Editorial: Alimentary School; The Latest Advice on Nutrition

Americans like to feed off dietary advice, which is plentiful but often hard to digest. Are carbohydrates really so bad? Is chocolate truly healthful? What’s the deal with fat? French chef Julia Child never apologized for butter, insisting that it was good for the brain. And speaking of cholesterol, eggs appear to be making a comeback. We won’t go into sugar, which was recently branded as toxic.

All this to say that a study published recently in the New England Journal of Medicine may add to the general confusion. That would be too bad, because it appears to clarify what to eat and what not to eat. The research findings could be an important piece of evidence supporting the benefits of a Mediterranean diet. That’s a diet based largely on fruit, vegetables, nuts, legumes, fish and olive oil — not on spaghetti, as a person we know who’s an avid pasta eater mistakenly assumed.

Of course, a sensible portion of whole-wheat pasta with fresh tomato sauce would not be frowned upon. The Mediterranean diet, as New York Times food writer Mark Bittman points out, is flexible, forgiving and delicious, relying on fresh ingredients untainted by additives such as salt, sugar and corn syrup that make up processed food. Lean white meat, low-fat dairy products, whole grain cereals and red wine are permissible in moderation. So is chocolate high in cocoa, which contains an anti-oxidant good for human cells.

This dietary regimen, even without calorie restrictions, appeared to prevent cardiovascular disease in an observational study conducted in Spain, in which more than 7,000 participants between the ages of 55 and 80 were assigned one of three diets and watched for almost five years. All participants were considered at high risk of developing heart disease, because they had conditions such as diabetes, hypertension or high cholesterol. Those who followed one of two variations of the Mediterranean diet — one supplemented with olive oil, the other with nuts — had fewer heart attacks and strokes than those who followed a low-fat “control diet.” Statistically speaking, the results were impressive: The risk was 30 percent lower for the groups on the Mediterranean diet.

The study is significant not only because it is the first to rigorously investigate the effects of a particular diet; it is also noteworthy because it calls into question the practicality and thus the effectiveness of a diet that eliminates fat, or tries to. Many doctors strongly recommend a low-fat diet to prevent heart disease. The problem is that a diet that shuns fat is hard to maintain, in part because people crave the rich taste that butter and oil provide. In fact, researchers in Spain found that participants assigned to the low-fat diet were not able to reduce calories from fat very much because they ended up eating things they weren’t supposed to, like red meat and baked goods. Those following the Mediterranean diet, on the other hand, were able to stick to it. Olive oil and nuts are filling, and chocolate pleases the palate.

No doubt there will be further investigation of this and other diets, and recommendations will continue to shift. In the meantime, common sense should prevail in the fight against obesity and diet-related disease. Food writer Michael Pollan had it just about right when he summarized dietary advice in seven words: “Eat food. Not too much. Mostly plants.”