It’s the Whole Approach

“There is a perception among people who have heart attacks and heart disease – and I see this in my patients – that there’s already so much damage there’s not much they can do,” said Dr. Malhotra, an interventional cardiologist and adviser to the United Kingdom’s national obesity forum. “But by changing your diet, you can dramatically reduce your risk of having a heart attack even if you have coronary artery disease. We have data suggesting that the risk reduction can happen within weeks.”

Dr. Malhotra visited the Mediterranean with a documentary filmmaker, Donal O’Neill. Together they noticed that a healthful diet was one of many factors that seemed to play a role in the longevity of people in Pioppi, where the average person has a life expectancy of about 90.

They were surprised by how the people they encountered enjoyed and savored their food, turning every meal into an excuse for a social occasion with friends and family. They noticed that people spent a lot of time outdoors getting fresh air. Instead of designating daily periods of time to jog or exercise, they engaged in a great deal of leisurely physical activity like walking and riding bicycles. And they seemed to have low levels of chronic stress.

“We need to redefine the Mediterranean diet,” Dr. Malhotra said. “The truth is that it’s a lifestyle. It’s the whole approach. It’s the food. It’s the social interaction. It’s getting the right kind of exercise. It’s being outside. It’s getting sunlight and sunshine. The question, though, is how can we combine all these lessons from this village with what we know about modern medicine.”

Dr. Malhotra and Mr. O’Neill were also surprised by what they learned about food in the Mediterranean.

Although olive oil and vegetables were a constant, some aspects of the traditional diet varied greatly from one part of the region to the next. They found that pork and lamb were common in some areas, but that sugar was traditionally consumed infrequently. They learned that all olive oils are not created equal. And they discovered that the type of grain typically eaten in Pioppi is very different from what most Americans consume.

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