (2002) Optimal diets for prevention of coronary heart disease. JAMA. 2002 Nov 27;288(20):2569-78. Review.