- New research has found that a Mediterranean lifestyle may boost heart health.
- This includes the ever-popular Mediterranean diet, which prioritizes fruit, vegetables, healthy fats, whole grains, and lean protein.
- Experts agree that the combination of diet, social life, and physical activity can make a generous impact on an individual’s heart health.
The Mediterranean diet has long been praised for its positive health benefits, but new research found that a Mediterranean lifestyle—including but not limited to diet—may specifically boost heart health.
While the Mediterranean diet, with its focus on fruit, vegetables, olive oil, whole grains, fish, and lean meats, is helpful for a myriad of health reasons, researchers found that the lifestyle surrounding the diet was worth emphasizing.
“It’s not just the diet, it is the other environmental factors also that benefit us,” said John P. Higgins, MD, a professor of cardiovascular medicine at the UTHealth Houston McGovern Medical School who was not involved in the new study.
Dr. Higgins continued, “Things like setting up your environment so that walking is the healthy choice, being happy and smiling, having sociable interactions, as well as good sleep, appear to work in concert with the Mediterranean diet to improve health and wellness.”
Adhering to a certain lifestyle may sound overwhelming, but the Mediterranean lifestyle is fairly simple to follow. Sustainable shifts in nutrition, physical activity, and social life are all that are needed for these heart-healthy habits.
Understanding a Lifestyle’s Impact
The new findings that encourage a Mediterranean lifestyle for heart health were presented on February 28, 2023, at the American Heart Association’s Epidemiology, Prevention, Lifestyle, and Cardiometabolic Health conference in Boston.
Researchers gathered data from more than 110,000 individuals, between the ages of 40 and 69, logged in the U.K. Biobank cohort. These participants were followed between 2006 and 2010 to 2020, to fully understand how lifestyle impacted their continued well-being.
In order to understand the data points behind these factors, the team used a 26-point Mediterranean lifestyle (MEDLIFE) index to measure how well each person in the study adhered to a Mediterranean lifestyle. This included what they ate, how they ate—including whether or not they snacked or added salt to their food—whether people ate meals with family and friends, how often they were sedentary and how often they engaged in physical activity with others, how often they socialized, and how much sleep they got each night.
The team followed up after about 9.5 years, taking death records and causes of death (cancer, cardiovascular disease, and all other causes) into account. They found that the more people followed a Mediterranean lifestyle, the less likely they were to die of cancer or cardiovascular disease. Those with the closest adherence were about 30% less likely to die of cancer or heart disease than those with the lowest adherence.
Prioritizing a Healthy Social Life
Research has shown isolation and loneliness both increase a person’s risk of cardiovascular disease, highlighting the importance of the social aspects of a Mediterranean lifestyle.
“Meals are something that happen around the family and friends,” Mercedes Sotos-Prieto, PhD, an adjunct assistant professor of environmental health at the Harvard School of Public Health and first author of the new study, told Health. She noted a concept called conviviality, one of the key factors evaluated in the new study. The concept relates to how individuals eat, rather than what they eat. In the study, this was measured as sharing meals.
“This is something very characteristic of the traditional Mediterranean lifestyle, the pleasure of sharing meals that fosters the sense of community,” Sotos-Prieto explained. “That moment where we chat in a relaxed way while savoring the food.”
Social habits were also tied to doing physical activity with others, such as taking a walk, or how often people attended different social events that applied to their lives, such as going to church.
At their core, social interactions like these foster opportunities for hospitality and social support systems, according to Sotos-Prieto. This support can reduce the stress that puts strain on the cardiovascular system. When paired with exercise—like taking a walk with a friend—this can make a big difference on an individual’s overall health.
Eating meals in a social setting may also impact what an individual is likely to eat.
“I have a lot of patients who are single and they are eating by themselves and I find they are less likely to plan and prepare a healthy balanced meal for themselves, and then their nutrition is being compromised,” explained Jenifer Bowman, RD, a registered dietitian in the department of cardiology at UCHealth in Fort Collins, Colorado.
By simply sharing a meal with someone—family, friends, a roommate—individuals may naturally make more nutritious (and heart-healthy) decisions.
How Eating Habits Impact Heart Health
According to Bowman, early research on the Mediterranean meal plan sought to identify one single nutrient that was responsible for reducing the risk of everything from heart disease to cancer to Alzheimer’s disease.
However, she emphasized, “it’s not just one individual nutrient, it’s the power of all of these nutrients all together that makes the Mediterranean meal plan overall healthier.”
The eating style’s prioritization of fruits and vegetables provides both fiber and antioxidants. It also encourages whole grains, as well as beans—more high-fiber foods.
“Fiber takes some work for your digestive system to break down, so you have a more gradual raise in your blood sugar with higher fiber food,” explained Bowman. “Fiber also has the ability to bind to cholesterol and help remove that cholesterol from our digestive tract, which helps manage cholesterol overall.”
The Mediterranean diet also emphasizes healthy fats, especially olive oil, nuts, seeds, and lean meat, especially fish.
According to Sotos-Prieto, these foods have antioxidant and anti-inflammatory properties, including Omega-3 fatty acids, that boost heart health by reducing triglycerides, a type of fat in the blood, reducing the risk of irregular heartbeats, and slowing the build-up of plaque that hardens and blocks the arteries.
According to Dr. Higgins, the way of eating also boosts levels of nitric oxide, a gas that regulates blood vessel dilation, and therefore blood flow, which boosts heart function.
Following a Mediterranean Diet
If an individual wants to start adhering to a Mediterranean diet, Bowman encouraged keeping it simple for the sake of sustainability.
“Your perception of what healthy eating is is often more complicated than it actually is,” she told Health. “It does not have to be only fresh fruits and vegetables, that’s a huge myth. Frozen is fine.”
If fatty fish is not accessible, lean meat such as skinless chicken breasts provides healthy protein without adding saturated fat. The important thing is to avoid processed, prepackaged meals when possible, she said.
“People in this [Mediterranean] region are not eating macaroni and cheese and frozen pizza,” she said, adding that it can be helpful to keep in mind that three-quarters of your plate should be plant-based.
“Half of the plate should be vegetables, a quarter of it is lean protein, then the other quarter high fiber plant foods like beans or whole grains,” she said. “The Mediterranean meal plan is not anything fancy. It’s fruits, vegetables, lean meats, legumes, and whole grains.”
American Heart Association. Association of a Mediterranean lifestyle with all-cause and cause-specific mortality: a prospective cohort study from UK Biobank [presentation abstract].
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ScienceDaily. Interacting with more people is shown to keep older adults more active.
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