People who closely follow a Mediterranean diet — rich in vegetables, grains and olive oil — live longer than those who don't. Working with a 10-point scale that gauged adherence to the diet, researchers found that an increase of two points on the scale led to a 25 percent reduction in overall death rates. It also led to a 33 percent reduction in deaths from coronary heart disease, and a 24 percent reduction in deaths from cancer. The findings appear in the June 26 issue of the New England Journal of Medicine.

"Twenty-five percent is a very substantial reduction," says Dr. Dimitrios Trichopoulos, the senior author of the study and a professor in the department of epidemiology at the Harvard School of Public Health. "It tells you that diet can accomplish that [decreased mortality] over and beyond obesity and everything else. This is an important message because there has been doubt about what you can accomplish with diet," he adds.

Dr. Ira Nash, associate professor of medicine at Mount Sinai School of Medicine in New York City, says, "This is more support for a concept that's been emerging: that there's something particularly beneficial about eating in a way that doesn't concentrate on just one dimension of changing the way people eat, but instead promoting a healthy approach to food in general. This appears to be a more palatable and sustainable way of eating than a lot of more extreme diets."

‘As Much Myth as Evidence’
The search for a dietary fountain of youth has been going on for centuries. The so-called Mediterranean diet has emerged as a leading contender but, as Dr. Frank Hu of the Harvard School of Public Health states in an accompanying editorial in the journal, "the diet... has been surrounded by as much myth as scientific evidence."

The traditional Mediterranean diet puts the emphasis on vegetables, legumes, fruits, nuts, cereals and olive oil. It goes light on saturated fats and involves a moderately high intake of fish, a low-to-moderate intake of dairy products, a low intake of meat and poultry and a regular, albeit moderate, intake of alcohol, mostly in the form of wine at meals.

The new study analyzed the dietary patterns of 22,043 adults in Greece. Each participant was given a detailed questionnaire about 150 foods and beverages commonly consumed in Greece. They were asked to record how frequently they consumed the items and what the portion size was. The researchers also collected information on physical activity.

The participants, who ranged in age from 20 to 86, were followed for an average of almost four years, during which time there were 275 deaths, 97 from cancer and 54 from heart disease. Those who adhered more closely to the Mediterranean diet were less likely to die, in general, and were less likely to die of coronary heart disease or cancer.

"What is intriguing is that they [the researchers] weren't able to find an association with individual foods, so it also speaks to the fact that we really don't know so much about nutrition and the impact of various interactions of foods with one another," Nash notes.

Diet Shouldn’t Be Difficult for Americans
"You can substitute whatever lipids [fats] you use with olive oil," Trichopoulos suggests. "Consider increasing your consumption of vegetables and legumes, which are important, or you can reduce your consumption of meat. A reduction of a little bit of dairy products will be useful."

But paying attention to types of food isn't enough, says Samantha Heller, a senior clinical nutritionist at New York University Medical Center in New York City. "If you eat healthy foods, you still have to watch out for how much you eat," she warns. "It's how much and what you eat."

The other part of the equation is physical activity.
"What we want to say to the public is, follow the guidelines of that diet, which is generally very healthy. Watch your portion size and move physically," Heller says. "None of this is new. How we get people to do it is the hard part."