Cretan Mediterranean Diet -
The Seven Countries Study
The Seven Countries Study gave the best scientific proof for the association between a diet low in animal products and saturated fat and low mean population levels of serum cholesterol with low incidence and mortality from CHD.
Highlights of the Seven Countries Study
- The Cretan Mediterranean Diet is not a theoretical construct -- it was a proven cultural model for healthy eating during the '50s and '60s.
- Greek men who ate the Mediterranean Diet enjoyed the longest life expectancy in the world, at that time.
- The Mediterranean Diet is characterized by abundant plant foods.
The value of eating Mediterranean style came into focus in the 1960s. At that time men living in Crete, parts of Greece, and southern Italy were least likely to develop coronary heart disease.1 The premature death rate from heart attack for Greek men was 90 percent lower than that of American men. And Greek men enjoyed the longest life expectancy in the world. This may no longer be true today, as the traditional Greek Diet has become increasingly westernized.
This study of the local Mediterranean population was carried out by a American nutritionist, Ancel Keys. In this study, he had noted a lower incidence of some diseases compared with the United States. This scholar undertook research which lasted twenty years and the results of which were published in his Seven Countries Study. Since then scores of papers have published on this Seven Countries Study.
The Seven Countries Study was conducted with almost 13,000 men, aged 40 to 59 years, and healthy at entry examination, enrolled in 15 population samples located in seven different countries (Italy, Greece, former Yugoslavia, the Netherlands, Finland, United States, and Japan).
The Seven Countries Study came to several important conclusions. "It established that population death rates from coronary heart disease can be predicted precisely by knowledge of the average serum cholesterol." A strong correlation was found between heart disease incidence and average saturated fatty acid intake. "The study was the first to demonstrate in population correlations a strong inverse relationship of monounsaturated fatty acids (olive oil) in the diet to coronary, cancer and all-cause mortality." "Both habitual physical activity and resting heart rate were [found to be] significant predictors of death and coronary death." "Systolic and diastolic [blood] pressure were both [found to be] significant risk factors for coronary and total deaths when adjusted for all other risks."
Mediterranean Diet Basics
Among all cohorts from southern Europe, Crete showed the lowest mortality from CHD and all causes. More than other Mediterranean Diet, the Cretan diet was, at least in the 1960s, rich in legumes, fruit, and edible fats that were mostly olive oil. The Cretan diet contained much less meat, but supplied moderate amounts of fish and alcohol, mostly in form of red wine.
"The total red meat, poultry and fish consumed on a per-person basis in southern Italy was 434 grams (15.5 ounces) per week in 1960, and in Crete it was about 371 grams (13 ounces) per week." 
"The diets of the Mediterranean region have been shaped in large part by various factors that can be tied to the Mediterranean Sea. At least for coastal residents, fish was a significant part of the diet. However, available data on the food consumption patterns of Greece and southern Italy in the early 1960s do not show a particularly large contribution to the diet from fish."
"Fish consumption in the Mediterranean in 1960 varied from 126 grams (4.5 ounces) per person per week in Crete to 420 grams (15 ounces) per person per week in Corfu in individual dietary surveys, while FAO Food Balance Sheet data indicate that in the same year weekly per-capita supply of fish in Spain was 519 grams (18.5) ounces and in Portugal was 1,057 grams (38 ounces). Both countries follow a traditional Mediterranean food and health pattern. In Japan, which now enjoys the highest life expectancy in the world, per-capita consumption of fish has ranged from 532 to 672 grams (19 to 24 ounces) per week over the last 25 years "
The Mediterranean Diet "is characterized by abundant plant foods (fruit, vegetables, breads, other forms of cereals, potatoes, beans, nuts, and seeds), fresh fruit as the typical daily dessert, olive oil as the principal source of fat, dairy products (principally cheese and yogurt), and fish and poultry consumed in low to moderate amounts, zero to four eggs consumed weekly, red meat consumed in low amounts, and wine consumed in low to moderate amounts, normally with meals."
"In the early 1960's, per-capita consumption of cheese in Crete was 91 grams ( 3 ounces) a week, with about an additional cup (2.5 deciliters) of milk consumed per day, usually in the form of yogurt. In southern Italy in the 1960's, per-capita consumption of milk was 609 grams per week or the equivalent of about 61 grams (2 ounces) of cheese per week."
"The Seven Countries Study reported that men in rural Crete in 1960 were apparently safely consuming 40 percent of their energy (calories) in the form of fat, following this pattern: 29 percent monounsaturated fat, 8 percent saturated fat, and 3 percent polyunsaturated fat."
"Throughout the Mediterranean, bread was and remains fundamental to the diet. It is eaten and enjoyed without butter or margarine."
Check out the following link for more information on the Seven Countries Study.
- On the Trail of Heart Attacks in Seven Countries (A very long series of articles written by Henry Blackburn M.D., one of the principal authors of the study. The articles are sequentially linked at the bottom of each page, or you may jump around by using the links in the left margin.)
Conclusions on the Seven Countries Study are summarized on this site in the Advanced Healthy Diet Guidelines webpage.
- Willett WC; Sacks F; Trichopoulou A, Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995 Jun;61(6 Suppl):1402S-1406S
- Main Results of the Seven Countries Study