How to Eat Like a Mediterranean and Live to 100

This traditional diet provides delicious insight into how to eat well so you can live well

How to Eat Like a Mediterranean and Live to 100
A traditional Italian Caprese salad belongs to the Mediterranean diet. (Shutterstock)
Heather Lightner

What if changing your diet meant that you might be able to live to be 100? Too good to be true? Research says otherwise—and to “pass the olive oil.”

It turns out that the prescription for good health is a Mediterranean diet.

What is the Mediterranean diet? It has been touted for years by doctors, researchers, and registered dietitians as an easy and healthy way of eating to promote well-being.

The U.S. Department of Agriculture (USDA) defines the Mediterranean diet as one that's “high in fruits and vegetables, cereals and bread, potatoes, poultry, beans, nuts, olive oil, and fish while low in red meat and dairy and moderate in alcohol consumption.”
This pattern of eating comes with many potential health benefits; it can prevent heart disease and stroke and reduce risk factors, including obesity, high cholesterol, high blood pressure, and diabetes.
The term “Mediterranean diet” was first coined by Ancel Keys, an American scientist specializing in biology and physiology. Keys conducted research on nutrition throughout his entire career. In the 1950s, he began the Seven Countries Study—a study of middle-aged men living in seven different countries, including the United States. He observed that some countries had much lower rates of heart disease than the United States, suggesting that heart disease could perhaps be prevented.

Keys and his colleagues in their research discovered that dietary patterns in the Mediterranean region and Japan were linked with low rates of coronary heart disease and lower deaths due to any other cause (all-cause mortality). Their findings led Keys and other scientists to promote an eating model they discovered in Italy and Greece, which we now know as the Mediterranean diet.

The second phase of the Seven Countries Study also found that a healthy Mediterranean-type diet and exercise could delay cognitive decline and reduce the risk of depression.

It’s no coincidence that a lifetime of studying health and nutrition reaped benefits for Keys; Keys continued to work into his 90s and died two months short of his 101st birthday.

The Lyon Diet Heart Study assessed the benefits of a French version of the Mediterranean diet on patients who had already suffered from a heart attack. Researchers decided to include rapeseed oil, which is rich in omega-3 fatty acids, along with olive oil to simulate a Greek diet. The study yielded a 50 percent to 70 percent decrease in recurrent heart disease-related events (such as heart attacks, strokes, blood clots, and so forth), as well as a reduction in the number of new cancer cases. This study resulted in a heightened awareness among the medical community regarding the potential health benefits associated with a Mediterranean diet.
A Swedish study published in 2015 concluded that following a Mediterranean diet reduced the risk of heart attack, heart failure, and ischemic stroke. The researchers went on to say that the Mediterranean diet was considered “beneficial in primary prevention of all major types of atherosclerosis-related CVD (cardiovascular disease).”

Following Mediterranean Diet to Help Promote Longevity

Much research has been focused on Italian centenarians. A well-performing immune system along with an elevated expression of anti-inflammatory and immunity genes have been identified as longevity markers in Sicilian centenarians.

Although genes are an important factor in longevity, lifestyle factors such as nutrition and diet also influence health and the possibility of a lengthened lifespan.

Researchers at the University of Palermo studied centenarians living in the villages of the Sicani Mountains in central Sicily. Out of 18,328 residents, they discovered 19 men and women between the ages of 100 to 107. When researchers did the math, they learned that the percentage of centenarians living in the Sicani Mountain villages was greater than four times the national average.

An assessment showed that these centenarians had followed a Mediterranean diet and consumed foods low on the glycemic index (foods that don't cause insulin levels to spike).

The centenarians were given a physical exam and had fasting blood lab work done. Their height was also measured, and their weight was taken so that a body mass index (BMI) could be calculated. They were also given a nutritional assessment. They were assessed for competency with physical tasks (such as bathing, toileting, and dressing), life management capacity (for instance, managing finances), sensory items (visual acuity and vision), and cognitive abilities (comprehension and the ability to express self).

Not surprisingly, the centenarians were physically active and had normal BMIs. The assessments showed that the centenarians were “moderately independent” with physical and life management tasks. All the centenarians lived in a family home, usually with relatives, making it possible for loved ones to fill in any gaps in self-care.

The study subjects didn't have any cardiac risk factors or significant age-related diseases, such as heart disease, severe cognitive or physical impairment, clinically evident cancer, or renal disease. Most lab test results, including cholesterol and triglycerides, were within normal limits.

Of note, the centenarians’ lives revolve around socialization, appropriate physical activity, small amounts of food containing small amounts of carbohydrates and meat, and copious amounts of seasonal fruit and vegetables divided among three meals.

What’s for Breakfast, Lunch, and Dinner?

So what would someone who would like to follow a Mediterranean diet eat in terms of actual meals? Registered dietitian Kelly Bakes advises clients to try to follow a diet made up of whole foods as much as possible and to incorporate more vegetables into all three meals.

Since the Mediterranean diet is big on whole grains, Bakes says oatmeal is a good breakfast option. For those who prefer eggs in the morning, adding some vegetables and some whole-grain toast can also be a healthy choice. Greek yogurt or kefir (unsweetened) and fruit or even Cheerios are also foods that could be eaten for the first meal of the day.

For snacks, she suggests eating yogurt with fruit, seeds, and nuts.

At lunch, Bakes says she has “super motivated clients” make bowls of quinoa, farrow, or barley and vegetables, such as spinach, an undressed coleslaw or broccoli slaw mix, arugula, kale, tomatoes, and cucumber.

“If you don’t have to do an animal protein, beans or lentils is going to be healthier,” she said.

If you’re not feeling super motivated, however, steaming a bag of broccoli with lunch or incorporating some rinsed, low-sodium chickpeas are some foods that can make your meal a little more nutritious. For sandwich lovers, a sandwich made with freshly cooked chicken (or even deli chicken or turkey) on whole grain bread is fine—just add some vegetables on the side to complete the meal.

According to Bakes, a dinner might include a protein (such as fish or seafood), roasted vegetables, and maybe a grain or starch at night—for instance, a small sweet potato or some butternut squash.

Weight loss is an inevitable result of those following the Mediterranean diet, even if that isn't the goal, since foods that might otherwise be eaten are replaced by low-calorie, high-fiber foods.

“If you’re eating five cups of vegetables, that is going to displace other foods you would be eating,” Bakes said.

Eating a lot of fiber comes with benefits, she said. Fiber “keeps things moving” in your gastrointestinal system and contains prebiotics, which help feed healthy gut bacteria.

Bakes's clients report that their energy level is improved and that they have less bloating and “feel thinner.”

Down the road, cholesterol and blood sugar levels also improve.

“I have had many clients completely go off cholesterol medications, go off diabetes medications,” she said.

Some with inflammation in their joints and other places also see a decrease in inflammation.

“They just feel better," Bakes said.

Stepping Into the 'Blue Zone'

Dan Buettner, the bestselling author of "The Blue Zones Solution," has studied research on the diets, eating habits, and lifestyles of communities that he calls “blue zones”—places with the oldest and healthiest residents in the world. Blue-zone locations include Okinawa, Japan; Ikaria, Greece; Sardinia, Italy; Costa Rica’s Nicoya Peninsula; and Loma Linda, California.

Through his research, Buettner discovered that blue-zone residents followed a unique Mediterranean eating pattern referred to as the Blue Zones Diet. These people, particularly Ikarians (Greece) and Sardinians (Italy), ate a diet that included a lot of vegetables, olive oil, small amounts of dairy and meat products, and moderate amounts of alcohol, he wrote in an email to The Epoch Times.

What set these areas apart from places in other regions is their emphasis on certain foods, according to Buettner. These foods include potatoes, honey, legumes (especially garbanzo beans, black-eyed peas, and lentils), wild greens, some fruit, and relatively small amounts of fish.

“Their diets are predominantly (90 percent to 100 percent) plant-based,” he wrote.

Blue-zone residents also eat little to no dairy, fish, or eggs and rely heavily on beans, greens, nuts, and whole grains for nutrition, Buettner said.

“Sourdough bread and red wine are also staples of four of the five blue zones,” he said.

Not Just a Diet, But a Lifestyle

The Danish Twin Study established that roughly 20 percent of longevity is based on your genes.

"That leaves 80 percent for you to impact through your eating, moving, environmental, and social habits,” Buettner said.

He noted in his book that it’s not just what blue-zone residents are eating but how a Mediterranean-type diet is lived.

He said that there are nine commonalities practiced in all the blue zones that may be behind their inhabitants' longevity. These are known as the "Power 9":

1. Move Naturally

Living a lifestyle that naturally encourages movement is a major component of the blue-zone lifestyle.
“The world’s longest-lived people don’t pump iron, run marathons, or join gyms,” Buettner said. “Instead, they live in environments that constantly nudge them into moving without thinking about it."

2. Purpose

Having a sense of purpose is worth up to seven years of extra life expectancy.

3. Down Shift

Stress leads to chronic inflammation, which is associated with every major age-related disease.

“Even people in blue-zone areas experience stress, but they have daily routines to shed that stress,” Buettner said.

In other words, by creating a strategy for relieving stress, disease processes could be reversed.

4. 80 Percent Rule

It's important to eat mindfully and stop when 80 percent full.

“The 20 percent gap between not being hungry and feeling full could be the difference between losing or gaining weight,” Buettner said.

People living in blue zones eat their smallest meal in the late afternoon or early evening and then don’t eat any more the rest of the day.

5. Plant Slant

Adding more fruits and veggies to your plate can add years to your life. Beans, including fava, black, soy, and lentils, are the cornerstone of most centenarian diets.

6. Wine at 5

For people who have a healthy relationship with alcohol, enjoying a glass of red wine with good friends each day during dinner is part of a blue-zone lifestyle.

7. Belong

“Research shows that attending faith-based services four times per month will add four to 14 years of life expectancy,” Buettner said.

8. Loved Ones First

Centenarians in blue zones put their families first.

9. Right Tribe

“The world’s longest-lived people also choose—or are born into—social circles that support healthy behaviors. Research shows that smoking, obesity, happiness, and even loneliness are contagious. The social networks of long-lived people favorably shape their health behaviors,” Buettner said.
It has been suggested that by 2050, the number of centenarians will approach 3.2 million worldwide, representing an 18-fold increase from the past century.

If You Can Only Do 1 Thing

For the average person who may not be willing or for some reason is unable to fully change their eating habits, what small daily actions can one take to increase his or her chance of living to 100 years?

Buettner says just making a small effort to eat more plant-based meals during the week can have a huge effect.

“Maybe having a few meals a week where there is no meat or it’s simply a side would be a great start,” he said.

Bakes agrees with Buettner.

“For every client, I always say, if you hear nothing else I say, eat more vegetables,” she said.

A meta-analysis that followed hundreds of thousands of people for decades found that switching to a blue-zones-type diet (from a standard American diet) can add an average of a little more than 10 years of life for women, or 13 years for men.

For those people who aren't ready to change their diet quite yet, implementing aspects of the Power 9 can help promote the chance of longevity.

Get more natural movement each day, volunteer, eat less, and enjoy time together with friends and family.

“Adding small nudges each day adds up over time," Buettner said.

Heather Lightner is a medical writer for The Epoch Times. She is a registered nurse and board-certified case manager.