Mediterranean Lifestyle Slashes Risk of Early Death, Even if You Live Elsewhere

I have long advocated for a Mediterranean diet because of its focus on eating plants instead of animals—which we know is a boon for the planet (not to mention the animals). It doesn't proselytize and forbid meat altogether; rather, it embraces a flexitarian attitude that favors plants but leaves some wiggle room.

The Mediterranean diet almost always lands on top of lists that rank healthy diets and eating styles (as well as sustainability rankings). I used to quip that I'd probably live longer, too, if I lived in the South of France or coastal Spain. But according to a new study led by La Universidad Autónoma de Madrid and Harvard T.H. Chan School of Public Health, the health perks are not reliant on location.

The study is one of just a few to examine the health benefits of the Mediterranean diet in a non-Mediterranean context—and also to assess the health benefits of an overall Mediterranean lifestyle.

The findings are noteworthy. As explained in a statement from the Harvard T.H. Chan School of Public Health:

"In a study of adults in the United Kingdom, those who adhered closely to a Mediterranean lifestyle—including eating a healthy, plant-based diet with limited added salts and sugars and getting adequate rest, exercise, and socialization—were found to have a 29% lower risk of all-cause mortality and a 28% lower risk of cancer mortality compared to those who were nonadherent to the lifestyle."

We have been hearing about the Mediterranean diet for ages now: It includes a diet rich in produce and whole grains, with limited meat, salt, and sugar. For the new study, the authors included diet factors in the context of overall lifestyle.

The research was comprised of data collected from 110,799 members of the United Kingdom Biobank cohort, a long-term population-based study in England, Wales, and Scotland. The team used the Mediterranean Lifestyle (MEDLIFE) index, which is based on a lifestyle questionnaire and diet assessments. Participants aged 40 to 75 answered questions according to the three categories the index measures:

• Mediterranean food consumption: Intake of foods part of the Mediterranean diet, such as fruits and whole grains.
• Mediterranean dietary habits: Adherence to habits and practices around meals, including limiting salt and drinking healthy beverages.
• Physical activity, rest, and social habits and conviviality: Adherence to lifestyle habits, including taking regular naps, exercising, and spending time with friends.

Each item within the categories was scored—the more adherence to a Mediterranean lifestyle, the higher the score. Playing the long game, researchers followed up nine years later to analyze participants’ health outcomes.

"Among the study population, 4,247 died from all causes; 2,401 from cancer; and 731 from cardiovascular disease. Analyzing these results alongside MEDLIFE scores, the researchers observed an inverse association between adherence to the Mediterranean lifestyle and risk of mortality," according to Harvard Chan School.

Those who had higher MEDLIFE scores were found to have a 29% lower risk of all-cause mortality and a 28% lower risk of cancer mortality compared to those with lower MEDLIFE scores.

The study authors conclude that adopting a Mediterranean lifestyle adapted to the local characteristics of non-Mediterranean populations may be possible and part of a healthy lifestyle.

“This study suggests that it’s possible for non-Mediterranean populations to adopt the Mediterranean diet using locally available products and to adopt the overall Mediterranean lifestyle within their own cultural contexts,” said lead author Mercedes Sotos Prieto, Ramon y Cajal research fellow at La Universidad Autónoma de Madrid and adjunct assistant professor of environmental health at Harvard Chan School. “We’re seeing the transferability of the lifestyle and its positive effects on health.”

So maybe we can't all live in Marseille, but by focusing on an eco-friendly plant-forward diet—and remembering to take a nap and hang out with friends—it looks like we can still get a Mediterranean-style longevity boost.

The study was published in Mayo Clinic Proceedings.