A Moveable Feast

The Mediterranean Diet, an essentially American myth, is at last coming to the Mediterranean region itself

The “Traditional” Mediterranean Diet Pyramid: healthful eating in America, in recent years, has meant following this diet’s principles. Photography by Natalie Matutschovsky

The chemist on our corner in Barcelona has pinned up in his window a riposte to what he considers to be a well-intentioned but ignorant North American notion: the Mediterranean Diet Pyramid, which tells people what foods they should eat daily and in what proportions. He has chosen, rather, to publicize a Catalan version, designed by the Barcelona College of Pharmacists.

The official, internationally disseminated pyramidal diagram, devised by distinguished North American research teams, includes a decree that almost no red meat shall be eaten: red meat occupies the tiny tip of the pyramid, and should pass one’s lips only “a few times a month.” The Catalan pyramid puts meat in a large layer in the middle of the triangle: “two or three servings a day.” Eggs likewise. The Mediterranean Diet Pyramid allows eggs “zero to four times a week, including any egg used in cooking and in prepared foods.” Catalans, looking around for something small enough in their food range to occupy a pyramid tip, decided that only salt would fit: salt should be eaten as little as Americans say you should eat red meat. And who, after all, is Mediterranean around here?

That’s not a rhetorical question: it expresses some irritation, and also a real bewilderment. Healthful eating in America – Atkins notwithstanding – still in large measure means following the Mediterranean Diet’s principles. Spaniards are eager to tap into the huge economic potential of this phenomenon. Alimentaria, Barcelona’s enormous food fair, now the second largest in the world, was host this year to the Fifth International Congress on the Mediterranean Diet. It has become urgent for the Spanish food industry, and for those of other Mediterranean countries, to understand exactly what is driving this essentially American myth.

The Mediterranean Diet Pyramid itself began as a riposte, in 1993, to a U.S. Department of Agriculture Diet Pyramid. The latter diagram was at that time preaching three servings – that is nine ounces – of meat per day. Critics attributed this to a cosy relationship between the Department of Agriculture and the meat industry.

Whatever else it was, the usda Pyramid was a preferential model that in its general outlines had prevailed for at least a century. But by the mid-1970s, several things had become obvious in America. More and more people were becoming obese, and far too many were suffering from heart attacks and cancer. This had not always been so; moreover, there were other societies where this was still not the case. It was also admitted that, where people have a choice, they usually make their concrete, individual, meal-by-meal decisions about what to eat following the attractions of pleasure rather than for austere reasons of health.

A third realization has become unavoidable more recently: in the modern world, where time is the structuring principle, “pleasure” for most people must include convenience. People have little time to eat, and almost none for cooking. More and more of us can’t cook, and won’t cook. The richer the homeowner, the more technologically and aesthetically advanced the kitchen – and the less it is used.

But first, the health issue. Which, the creators of the Mediterranean Diet Pyramid asked themselves, are the model societies, the ones enjoying good health? Well, one was the population of Crete – Crete in the 1940s. In 1948 the post-war Greek government invited the Rockefeller Foundation to help them evaluate the country’s standard of living. Crete was chosen for a survey of its demographic, economic, social, medical, and dietary characteristics. A report was eventually published: Crete: A Case Study of an Undeveloped Area (1953).

Researchers were first trained, then sent to live in the villages of the 765 families being studied. Their work included interviewing 128 of these families daily, weighing all of their food intake, describing it in detail, witnessing cooking practices, counting the number of times people put anything into their mouths, and investigating what was carried out with the garbage. “It is difficult to imagine,” wrote a nutritionist in 1995, “that anything like a survey of this magnitude could be initiated – or funded – today.”

It is notoriously difficult to find out the exact truth about what people eat and drink. The best-intentioned persons in the world misrepresent what they ingest, exaggerate it, minimize it, forget what they have done, fail to notice what they are doing, give up on keeping the regular records they promised. Food surveys constantly contradict both each other and the facts discernible through other means. The Crete report is thought to have been uniquely thorough in its genre. It was hard, however, even for these thorough researchers, to find out just how much wine was being drunk. Cretans evidently placed some limits on the ambitions of their nosy guests.

The document’s section on food practices caused a sensation and still makes waves today. It was brought to bear on information that arrived later: that Greeks had low incidences of heart disease. People on Crete ate almost no meat or eggs, hardly any dairy products, plenty of cereals, bread, vegetables, nuts – and a great deal of olive oil. People were thin, but with “few serious nutritional problems.” They said they loved meat, though – 72 percent said meat was their favourite food. They also habitually did hard physical work, and almost nobody owned a car.

A separate report was published in 1954 by an epidemiologist at the University of Minnesota, Ancel Keys, and his wife, Margaret. They loved to holiday in Italy, and they chose Naples as a place where heart disease was said to be low, and studied the Neapolitan diet. Later, a team headed by Keys produced the Seven Countries Study (1980), covering Greece, Finland, Japan, Italy, Holland, the U.S., and Yugoslavia. This confirmed suspicions that it was blood cholesterol, resulting from a meat-and-dairy diet, that was responsible for many health problems. People with ideal diets and better health ate lots of plants instead. It was concluded that “dominance of olive oil in the diet” reduced heart attacks. “It would be hard to do better,” wrote Keys in 1975, “than imitate the diet of the common folk of Naples in the early 1950s.”

The very thought of olive oil, it is now quite difficult to remember, had long been enough to reawaken in an Anglo-Saxon a nostalgia for toad-in-the-hole. “Swimming in olive oil,” people would recall with a shudder only a few decades ago when they came back from a trip to Italy or Greece and tried to sum up their response to the food. And classic French cuisine, as close as gastronomy could get to the fine arts, was built on butter; olive oil was a low-lier cooking medium altogether.

But now, in North America in the 1980s, books began to pour from the presses about the Mediterranean Diet. Olive oil – reconceived and nicknamed “liquid gold” – was shown in study after study to be a kind of magic panacea. It is good for the bloodstream, helps children grow, slows aging, fights cancer, improves the skin. And people on the Mediterranean coasts, who rejoiced in olive oil at almost every meal, seemed to be committed to living on their other good foods, brightly coloured and intense of flavour, all in the hierarchy laid down by the Pyramid. They were not only healthier on the whole; they also seemed, to the wistful eyes of many northerners, to live splendidly happy lives. They had plenty of sun and sea, family togetherness around the table, siestas and fiestas and history. They were Mediterranean. It was a word to conjure with.

Its connotations derived from novels and travel literature; from British grand tours; German Romantic exhilaration on crossing the Alps at last to find lemon trees; paintings, by Italians mostly, that had once taught northern Europeans, and then Americans, what it was that was beautiful. Even today, when people visit Italy they don’t discover it, they recognize it. Italy can still, despite a great deal of sprawling concrete and hysterical graffiti, represent that original ideal beauty. Its food was now admitted to participation in the general distinction. Not only healthy but delicious! What more could one ask? Yes, there was another thing. Food, today, should be quick and easy to prepare – unless you are rich enough to pay for someonelse’s time and trouble. Given dried pasta and a few more aids from modern technology, Italian food could fill the bill once again.

It will be noted that, quietly, Italy had become the model, rather than Crete. Italians had emigrated to America in huge numbers, and done well there. They knew America – what it wanted, how people thought and bought. By the time the Mediterranean Diet had matured as an ideal structure and given birth to a Mediterranean Pyramid, Italians were ready. Olive oil, businessmen saw, was going to be big; American consumption of it has indeed quintupled since 1982. Things Italian, especially foods Italian, had worked their way up front, and Italians made it their business to keep them there.

Other Mediterranean countries – fifteen of them – also grew olive trees: 90 percent of the world’s olive oil comes from around the Mediterranean. None, to Americans, had the clout and the visibility of the Italians. Spain grows more olive trees than anywhere else – five million acres of them. But most olive oil in America is Italian – or rather, arrives there in Italian bottles.

The Spanish, piqued, are beginning to get their act together, and are energetically promoting their culinary image as well as their oil. Greeks, finding their oil unfairly downplayed, are resentful. Eastern and Southern Mediterranean countries have public-relations problems. The French – well, their olive oil may be extremely fine, but they export little of it. And the French are awkward anyway, have had their culinary day, and the trouble with their haute cuisine is that it is just too haute. They also eat all that meat and butter.

The Pyramid is the Mediterranean Diet’s flag – simple, definite, and proud. It is a marvellous selling tool for olive oil, and for other Mediterranean products too, telling people what they want, and showing merchants what to stock and sell. It is attractive to North Americans, and now also to northern Europeans, who have reason to fear contaminated eggs, febrile chickens, mad cows, and similar nightmares. Northern Europeans too are becoming obese, and developing cardiovascular disease and cancer. (Obesity, unlike the latter two conditions, is a distressingly visible warning, even for those who aren’t suffering yet.)

The Catalan Diet Pyramid: developed by the Barcelona College of Pharmacists, it’s being promoted in Spain.

But in the Mediterranean itself, the Diet remains a puzzle. Firstly, in Latin languages “diet” mostly means something you do painfully and temporarily, to lose weight; in English it can also mean a way of eating that is habitual and (in this case) joyful. Should the Diet be called Mediterranean Cuisine instead? But that sounds a little elitist and appears to slight the health component.

Spaniards are baffled by the Diet, not least because it is Americans, mainly, who are telling them what it is. It is certainly not what they themselves eat. The fact is that the Spanish adore meat, and eat unconscionable numbers of eggs. It is wise when ordering a vegetarian dish in Spain to request explicitly that no ham be added, ham being thought to lend Spanish decorum to any dish. Moreover, Spaniards are being bombarded by advertising (much of it from multinational corporations) exhorting them to consume more milk, although traditionally milk was for babies and breakfasts.

All the Mediterranean peoples point out that their diet not only differs from country to country but also constantly changes. Imagine Mediterranean food without tomatoes, beans, potatoes, or peppers – imports from South America – or rice, aubergines, and lemons from the East. Maybe the word “Mediterranean” is a misnomer – but nobody suggests relinquishing it.

The Mediterranean Diet’s answer to all this has been to begin calling itself the traditional Mediterranean Diet. The debate shows signs of breaking up into factional confrontations. Health groups point out that it’s not the foods as such but the chemistry and the proportions that count. But is it not pleasure that is the lure of the Pyramid? Many now say that people should just eat what they like, provided they have enough exercise; that health is never only a question of what foods you eat. Has the Diet fixated us on foodstuffs – things you can buy – while not making enough of the Mediterranean lifestyle in general? The Diet Pyramid has accordingly gained a new bottom layer: exercise. But “exercise” itself has now come to seem inconceivable without buying things, and it cannot sum up a way of life.

Meanwhile, the Mediterraneans themselves are becoming fatter; obesity in children is growing alarmingly in Greece, Italy, and Spain. In this year’s Alimentaria vast floorspace was given to olive oil and to wine, but there was also a truly enormous pink-carpeted hall crammed with cookies and candy. In Catalonian supermarket aisles potato chips, ready dips, and snacks are the third-fastest-growing category of food items. Processed and convenience foods (nasty, expensive, and quick) and “functional” foods (supplements added) predict for themselves a gigantic future in the Mediterranean region. Sales of boxed fruit juices (in Spain!) have doubled this year because people prefer inferior taste to squeezing an orange. Perhaps, galling though it might be, Mediterraneans should now themselves adopt the Mediterranean Diet, again following America’s example?

Other Diets are being elaborated, in imitation of the envied Mediterranean model. The Atlantic Diet in Spain, for instance, is that of the Basque-to-Galician coasts where, according to gourmet standards, the best cuisine in Spain is to be found. The Atlantic Diet, however, cannot conceivably recommend itself to slimmers.

What no one foresaw was the arrival of a new pyramid – an upside-down one, teetering on its tip: the Atkins Diet. Eat masses of proteins (e.g., meat and eggs), we are told, cut out carbohydrates, and lose weight. The Atkins name has become a valuable commodity, but the diet itself is a very old idea. It was once known in England as “banting,” after Mr. William Banting, an undertaker, who publicized an already traditional practice in his pamphlet, Letter on Corpulence (1864).

The Atkins Diet is hardly heard of in Spain yet. One feels that Spaniards, if they only knew, would embrace it fervently – the meaty, eggy part anyway. The French seem not to have heard of it much either, although their buttery, meatcentred cuisine, demoted by the Mediterranean Pyramid, stands to return to favour should the Atkins fad last. It is almost impossible to “bant” in Italy. I was standing in line at the “innovations” section of the Alimentaria, and got talking to two men in the queue, a Puerto Rican and a Turk who was promoting the new corn pellets (grown in South America, processed and packaged in Spain) to serve with drinks in Turkey. The Puerto Rican asked the Turk if the Atkins Diet had made inroads in Turkey yet. “Oh yes,” the Turk said. “We eat a lot, a lot of bread in our very famous Atkins Diet.” “Bread?” The Puerto Rican brought his hands together in a pleading gesture. “A lot of bread, potatoes, rice,” the other replied. “Yes and now corn. . . .” And he added enthusiastically, “That is our Mediterranean Diet in Turkish. Akdeniz. ‘Mediterranean’ in Turkish. Akdeniz Diet.”

The U.S. Department of Agriculture Diet Pyramid: its general outlines prevailed for much of the last century.
Margaret Visser