Mediterranean Diet Ranked Best Diet Overall – What’s Missing?

By Katie McKee MCN, RDN, LD on 02/22/2019

Tags: Research, Diet, Heart Health

The Mediterranean diet – often considered one of the healthiest diets in the world and recognized for a variety of benefits, including its effects on promoting cardiovascular and metabolic health – was recently voted No. 1 in Best Diets Overall by U.S. News & World Report. A panel of health experts evaluated 41 different diets and acknowledged the Mediterranean diet’s heart-health benefits, plant-forward focus and ease to follow, among other characteristics. But what is the Mediterranean diet? Does it meet nutrient needs? What does the research say?

What Is the Mediterranean Diet?

Worldwide, the diet is characterized by its emphasis on fruits and vegetables, whole grains, beans, nuts, legumes, extra virgin olive oil and flavorful herbs and spices; moderate consumption of fish, eggs, poultry, dairy foods and red wine; and low consumption of red meat and commercial sweets. The diet has a unique and rich history dating back centuries to the countries surrounding the Mediterranean Sea, including France, Italy, Spain, Morocco and Greece. Today, the diet is recognized by the 2015-2020 Dietary Guidelines for Americans (DGA) as one of three healthy eating patterns.

Research has shown that the Mediterranean-style of eating has numerous health benefits, including improvement in lipid profiles and insulin sensitivity and a reduction in inflammation; blood pressure, blood glucose and lipids; oxidative stress; cardiovascular disease risk; and total mortality.

The Mediterranean Diet Lacks One Thing Americans Need

While the Mediterranean diet has a lot going for it, the DGA acknowledge that it doesn’t meet the current calcium recommendations in the United States (or in many other Western countries, such as Australia). Worldwide, the Mediterranean diet recommendation is one to two servings of dairy foods per day – providing between 700-800 milligrams of calcium daily (compared to the 1,000-1,300 milligrams recommendation in the United States). The DGA Healthy Mediterranean-Style Eating Pattern recommends two daily servings of dairy, while the DGA Healthy U.S.-Style Eating Pattern recommends three daily servings of dairy.

It’s not just calcium; dairy foods also contain many other essential nutrients. While dairy foods are the number one source of calcium in the U.S. diet, they are also the number one source of vitamin D and potassium – three nutrients the DGA identified as shortfall nutrients, nutrients underconsumed by the U.S. population.

Adding More Dairy to the Mediterranean Diet

A recent study conducted by Wade et al. looked at a Mediterranean diet supplemented with dairy foods to meet Australian dairy and calcium recommendations – in particular, as it relates to improvements in biomarkers for cardiovascular disease risk. The study was a randomized, controlled, crossover design that compared a modified Mediterranean diet (including three to four daily servings of dairy) with a low-fat control diet. Forty-one participants aged 45 and older, at risk for cardiovascular disease, followed each of the diets for eight weeks, with an eight-week washout period between them.

Compared to the low-fat diet, the Mediterranean diet lowered blood pressure, increased HDL cholesterol, decreased blood triglycerides and improved total cholesterol/HDL cholesterol ratio all while meeting calcium recommendations. The authors concluded that including three to four daily servings of dairy as part of the Mediterranean-style eating pattern resulted in significant positive changes in markers of cardiovascular disease risk. This research underpins the importance of dairy foods in a healthy eating pattern, including the Mediterranean diet, and builds on the current body of research regarding dairy’s health benefits.

So, can you recommend the Mediterranean diet to your clients? Absolutely – just make sure they consider the crucial need for additional dairy.