Antonia Trichopoulou seated next to Clemens Wittenbecher

Headlines worldwide praise the health benefits of the Mediterranean diet. At a conference on the Greek island of Crete, international experts emphasized what many have agreed on for years: the foundation of this diet was discovered in the culinary tradition of Crete decades ago. Scientists argue that this tradition still offers a wealth of benefits.

The Mediterranean diet was ranked the Best Diet Overall by U.S. News & World Report for the sixth year in a row this year. In Crete we find “one of the best, if not the best, expressions of the Mediterranean diet,” asserted Dr. Antonia Trichopoulou in her keynote speech on Eating Habits of Crete from Past to Present at the “Cretan Lifestyle: Mediterranean Tradition & Modern Applications” Conference in Rethymno, Crete last November.

One of the most highly cited researchers in Greece and the world, according to conference organizer Dr. Stefanos Kales, Trichopoulou helped develop the first Mediterranean diet food pyramid, as well as a Mediterranean diet score that simplifies research on its effects on health.

The Cretan Diet, Historic Foundation of the “Mediterranean Diet”

The Cretan diet was already drawing the attention of outsiders by 1837, when British scholar Robert Pashley visited Crete. As Trichopoulou showed, Pashley noticed that boiled wild greens with olive oil were central to the islanders’ diet, along with bread and olives. The bread was almost always eaten with olive oil, which was also used with vegetables, meat, and fish—in fact, with most dishes eaten in Crete. While Pashley’s description can no longer be called typical of all Cretan meals or families, it still sounds familiar to health-conscious islanders. To some extent, olive oil’s centrality to the Cretan diet and lifestyle has continued to this day.

Herbs and wild and cultivated greens have also remained important to those who still follow the traditional Cretan diet and lifestyle, with more than 100 different varieties of greens gathered by women who mix them and use them in dishes and pies, as Trichopoulou explained. According to scientific analyses, these pies made of greens have a very high healthy flavonoid content, in some cases far more than apple juice, black tea, and red wine. “Yet no one advertises these green pies,” lamented Trichopoulou, as they deserve.

In Greece, World War II was followed by a destructive civil war that ended in 1948. “So,” said Trichopoulou, “the Rockefeller Foundation decided to come to Greece to find out what was happening.” As the resulting Rockefeller Report explained, “olives, cereal grains, pulses, fruit, wild greens and herbs, together with limited quantities of goat meat and milk, game, and fish consist the basic Cretan foods ... no meal was complete without bread … Olives and olive oil contributed heavily to the energy intake ... food seemed literally to be ‘swimming’ in oil.”

The report added that Cretans’ “food consumption levels were surprisingly good. On the whole, their food pattern and food habits were extremely well adapted to their natural and economic resources as well as their needs.” Researchers had not expected such good news from an impoverished, war-torn society. In fact, this was multi-faceted good news: Trichopoulou described it as “the first recognition of the value of the Cretan diet beyond health -- for the economy, for the climate, for the environment” and sustainability.

The Cretan Diet, for Human Health

When the famous Seven Countries Study initiated by Ancel Keys showed the lowest heart disease and mortality rates in Crete (compared with the six other countries) in the middle of the 20th century, the traditional Cretan diet was credited for these findings. Interest in the diet increased and spread beyond the region, although it came to be known as “the Mediterranean diet.”  

Cretan Lifestyle Conference speakers repeatedly referred to the traditional Cretan diet as the gold standard for what has been called the Mediterranean diet--a more general phrase actually referring to a number of traditional dietary patterns in different countries bordering the Mediterranean, with certain points in common (such as plenty of olive oil, fruits and vegetables, whole grains, and pulses, but little red meat). Many use the phrase “Mediterranean diet” since that is the one most people associate with healthy eating, but it can also be viewed as an overgeneralization.

Since the Seven Countries Study, countless scientific studies have explored the health benefits of this traditional diet. But today, Trichopoulou laments, “not only in Crete but all over the world, … the modern way of life is influencing us, and we’re abandoning the traditional Cretan diet. Children in Crete are becoming obese, elders are becoming obese, dying of cardiovascular disease.”

Cretans still follow what is now called the Mediterranean diet to some extent, Trichopoulou explained, but they eat fewer vegetables and more meat than they did traditionally, because of globalization of the food supply, socioeconomic conditions, urbanization, and wider availability of inexpensive foods with poor nutritional quality. “It’s a problem of society,” Trichopoulou believes; “it’s a problem of values, a problem of way of living.”

Part of the solution, Trichopoulou says, is olive oil: “Cretans need to try to use only olive oil as in the past; there is no need for seed oils, there is no need for margarines.” Traditionally, Cretans did very well without them, and Trichopoulou believes that should happen again.

Referring to an article in The Lancet on Food in the Anthropocene—our current era--Trichopoulou mentioned that the “Mediterranean diet has emerged as a pattern that promotes good health.” In fact, she said, “in epidemiology, it is rare to have such consistent evidence of the beneficial effects” as what researchers have found regarding the Mediterranean diet: “a diet that maximizes longevity, improves health-related quality of life, and is ecologically sustainable and environmentally friendly.”

The Cretan Diet, for Planetary Health

This is a diet that is good for the earth as well as the humans who live on it. As Trichopoulou reminds us, “the traditional Cretan diet is a social practice based on a set of skills, knowledge, practices and traditions ranging from the landscape to the cuisine.” It began with food that could easily be produced on the island, from trees, plants, and animals well adapted to the climate and terrain.

Traditionally, in Crete food has been “produced locally and consumed locally--that’s the secret.” In fact, Trichopoulou contends, “the Mediterranean diet has evolved from being [known only as] a healthy dietary pattern to a sustainable dietary pattern.” This sustainability should be considered alongside the nutritional benefits.

The Cretan Diet, for the Future

Trichopoulou urges that we need to “preserve what we learned for the next generation. Our children are not exposed to the traditional tastes; they will not transmit these tastes to their children, then the tradition will be lost.” This must not happen; instead, more should learn about this priceless tradition.

“We know the Mediterranean diet is healthy and effective,” as well as ecologically friendly; now, according to Trichopoulou, it is time to focus on why that is true. In addition, “there is a need to move from the evidence of the relation of the Cretan diet to health, to policies” that support its use and its continuation. For the sake of the planet and its inhabitants, the Cretan diet and its principles should be well understood, widely known and adopted, and passed down through the generations.

Greek Liquid Gold was a Technical Partner of the Cretan Lifestyle: Mediterranean Tradition & Modern Applications conference. Thanks to the Hellenic Center of Excellence for Health & Wellness and Grecotel for access to the complete experience of the conference.

President of the Hellenic Health Foundation and a member of the Academy of Athens, Antonia Trichopoulou is also an advisor to the Hellenic Center for Excellence in Health and Wellness.

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