The “Mediterranean diet” gained much recognition and worldwide interest in the 1990s as a model for healthful eating habits. The diet is based on the traditional dietary patterns of Crete, a Greek island, and other parts of Greece and southern Italy. The diet has become a popular area of study due to observations made in 1960 of low incidences of chronic disease and high life-expectancy rates attributed to the populations who consumed a traditional Mediterranean diet. This healthful diet model goes far beyond the use of particular ingredients and recipes. It attains its full meaning in the context of climate, geography, customs, and the way of life of Mediterranean peoples.
Halal (Halaal) food products
Haram (Haraam) food products (not halal)
Mashbooh (questionable or cautionary ingredients)
Milk and eggs from halal animals (cows, sheep, camels, goats)
Fish and most seafood
Vegetables that are not intoxicants
Fresh or dried fruits
Legumes and nuts
Grains such as wheat, rice, rye, barley, and oats
Pork and pork by-products
Animals improperly slaughtered or dead before slaughtering
Alcohol and intoxicants
Carnivorous animals, birds of prey, and land animals without external ears
Blood and blood by-products
Foods contaminated with any of the above products
Animal fat or proteins
SOURCE: Islamic Food and Nutrition Council of America. “What is Halal?” (accessed April 4, 2018).
The lands surrounding the Mediterranean Sea contain some of the oldest cultures in the world. Greece, as well as other countries of Europe, North Africa, and some Middle Eastern nations, played a central role in the expansion of empires and crosscultural exchanges over the centuries. Over 2,000 years ago trade by means of sea routes allowed Greek, Roman, Phoenician, Carthaginian, Arab, and Oriental products and traditions to intermix, resulting in mutual enrichment and an evolution of what is now incorporated into the Mediterranean diet. However, many different diets exist throughout the Mediterranean region, and there is no such thing as just one Mediterranean diet. Variations of this diet have traditionally existed in the North African countries of Morocco and Tunisia, parts of Turkey, and other Middle Eastern countries such as Lebanon and Syria.
Mediterranean and Middle Eastern culture is centered on a strong patriarchal family. This has lessened in recent years, but family ties are still strong. Customs and family traditions influence nutrition greatly.
Food is an integral part of family celebrations, special days of honor, and festivals. In the Middle Eastern nation of Israel, kosher dietary laws concerning the selection, preparation, and eating of food remains influential in Jewish life. The Jewish laws of kashrut, or keeping kosher, determine which foods are kosher and which are non-kosher. Many ancient practices and rituals, handed down from generation to generation, are observed.
Many people from Mediterranean and Middle Eastern cultures observe Islam and Eastern Orthodox religions, which influence the kinds of food chosen and how the foods are combined. Fasting from sunrise to sunset is a Muslim religious obligation practiced during the sacred month of Ramadan. Muslims do not eat any form of pork, or any meat that has been slaughtered without mentioning God's name. Muslims cannot drink alcoholic beverages or foods flavored with alcohol—which differs from Greek and other Mediterranean cultures, where wine is a large part of the diet. Dairy product consumption is rising in the Middle East, but dairy products must be imported due to the dry climate.
Traditional eating habits of Mediterranean countries, and those countries along the basin, include olives, fish, lamb, wheat, rice, chick peas and other legumes, pistachios, dates, cheese, and yogurt. Bread typically accompanies each meal.
Traditional food consumption includes the following:
Grilling, frying, grinding, and stewing are the most common ways of preparing meats in countries bordering the Mediterranean Basin. A whole, roasted lamb or leg of lamb is a special dish prepared for festive gatherings. Spices and seasonings are essential in the preparation of Middle Eastern dishes. Common spices and herbs include dill, garlic, mint, cinnamon, oregano, parsley, leek, and pepper.
Today, the Mediterranean region is characterized by a high increase in modernization. The traditional diet of the Mediterranean region has been affected by modernization, particularly in the area of agricultural production for trade. The countries of North Africa and the Middle East struggle the most with modernization problems. This has led to an increase in dependence on costly food imports from outside the region. While the Greek economy remains rooted in agriculture and the government places a strong emphasis on agricultural reforms, Middle Eastern nations face constraints such as high rates of urbanization, leading to the loss of vital agricultural land.
The wide use of olive oil in food preparation throughout the Mediterranean region contributes to a diet high in monounsaturated fatty acids. Research has shown that a Mediterranean diet is generally healthful, and a diet that derives much of its fat from olive oil and other products containing monounsaturated fats may lower low-density lipoprotein (LDL) cholesterol levels (often referred to as “bad” cholesterol). Olive oil also contains antioxidants that may help prevent artery clogging.
The Mediterranean diet offers a practical and effective strategy that is relatively easy to adopt and more likely to be successful over the long term than most heart-healthy nutrition plans. In April 2001, the American Heart Association (AHA) published a science advisory stating that some components of the Mediterranean diet may be beneficial when used in conjunction with the association's traditional diets for the prevention and treatment of cardiovascular disease.
In the Mediterranean diet, not all fat is regarded as bad, however. In fact, the focus of the diet is not to limit total fat consumption, but rather to make wise choices about the type of fat in the diet. The Mediterranean diet is low in saturated fat, which is found mostly in meat and dairy products, vegetable oils such as coconut and palm oils (tropical oils), and butter. The diet views two types of protective fats, omega-3 fatty acids and monounsaturated fats, as healthful and places no restrictions on their consumption. Omega-3 fatty acids are found in fatty fish (e.g., sardines, salmon, fresh tuna) and in some plant sources (e.g., walnuts, flax seeds, hemp, rapeseed, soy, and green leafy vegetables). Monounsaturated fat is abundant in olive oil, nuts, and avocados.
Many Middle Eastern nations, such as Turkey, Syria, and Lebanon, have predominantly Muslim populations. Eating halal is obligatory for every Muslim. Halal is an Arabic word meaning “lawful” or “permitted,” and refers to Islamic law regarding the diet. Animals such as cows, sheep, goats, deer, moose, chickens, ducks, and game birds are halal, but they must be zabihah (slaughtered according to Islamic method) in order to be suitable for consumption. Halal foods are those that are:
The Mediterranean diet emphasizes eating whole, natural foods and is generally low in trans fats, which are thought to contribute to heart disease. These fats are found in hard margarine and deep-fried and processed snacks and food, including fast food and commercially baked products. They are similar to saturated fats and are known to raise levels of LDL cholesterol. Eating a diet incorporating the traditional foods of the Mediterranean, such as a variety of fruits and vegetables, has been shown to decrease the risk of heart disease. Five important dietary factors may contribute to the cardioprotective effect of this eating pattern. These are the inclusion of fish rich in omega-3 fatty acids, olive oil, nuts, and moderate amounts of alcohol, and the exclusion of trans fatty acids.
Many common characteristics exist among the countries along the Mediterranean Basin, but each country has adapted to the geography and developed its own customs. The common core, however, can be seen in the diets of these countries. It is important to remember that the Mediterranean diet emphasizes eating whole, unprocessed foods that are extremely low in harmful LDL cholesterol. Recent studies indicate that the use of natural, monounsaturated oils such as olive oil, a balanced intake of vegetables and fish, and a low intake of red meats provides a natural defense against cardiovascular disease. Although more research is needed, the Mediterranean way of eating is potentially an ideal diet to improve health by warding off illnesses.
See also Antioxidants; French paradox; Mediterranean diet; Omega-3 and omega-6 fatty acids; Soy; Trans fats.
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Revised by Laura Jean Cataldo, RN, EdD