How to age well with the Mediterranean diet

On Nutrition

It seems nearly every week a new study comes out that shows a different health benefit from the Mediterranean diet. So far, the list includes reduced risk of heart disease, diabetes, asthma, inflammation as well as some cancers. Some of the latest research suggests that the Mediterranean diet may also help you age well.

Aging is inevitable, and who doesn’t hope to remain mentally sharp and physically strong as they age? I know I do. Since I also find Mediterranean-style diets delicious, I was intrigued by the one-two punch of studies suggesting that the Mediterranean diet may be good for preserving brain health and preventing frailty.

The scope of the situation
Dementia is a major health problem worldwide, with one new case diagnosed every three seconds — a rate expected to double by 2050. In 2016, an estimated 5.4 million Americans were affected by the most common type of dementia — Alzheimer’s disease — with most of those age 65 or older. Currently, there is no medical treatment for dementia, so the focus is on controlling risk factors like high blood pressure and diabetes and promoting lifestyle behaviors such as diet and exercise that may slow the rate of cognitive decline.

Similarly, frailty — which typically includes unintentional weight loss, exhaustion, slowed gait, deterioration in physical activity and reduced grip strength — is an all-too-common syndrome associated with increasing age. It’s estimated that frailty affects 10 percent of people age 65 and older, rising to 15 percent after age 80 and 26 percent after age 85. While it’s long been understood that good nutrition reduces the risk of frailty, there has historically been little information about whether any specific dietary pattern was ideal.

What the latest research says
A meta-analysis (a study of studies) published in March in the American Journal of Clinical Nutrition looked at five randomized control trials on the effects of a Mediterranean diet on cognition. While the results were mixed, the evidence overall supported the benefits of a Mediterranean diet for several measures of memory and brain function.

A study published last month in the journal Neurology suggests that a Mediterranean diet could delay the onset of Alzheimer’s disease by as much as 3 1/2 years. Researchers at Weill Cornell Medical College in New York City did brain scans on 70 “cognitively normal” volunteers between the ages of 30 and 60 at the start of the study, and again three years later. Biological markers for Alzheimer’s disease were higher in the 36 volunteers who had lower adherence to a Mediterranean diet than in the 34 who had higher adherence. A 2016 study in the same journal found that higher adherence to a Mediterranean diet was associated with less brain atrophy among 674 elderly adults without dementia.

So what about frailty? A meta-analysis of four studies published in January in the Journal of the American Geriatric Society — which involved a total of 5,789 people age 60 or older — found that closely following a Mediterranean diet was associated with lower risk of frailty. Interestingly, while three of the included studies were from Mediterranean regions of Europe, one was from China, which suggest that the findings may be applicable to people who come from non-Mediterranean countries. I do want to point out that these were observational studies, not clinical trials, so they can’t prove that the Mediterranean diet caused the lower frailty risk. Results of a French study, published in March, suggest that following a Mediterranean diet in middle age may help maintain health during aging, including physical independence.

Defining the Mediterranean Diet
The traditional Mediterranean diet is a “plant-forward” diet, with a focus on whole or minimally processed foods. It’s high in unprocessed plant foods (grains, vegetables, fruits, legumes, nuts and seeds, and extra virgin olive oil), moderate in fish and shellfish and red wine, and low in meat, dairy, eggs, animal fats and sweets.

Importantly, the Mediterranean diet isn’t about any one particular food — it’s about how many nutrient-rich foods work together to support health. There’s a huge variety of foods to choose from, and many delicious ways to prepare them, because many countries and food cultures fall under the Mediterranean diet umbrella, including Greece, southern Italy, southern France, southern Spain, Lebanon, Turkey and Morocco. Here are some of the foods you can include to make your diet more Mediterranean:

Greens. Dark leafy greens are rich in vitamins, minerals and phytonutrients, as well as plant-based omega 3 fatty acids. Add greens to frittatas, scrambled eggs or bean and lentil soups. Sauté greens with garlic and finish with a squeeze of lemon and enjoy raw salads of dark leafy greens, dressed with an olive oil vinaigrette.

Pulses. Pulses are an important part of the Mediterranean diet. Chickpeas (garbanzo beans), lentils, fava beans and other pulses are common ingredients in soups, stews and spreads (hummus), contributing protein, fiber and nutrients.

Herbs. Herbs are high in antioxidant and anti-inflammatory phytonutrients. Each region in the Mediterranean has a different flavor palate, but herbs and spices are universally important in the Mediterranean cuisine. Try adding fresh herbs to salads to give them an antioxidant boost.

Lemons. Lemon juice is a staple ingredient in hummus, but you can also go Med by squeezing lemon juice on salads, fish, roasted broccoli, and beans, or into soups and drinking water.

Nuts. Almonds, walnuts, pistachios, hazelnuts and other nuts are dietary mainstays. Eat them on their own or chop and add to salads and other dishes for heart-healthy fats along with protein, fiber and a wealth of nutrients.

Olive oil. Olive oil is the principal source of dietary fat for both cooking and baking, and is important for its antioxidant and anti-inflammatory properties, as well as for making food more delicious.

Yogurt. Yogurt and cheese are the primary forms of dairy, and both have the added benefit of being fermented.

Fish. Fish and shellfish are the most commonly eaten animal foods, with poultry and red meat eaten less frequently.