Chapter 4: The shaping and shipping away of Mediterranean cuisines
Here is a fourth chapter of the series, based on the book of Gary Paul Nabhan Why Some Like It Hot: Food, Genes and Cultural Diversity.
A lot has been written and studied about Mediterranean diet and this diet is seen as one of the great solutions to the modern non-communicable (non-infectious, chronic) metabolic diseases. Probably the most promising effect of Mediterranean diet has been pronounced in relation to the cardiovascular diseases, the biggest killer in the world today.
In this chapter Gary focused on Crete, one of the Mediterranean isles, where people lived quite isolated for millennia and adapted for their environment and nutritional resources, whether from the land or sea. Even today, only small amount of food is being imported so the Crete which preserves its traditional cuisine more than most of other European countries or cultures.
The soil on this land has been described as ‘stony, often salty or limey’ and, as Gary moved from the seaside towards the inland, up to the hills, he noticed that every piece of land which was only little less like a solid rock was used to grow vine, olives, beans or used as a pasture for livestock, mainly sheep and goats. And although Cretans diet is also rich in seafood in the coastal area, the focus of this chapter will be on the highlands, because:
“…highlands of Crete offer something altogether unique, easily distinguished from the rest of Greece and even from the coastal plains of Crete: a traditional cuisine that has changed very little over the last 6000 years.”
And paleo enthusiasts will not like this:
“At its core, Cretan cuisine still swims in olive oil, with a ballast of wild bitter greens, various beans such as garbanzos, large whites and lentils, and barley rusk biscuits, all washed down with grapes fermented into retsina or distilled into ouzo and raki. There are also land snails, sometimes lamb, goat, shellfish or anchovies in season. But olive oil, beans and greens are woven into most meals…”
Despite all those carbohydrates, the Cretans are known for the low incidence of cardiovascular diseases and one of the longest lifespan in the world. This made the Mediterranean diet so popular among researchers, physicians and also people who had already suffered a heart attack, hoping that this is the best diet for everyone.
Ancel Keys research appreciated
Gary mentions the Ancel Keys Seven Countries Study and presents it as
“one of the first comparative health surveys of its kind that was anthropologically informed as well as quantitatively accurate in its nutritional assessments.”
Those promoting low-carbohydrate diet would surely like to argue with that but I leave it for now. The fact is though, that Cretans had 40 times lower incidence of coronary heart death rate than Americans, even despite Americans had better medical care than poor Cretans and therefore should have been able to manage the disease better. Coronary heart disease is not the same as death rate from it. The more recent epidemiology confirms this paradox: there was an increase of cardiovascular diseases in the world, but in the developed countries the death rate due to this disease has decreased, exactly because of a more advanced management of the disease. Interestingly, the Cretans had 3 times higher intake of fat than the Americans, or also 1.5 times more than other Mediterranean populations. The fat was mostly olive oil, minimally processed and produced by their own land, not imported. But it was not about the fat only. The A. Keys’ team announced that “… there was something about the particular use of olive oil in complement with other Cretan foods that merited further attention.” And I add, from reading of this chapter before – it was not only in the food.
Regional character and history
Gary then moves to the Cretan village called Spili and says that the original profile of Cretan health was undertaken in this village rooted at the foot of Mount Kedros. As he travelled to the village he observed the sceneries. Then he reported that there was about 2500 years long tradition in cultivating vine. Cretans were working the soil by hands, not machinery, even the stone for mashing the grapes was used for over 50 generations. Domesticating the olive trees started about 7000 years ago in that region. Impressive. There was a vegetation surrounding the places which the people inhabited and most of this vegetation was used as food or to spice up the food.
The village was noticeable by abundant elderly population and from their look, clothing and the presence of priest it was obvious that the religion (orthodox catholics) play a big role in their lives. However, not less important was their heritage which involved the knowledge and customs in farming, eating and living. Although the fast-food has touched this remote piece of world already, the village is still proud on its traditional authentic cuisine.
Gary outlined that “the Mediterranean diet is not ‘one species’, but a mosaic of variation from Spain through Sardinia, southern France, Italy, Sicily, Corfu, Greece and Asia Minor”. However, Spili was the most studied and region in terms of health and culinary practices post WW2.
There is no single Mediterranean diet
The chapter continues with the description of living conditions in the region post 1948. There was ‘devastating poverty’ in the rural areas and that caused the launch of the ‘first systematic studies of diet and health on the island, interviewing one out of every 150 inhabitants about their eating patterns’. From that research we know that 61% energy intake covered the Cretans by fruits, vegetables, greens, nuts and roots. That was nearly twice as much than of average American. Interestingly, 78% of fat the Cretans consumed was monounsaturated olive oil or from olives directly. It was concluded that despite the poverty, Cretans had a healthy diet which they maintained unchanged for as much as 4000 years.
Over those millennia, as the invaders came and gone, they introduced their own staples and food, such as rice, potatoes or tomatoes, zucchinis or green beans, coffee and tea. However, as Gary pointed out:
“… a number of factors have combined to ensure that the Cretans maintain many elements of their ancestral diet, even as many other ethnic populations around the world have lost theirs… and Crete has not suffered the wholesale loss of its traditional diet as has happened in so many other places.”
On top of that, Cretans do not simply grow and harvest the traditional foods in their gardens. Instead they have retained their traditional knowledge to seek out and prepare the whole range of wild plants and herbs that are in season. Everything seems to be prepared with attention and aimed for the best taste and quality. As an example were the snails. The chef who served the snails harvested them in March because of the moisture in the grass and shooting wild greens. He fed the snails with rosemary and flour to lose bitterness and to be at their best. The snails were served floating in extra virgin oil and also sprinkled with the oil and rosemary. Delicious, Gary says. Everything the village inhabitants eat is accompanied with the olive oil, covered with olive oil, floating in olive oil – bringing digestive discomfort to Gary, which was not used to consume so much grease, three times more than he was used to. No wonder, traditional Cretans consume 31 kilos of olive oil per year. And he was not alone in this, the whole group that travelled with him had similar issues. This is how different diet, albeit the most healthy for some, can cause trouble to others.
Gary mentioned that the elderly Greeks consume as much as 50g of virgin olive oil daily and that was reported to improve their lipid ratio profile (HDL/LDL), associated with reduced risk of cardiovascular disease. Moreover, it is not only in the fat itself. It is in the rich content of various polyphenols that olive fruits contain and which are transmitted to the extra virgin olive oil. These beneficial compounds were found to even fight the cancer. However, they are not present in animal fat or cheap processed vegetable oils. The processing of the commodity is the key difference here.
And they use this olive oil for everything, making it a vehicle for those beneficial compounds all day long. The Cretans even use the oil in the cosmetics and hygiene or to baptize the newborns and to bury the dead.
Gary then reports his talk with Dr Antonis Kafatos who did research on health impact of consumption of olive oil on people, whether Cretans or others, such as Britons or Irish people. What he found, after consumption of a meal and the oil, Cretans had a faster clearance of blood lipids than other natives. However, it did not suggest a genetic difference having an effect because when they continued with the study, over three to four weeks there was no difference, suggesting a metabolic adaptation.
Interestingly, when trying to implement the findings and to make other cultures to increase the consumption of virgin olive oil, they were confronted with refusal because the French, for example, sere not used to the distinct taste of the olive oil and they refused to consume it, managing to stomach only one fifth of the recommended amounts. In addition, the French also did not particularly adapt the high fruit, legumes and bread consumption, as Cretans normally eat. French, however, consumed more fish, alcohol and meat than Cretans. The culturally conditioned food preference was apparent. Nonetheless, even with smaller changes, but with the determination to follow the authentic Cretan diet, those French who shifted their diet had 70% less heart attacks and lived longer than those who did not change at all.
In contrast, as per another study, Cretans had impaired blood coagulation when on a saturated fat rich diet than when consuming olive oil as they normally do. And their metabolic response was different from that of Northern Europeans who were their counterparts in the study.
Gary summarized that people have different lipoprotein alleles in their genome and that makes them response differently to the same amount of fat/oil or to different kinds of fats/oils.
“Cretans have evidently developed a genetic adaptation to these levels of (olive oils) consumption.”
The secret of the great health of Cretans?
It appears that health is not only about what we eat but also how much and when we do NOT eat. You have probably heard about some kinds of fasting for this or that reason, to cleanse the body, get rid of toxins, lasting for a day or two, or a week, at the most. The word fasting also does not have an exact definition: it can mean not eating at all and drinking only water, or avoiding certain foods while consuming others, usually of plant origin. There is Ramadan in Islam or Lent in Christian tradition. However, Cretans, the Greek Orthodox are champions in fasting.
They do not starve though. The Cretans avoid eggs, meat, some also the olive oil, which is rich in calories. Some accept seafood (invertebrates) while others avoid it as well. What they include in their diet more are the seasonal wild plants, which also have tradition in their use, method of preparation or a specific time of use as a meal. They know, seek and use no less than 150 species of plant they call horta and which they seasonally take advantage of during the whole year. The hortas vary in bitterness and flavour and Cretans have learned to use them as a perfect complement in meals, especially during fasting.
When the Cretans were followed during a study, some of them fasted not less than 180 days in a year! The health outcomes were noticeable: lowered blood lipids by 12% and their bodies healthier and trimmer. Quite an opposite to the diet of abundance in the West, making people weighing more than their parents and grandparents and the prevalence of civilisation diseases are on the rise. In addition, almost every hint of bitterness has disappeared from the prevalent processed food, perhaps except of beer or other alcohol. Indeed, although the hortas are rich in nutrients and other beneficial compounds for health, the Cretans eat them for their flavour, not health benefits per se. And the history of likeness of these gifts of nature dates back to the Minoan civilisation.
In addition, knowing the wild greens and how to use them as food was a necessity for Cretans in times of hardship, such as during the wars. This was especially true in the mountain villages. When Germans occupied Crete and took everything they could, they left the poor Cretan with nothing to eat. That was the opportunity for them to test their survival skills – living entirely on wild greens for some time. Cretans knew the plants, their season, the place where to look for them – and how to porepare them for food.
Gary shared a joke:
“The Turks say, ‘Put a cow and a Cretan in the same pasture, and they will fight. They will compete to see which eats the most horta, and usually it will be the Cretan!”
Unfortunately, the young generations do not have the knowledge of their elderly and the horta heritage is disappearing fast. And although the Cretans are still known as the society eating the most wild greens in the world, this may not be true for long.
The rest of the chapter illustrates the difference between various horta plants and their specific use, some suggestions for recipes. Therefore, the secret of great health of traditional Cretans is not only in their faith. It is in the whole complex of interacting factors: enough physical activity – when going foraging the hortas, strong anti-disease properties of their diet – olive oil and greens rich in potent antioxidants and nutrients, not overeating all year round and, of course, their genetic fit into the diet and lifestyle they practiced for thousands of years. As Gary finishes the chapter:
“There is context to the way the folks of Spili live and pray, eat and fast, that cannot just be extracted and plopped down in another land to gain the same benefits. We cannot facilely assume that their cuisine will do as much for our genotypes as it does to their genotypes. It is not random; it is embedded in place. And while other Mediterranean dwellers may claim that their diet is purely a matter of taste, there is something deeper and more functional hidden in these gene-diet-culture interactions.”
Chapter 2: Searching for the ancestral diet
Chapter 4: The shaping and shipping away of Mediterranean cuisines
Chapter 5: Discovering why some (don’t) like it hot
Chapter 6: Should we change places, diets or genes?
Chapter 7: Rooting out the causes of disease