Adapting the Mediterranean Diet for the Western World

The modern iteration of the Western diet is a health catastrophe unfolding. It is making us sick. It is now mostly made up of ultra-processed foods, refined sugars, artificial sweeteners, refined fats, and processed meat. It's low fibre, low nutrition and now has blatantly obvious poor health outcomes.^[1]

These diets are eaten across most of the developed world, particularly the Anglo-world (i.e., Western Europe, North America, Australasia), but they are also becoming more popular in the developed world as well. And they have been linked to several severe, widespread diseases and poor health outcomes, like:

• Cardiovascular diseases
• Obesity and metabolic syndrome
• Several different cancers
• Type 2 diabetes
• Poor mental health
• Lower life expectancy and healthy life expectancy

These outcomes are direct consequences of a dietary shift. This is not a small problem. It is probably the biggest (but most easily fixed) public health issue Anglo-Western (and many other) countries face.

Sources: ^{[1][2][3][4][5]}

What is the answer to the Modern Western diet?

In response, public health organisations, scientists and nutritionists have turned to the Mediterranean diet. It is the most-studied diet in the world, with decades of high-quality research behind it. It's cheap. It has been tried and tested for centuries. It has unparalleled health outcomes.^[6][7]

Even in our own analyses, it features at the top of nearly every list we've compiled: heart health, brain health, healthy body weights, and good general health. However, despite its benefits, it has still not been widely adopted. In fact, most people in the West wouldn't have a clue what the Mediterranean diet actually is.

When you first hear about the diet, you might picture olive groves in Tuscany, vineyards, figs, tomatoes, wild-caught sea bream from the Aegean, and a shopping basket that costs a small fortune. You may assume that eating "Mediterranean" means buying Mediterranean. It doesn't.

The health benefits of this diet were never about latitude, sunshine, or where your nearest coastline is. It comes from its content, a specific combination of healthy fats, high fibre, and lots of phytonutrients. Your body cannot tell whether a molecule of omega-3 comes from an olive grove in Seville or a rapeseed field in Yorkshire.

However, for your average Western shopper, following the diet may be unsustainable. Premium extra virgin olive oil, imported out-of-season fruits and vegetables, and wild-foraged bitter greens are out of reach for most people: financially, environmentally and culinarily.

Can you adapt the Mediterranean diet?

There is proof-of-concept that the Mediterranean diet can be adapted at a national scale. The "New Nordic Diet" was created by Nordic nutritionists, scientists and chefs to try to improve the health outcomes of their people. This was based on the Mediterranean diet, but adapted to the Nordic regions using home-grown Northern European substitute ingredients.

• Rapeseed (or canola) oil instead of olive oil
• Root vegetables and berries instead of Mediterranean produce
• Cold-water North Sea fish instead of Mediterranean seafood

Nordic people who followed the new Nordic diet for 6-months lost weight (around 3kg) and lowered their blood pressure (by around 3-5 mmHg). They copied the Mediterranean diet formula, but not the exact ingredients, and they got comparable health benefits.^[8]

We aim to do the same in this article for the Western diet. The same proven health benefits, but a cheaper, local, seasonal, and sustainable variant. This version of the diet rests on three core pillars:

1. Nutritional: It matches or exceeds the exact nutritional and biochemical benefits of Mediterranean foods and food groups.
2. Sustainable: Aim to minimise food miles, food waste, pollution, and environmental footprint by prioritising foods that are native or efficiently grown.
3. Economical: Aim to lower the upfront $/£ cost, waste, and benefit the local economy by prioritising abundant, local, and shelf-stable staples.

Swap 1: Olive oil for cold-pressed rapeseed oil

Cold-pressed rapeseed oil is the closest widely available match for olive oil.^[9]

• It is easily grown and processed at scale in all Western countries already.
• It contains heart-healthy monounsaturated fats (oleic acid) and polyunsaturated fats (alpha-linolenic acid and omega-3 fatty acids).
• It contains the lowest saturated fat of any common cooking oil (including olive oil).
• It contains more vitamin E than olive oil, but not quite the same diverse antioxidant profile. Choose a cold-pressed, unrefined version.

Those in Australia and New Zealand can also use avocado and macadamia nut oil, which also have similar nutrition profiles to rapeseed and olive oil.

Swap 2: Mediterranean grains for oats and barley

Mediterranean grains like farro, bulgur wheat, and couscous are great sources of soluble fibre, plant-protein and some essential micronutrients. But they're not readily available, and when they are, they usually sell at a premium. Grains are meant to be a daily staple, not an exotic, overpriced luxury.

• Pearl barley and whole oats are cheap, sustainable Western crops that are rich in fibre, particularly beta-glucan, a soluble fibre that reduces cholesterol, insulin and blood sugar levels.^[10]
• Ground "cornmeal" (also known as polenta or grits) is grown in North America and has a similar nutritional profile to the Mediterranean grains.
• Drought-tolerant sorghum grain can be grown sustainably in Australia, as it requires minimal water. It is also gluten-free.
• Rye grain is also popular in Northern European climates, where it can be used to make bread. It is a low-glycaemic carbohydrate, high in fibre, and outperforms the highly processed wheat breads that are common to the region.

Swap 3: Mediterranean fish for local, sustainable, oily fish.

While the warm water in the Mediterranean supplies the locals with plenty of fresh fish and seafood, the colder waters of the West actually provide seafood with a superior nutritional profile.

The small, cold-water oily fish provide omega-3 fatty acids (e.g., EPA and DHA), which lower inflammation and are good for heart and brain health.^[11][12][13]

• For Britain, herring, mackerel and Cornish sardines are (relatively) cheap, sustainable and rich in protein, vitamin D, B3, B12, selenium, calcium, as well as omega-3s.
• Alaskan and Pacific salmon are a suitable alternative for North Americans and have a higher protein content.
• Sardines, school whiting and hoki are suitable equivalents for Australians and New Zealanders.

Swap 4: Mediterranean plants for local, seasonal, colourful ones

Britain

• Broad beans (or fava beans) and marrowfat peas provide the same fibre and protein as chickpeas. They also fix their own nitrogen, meaning they need less chemical fertiliser to grow.
• Kale, cabbage, other dark leafy greens and roots like turnips and beetroot have numerous proven health benefits.^[14]
• Summer berries, and the blackberries and blackcurrants that grow in the hedgerows, are rich in antioxidants and free if you pick them yourself.

Australia & New Zealand

• Kumara (New Zealand Sweet potato), Kent/Jap pumpkins and local ("warrigal") leafy greens are regional staples that offer fibre, potassium, antioxidants and other micronutrients, as are local leafy greens.
• Local kiwifruit can be used as a substitute for the Mediterranean citrus fruits. Kiwifruit contains more vitamin C and fibre.

North America

• North America produces a lot of protein-rich legumes. Pinto beans, black beans, navy beans, peas, lentils and chickpeas are all cheap, mass-produced, sustainable (nitrogen-fixers), and nutritious (fibre, protein, folate, iron, magnesium). They can easily cover the nutrition provided by the Mediterranean white beans.
• Sweet potatoes, pumpkins, butternut squash, cranberries and blueberries grow well, at scale, in North American soil. They provide fibre, several phytonutrients and micronutrients that can replace the Mediterranean vegetables and stone fruits.

How to replicate the diversity of Mediterranean produce?

For optimal health, you not only need to eat enough fruits and vegetables, but you also need to eat a variety of different types of plant foods. Different plants have different nutrient profiles, so eating a few different types ensures you're not missing any key nutrients.

We think the easiest way of doing this is to eat a range of different colours ("eat the rainbow"), as they do in the Mediterranean.

• Swap Mediterranean tomatoes and bell peppers for carrots, pumpkins, sweet potatoes and locally grown (or canned) tomatoes.
• Swap fresh figs, grapes and pomegranates for dark berries (e.g., blackberries, cranberries, blueberries, black currants) and kiwi fruit.^[15]
• Swap courgette, aubergine and artichokes for local brassica varieties (e.g., cabbage, kale, broccoli, sprouts). This swap is actually an upgrade.^[16]
• Swap Mediterranean leafy greens for beetroot, spinach or any other locally grown wild greens.

The benefits of adapting the Mediterranean diet to your region

Environmental

Although most of the Mediterranean foods are probably available in your area, these swaps can cut the food miles down. Shipping fresh produce across the world requires fuel, cold storage, and packaging — this comes at a cost to the environment.

So, choosing local root vegetables, brassicas, berries, domestically produced grains, legumes and oilseeds is better for the environment. The whole of the Western world was never going to be able to be solely reliant on extra virgin olive oil as its primary fat source.

Economical

A bottle of imported extra virgin olive oil, or fresh fish flown in from Mediterranean waters, will almost always cost more per serving than a bottle of local cold-pressed rapeseed, a bag of oats or barley, or a can of local oily fish.

There is a perception that eating healthily is expensive. However, this could not be further from the truth. In fact, traditional Mediterranean dishes were born from “cucina povera” or “peasant cooking” that was built from cheap ingredients.^[17]

The high costs usually come from imported foods. A Mediterranean sea bass confit in Ligurian olive oil with out-of-season artichokes is no more nutritious than a kipper (herring) cooked in rapeseed oil with pearl barley and seasonal cabbage, despite being five or six times the cost.

There is a second economic benefit. Buying local produce keeps the money within your local economy rather than going to multinational shipping networks and distributors. It supports domestic farming, fishing and rural communities that will improve your own food security, ecological needs and the higher agricultural standards in the West.

Lastly, the whole of the West needs to eat a lot more beans, lentils and peas. These crops require a lot less synthetic nitrogen fertiliser than cereal and grain crops, and can fix nitrogen for other crops. Over time, this will cut input costs for farmers and then eventually for shoppers.

Nutritional

There is no reason to suspect that the swaps suggested in this article shouldn't deliver the same nutrition and health benefits as the Mediterranean and new Nordic diets.

Some eagle-eyed readers may be able to identify some shortfalls in our swaps. However, we argue that the nutritional content of the foods within their home region may deteriorate when consumed outside their region, as ripe, seasonal, fresher food is more nutritious than food that has been harvested prematurely and sat in a shipping container for two weeks.

Second, we also believe that some of the foods that are native or local to the West are actually more nutritious and healthy than their Mediterranean equivalents (e.g., oily fish, some grains and legumes).

Bottom Line

A core principle of the Mediterranean diet is flexibility. Despite the name, it was never about slavishly following a rigid list of ingredients. It is a philosophy of eating; it's simple, seasonal, and local.

Mediterraneans chose not to eat a lot of milk and red meat, not because of TMAO or lactose, but because they couldn't farm cows in the region.

The Mediterranean diet is built on minimally processed plants, whole grains, oily fish, and unsaturated fats. Garlic, herbs and spices are used for seasoning, rather than excessive salt, sugar, and other artificial flavourings and sweeteners. And the New Nordic Diet proves that its health benefits can be translated outside of the Mediterranean basin.

We believe it can translate just as well to the Anglo-Western countries as it can to the Nordic countries.

First 5 Steps to Get You Going:

1. Buy one bottle of local cold-pressed rapeseed oil. If you are currently using extra-virgin olive oil, try this instead. If you're not, try replacing other fats with it (e.g., butters, margarines, lard, coconut, palm, vegetable or other seed oils).
2. Add a can of local oily fish to your next weekly shop. Herring, mackerel, sardines, or wild Pacific pink salmon, whichever is native to your coastline.
3. Add a can of beans, lentils or peas to your next weekly shop. Try broad beans, lentils, or black beans instead of imported chickpeas or white beans. Add them to your soups, stews or bolognese sauces. Mash them and put them on toast with a drizzle of rapeseed oil.
4. Swap your grains. Skip the white rice, bread and pasta. Buy rolled oats, rye bread, and pearl barley instead.
5. Try 1 new local fruit or vegetable a week. Fresh, frozen, or foraged. Become familiar with your local and seasonal produce. The foundation of the Mediterranean diet is plant-based; you need to know what's available in your region and what you (and your family) like.