Women who closely followed a Mediterranean diet lived much longer than those who did not, according to a new study that followed more than 25,000 women for 25 years.
鈥淔or women interested in longevity, our study shows that following a Mediterranean dietary pattern could result in about one-quarter reduction in risk of death over more than 25 years with benefit for both cancer and cardiovascular mortality, the top causes of death,鈥� senior study author Dr. Samia Mora, a cardiologist at Brigham and Women鈥檚 Hospital and professor of medicine at Harvard Medical School in Boston, said in an email.
The Mediterranean diet features simple, plant-based cooking, with much of each meal focused on fruits and vegetables, whole grains, beans and seeds, with a few nuts and a heavy emphasis on extra-virgin olive oil. Fats other than olive oil, such as butter, are consumed rarely, if at all, and sugar and refined foods should be avoided.
Red meat is used sparingly, usually only to flavour a dish. Eating healthy, oily fish, which are packed with omega-3 fatty acids, is encouraged, while eggs, dairy and poultry are eaten in much smaller portions than in the traditional Western diet.
鈥淚n this study, adherence to the Mediterranean diet was a proxy for diet quality. Those who adhered most closely were eating more legumes, more vegetables, more fruits, less meat, and less processed meats,鈥� said Dr. David Katz, a specialist in preventive and lifestyle medicine who founded the nonprofit , a global coalition of experts dedicated to evidence-based lifestyle medicine.
While the study was observational and thus could not show a direct cause and effect, 鈥渢he finding is entirely consistent with many other studies of the now famously healthful Mediterranean diet,鈥� said Katz, who was not involved in the research.
鈥淲e may be comfortable inferring that a high-quality diet did, indeed, 鈥榗ause鈥� a lower risk of death,鈥� Katz said in an email.
Why studying women is important
The Mediterranean diet has a long list of scientific kudos: The Mediterranean style of eating may reduce the risk for breast cancer, dementia, depression, diabetes, high cholesterol and memory loss. Adherence to the diet can also lead to stronger bones, a healthier heart and longer life. It鈥檚 also good for healthy weight loss.
In all that data, however, are few details on the specific ways the Mediterranean diet may affect women, especially long-term. That鈥檚 important, experts say, because women are not little men.
A woman鈥檚 brain works differently on a than a man鈥檚 brain. The may differ from a man鈥檚, and women have completely different symptoms for a heart attack than men. Women metabolize alcohol and differently than men. And then there鈥檚 the obvious difference of menarche and menopause, which creates an entire class of health risks specific to women.
Every bite counts
In the new study, published Friday in the journal , researchers asked 25,315 healthy women participating in the about their diet and collected blood and other biomarkers between 1993 and 1996. Those women were re-evaluated between 2018 and 2023.
Not only did closely following the Mediterranean diet cut the risk of early death by 23 per cent, it lessened the risk of dying from cancer by 17 per cent and dying from cardiovascular disease by 20 per cent, the study found.
鈥淭here was a graded stepwise increase in benefit 鈥� the more committed the more benefit,鈥� said lead author Shafqat Ahmad, an associate professor of molecular epidemiology at Uppsala University in Sweden, in an email.
Each increase in adherence to the Mediterranean diet was associated with a 6 per cent lower risk of all-cause mortality and a 5 per cent reduced risk of dying from either heart disease or cancer, Ahmad said.
鈥淲hat might be worth noting is that the adherence measure 鈥榗orrects鈥� for distortions of the Mediterranean diet,鈥� Katz said. 鈥淚n the US, simply adding olive oil to French fries might result in someone claiming to be 鈥榦n鈥� the Mediterranean diet.鈥�
However, the study corrects for distortions by looking at all the 鈥渒ey features of a 鈥榯rue鈥� Mediterranean diet, and thus precludes that kind of misrepresentation,鈥� Katz said.
Want to start the Mediterranean diet?
It鈥檚 not hard to incorporate a Mediterranean style of eating into your life, experts say. Start by adding more veggies and legumes to each meal and use all kinds and colours to get the broadest range of nutrients, phytochemicals and fibre. Cook, roast or garnish them with herbs and a bit of extra-virgin olive oil.
Add whole grains and fruit to every meal, but use nuts and seeds as a garnish or small snack because of their higher calorie and fat content.
Cut way back on the use of red meat. Instead turn to fish and other seafood, which are often consumed at least twice a week. Get as much protein as you can from beans and other legumes. Start with one bean-based meal a week, then add two and build your nonmeat meals from there.
Mix in cheese and yogurt daily to weekly in moderate portions. Chicken, pork and eggs are OK on occasion. Keep sweets for special occasions and satisfy your sweet tooth with fresh and frozen fruit.
