Healthy Aging and the Mediterranean Dietary Pattern

  • Maintaining health and well being particularly as we age is a hope we share and is of particular concern for the aging population of baby bombers.
  • In fact, more people were 65 years and over in 2010 than in any previous census.
  • New research under the direction of Dr. Walter Willet at the Harvard School of Public Health examined the association between dietary patterns in midlife and the prevalence of healthy aging in the Nurses’ Health Study (NHS).

When it comes to knowing which diet is best for any individual the seemingly endless numbers of diets makes it a formidable undertaking. The DASH, Mediterranean, Weight-Watchers, Atkins, Ornish, South Beach, Zone, and Paleo to name a few all have some reported benefits. The MIND diet -a combination (hybrid) of the DASH and Mediterranean pattern has recently reported benefits we all want -less memory loss -and less Alzheimer’s.

The best evidence for healthy aging

In popular culture a “diet” is unfortunately equated with “weight loss” but healthy aging is a more holistic and desired result of healthy nutrition. The available scientific evidence supports the traditional Mediterranean pattern as one of the healthiest dietary patterns in the world. 

Healthy aging was examined in the Nurses’ Health Study and was defined as survival to 70 years or older and found that greater adherence to a Mediterranean dietary pattern in midlife was related to 34% greater odds of healthy, that is, no major limitations in physical function and mental health versus usual aging. Better diet quality with more features of a Mediterranean dietary pattern at midlife seems to be strongly linked to greater health and well being in persons surviving to older ages.

A Mediterranean dietary pattern has a large amount of clinical and experimental evidence in support of many health benefits including survival advantage, a very unique in nutrition claim. A Mediterranean pattern rich in fruits, vegetables, whole grains, and low-fat dairy foods, fish, poultry, nuts and beans; and limited sugar-sweetened foods and beverages, red meat, and added fat are all essential parts of the AHA 2020 healthy dietary pattern.

The Mediterranean dietary pattern is not specific to one country but is based on the traditional cuisines of countries that border the Mediterranean Sea, such as Italy, France, Spain, Greece and Morocco with an emphasis on fruits, vegetables, legumes, monounsaturated fat, plant proteins, whole grains, nuts, seafood and a relatively low consumption of animal fats and red meat, refined
grains, and sweets. A Mediterranean pattern is typically rich in omega-3 fatty acids both from plant-sources: more nuts and oils and from more fish consumption.

Clinical studies

Some of the studies supportive of the Mediterranean pattern include:

  • Lyon Diet Heart Study (1994) considered a dietary pattern with many components of a Mediterranean pattern with increased amounts of the plant-derived omega-3 called α-linolenic acid (flax seed oil enriched margarine) and emphasized more fruit and root and green vegetables, more fish, poultry and less beef, lamb and pork and found that after 2 years the combination of cardiac death and non-fatal heart attack was reduced by an impressive 73%. The Lyon Diet Heart Study tested a Mediterranean dietary pattern that was rich in plant-based omega-3s with CV benefits that exceeded most contemporary drug trials. The early stopping may have resulted in an overestimate of the net health benefit, nevertheless, at the time the results were impressive.
  •  PREDIMED Study (2013) was a clinical trial of more than 7000 Spanish individuals at high CV risk that assessed the effects of the Mediterranean diet on the primary prevention of cardiovascular disease (New England Journal of Medicine, 2013). This was a pivotal dietary study with a statistically significant 30% decrease in heart attack, stroke and cardiovascular death found after about 5 years. The dietary pattern (similar to the pattern endorsed by the AHA) was rich in olive oil, nuts, fish, whole grains, fruits and vegetables, and healthier fats. In fact, those assigned to the PREDIMED dietary pattern also had a 50% reduction in the development of new diabetes. A substudy of PREDIMED published in the Journal of Neurology, Neurosurgery & Psychiatry found that individuals randomly assigned to a Mediterranean diet supplemented with extra-virgin olive oil or mixed nuts had better cognitive function than control patients who followed the control dietary pattern (note this pattern was also tested in the hybrid MIND diet).

The 30% percent lower risk of heart attack, stroke and cardiac death in those following the diet is arguably as powerful as the best cardiac drug therapy and with the added advantage (unlike statins and other medicines)  -no side-effects.


The Mediterranean dietary pattern contains many of the AHA 2020 nutrition recommendations that are backed by a growing number of scientific studies showing health benefits that equal the best prescription drugs. A dietary pattern rich in olive oil, nuts, fish, whole grains, colorful fruits and vegetables, and healthier fats and less processed foods, salt and sugar can go a long way to secure healthy aging.

Samieri, C et al. The Association Between Dietary Patterns at Midlife and Health in Aging: An Observational Study Ann Intern Med. 2013;159(9):584-591.