5 healthiest—and tastiest—diets from around the world

By Naveed Saleh, MD, MS
Published June 11, 2020

Key Takeaways

With a team of demographers, anthropologists, and other scientists, famed explorer and best-selling author Dan Buettner identified five Blue Zones—regions where people consistently live past 100 years of age. These zones include Loma Linda, CA; Nicoya, Costa Rica; Sardinia, Italy; Ikaria, Greece; and Okinawa, Japan. Buettner and his team then boiled down the evidence-based reasons explaining why these people live so long. Reasons include their high consumption of legumes, low consumption of meats, and moderate consumption of alcohol—all of which are prominent features of the highly touted Mediterranean diet.

Along with international variations of the Mediterranean diet, here are some other hyper-healthy diets from around the world: 

Cretan diet

So, what makes the Cretan diet—a variation of the Mediterranean diet—one of the healthiest in the world? For eons, Cretans have consumed only what they could reap from the land, including loads of fruits, vegetables, whole grains, pulses (ie, dried legume seeds like lentils and peas), and olives. What’s more, Cretans don’t use any oils besides olive oil, even to make sweets. Plus, the people of Crete cook their foods with no cream and few spices. According to NPR, Crete “offers a nutritionist’s dream diet.”

In more general terms, the Mediterranean diet is centered around mostly plant-derived foods. Dishes often include the incorporation of fruits, vegetables, beans, olive oil, legumes, whole grains, nuts, and spices. Animal products such as red meat and dairy are consumed sparingly, with a focus on fish and seafood instead. Adhering to the diet does not entail watching portion sizes but rather proportional intake of food groups (eg, more fruits and vegetables and less dairy). 

With respect to nutritional components, the diet stresses healthy fats in lieu of other less healthy fats such as butter and margarine. Healthy fats are found in avocados, oily fish, and nuts, which are prominent components of the diet. Additionally, fish and walnuts are high in healthy omega-3 fatty acids. Although moderate wine consumption is a part of the diet, water is the beverage of choice. (And nothing beats a tall glass of ice-cold water!)

In a randomized, prospective study following a cohort of 605 patients who had myocardial infarction and who were either on the Cretan diet or the usual prescribed diet for 27 months, researchers found that the Cretan diet outperformed in terms of protection from coronary heart disease (CHD). 

“These protective effects were not related to serum concentrations of total, low-density-lipoprotein (LDL), or high-density-lipoprotein (HDL) cholesterol,” wrote the authors in the American Journal of Clinical Nutrition.

They added: “In contrast, protective effects were related to changes observed in plasma fatty acids: an increase in n-3 fatty acids and oleic acid and a decrease in linoleic acid that resulted from higher intakes of linolenic and oleic acids, but lower intakes of saturated fatty acids and linoleic acid. In addition, higher plasma concentrations of antioxidant vitamins C and E were observed.”

Antioxidants also play a key role in the efficacy of the Mediterranean diet. According to the authors of a review article published in Lipids: 

“Traditional Mediterranean diets, as opposed to North European and American diets, include a significantly large amount of plant foods; this notable difference between the two eating styles, despite the similarities among other classic risk factors for CHD such as high plasma cholesterol levels, has been associated with a lower risk of developing the CHD and certain cancers. The involvement of excessive free radical production and the great number of epidemiologic studies linking antioxidant intake with a reduced incidence of the above-mentioned diseases indicate that dietary antioxidants likely play a protective role.”

Spanish diet

Much like Crete, Spain has its own take on the Mediterranean diet. It incorporates olive oil, vegetables, dried fruit, pulses, rice, fresh fish, cheeses, and moderate wine consumption. Popular dishes include paella, anchovies, cod, and pescaíto frito, or fried fish. Blue fish and seafood are typically consumed once or twice a week, with red meat and sugary sweets eaten sparingly. Despite what some may believe, jamón (ie, dried cured ham) and churros con chocolate (ie, churros with chocolate) are only occasional treats in Spain.

As cited by the American College of Cardiology, a re-analysis of the PREDIMED study published in the New England Journal of Medicine promoted the cardioprotective effects of the Spanish iteration of the Mediterranean diet. 

Researchers conducted the study at 11 Spanish sites, with 7,447 adults aged between 55 and 80 years who did not have—but who were at high risk for—heart disease. The participants were followed for about 5 years after being assigned to 1 of 3 diets: Mediterranean diet plus 30 g of mixed nuts (ie, walnuts, hazelnuts, almonds); Mediterranean diet plus ≥ 4 tablespoons of extra-virgin olive oil; and a low-fat diet, sans oil, meats, and nuts. The researchers discovered that the Mediterranean diet plus either nuts or olive oil decreased risk of heart events by about 30% compared with a low-fat diet.

“In this primary prevention study involving persons at high risk for cardiovascular events, those assigned to an energy-unrestricted Mediterranean diet, supplemented with extra-virgin olive oil or nuts, had a lower rate of major cardiovascular events than those assigned to a reduced-fat diet. Our findings support a beneficial effect of the Mediterranean diet for the primary prevention of cardiovascular disease,” concluded the authors.

Nordic diet

Still staying in Europe, let’s turn our attention to cuisine from a different region: the Nordics. In 2004, culinary experts from five Nordic countries convened to develop a healthier regional cuisine. The resulting Nordic diet shares many similarities with the Mediterranean diet, save for the use of canola oil instead of olive oil and incorporation of fruits and vegetables sources—such as dark greens, cruciferous vegetables, roots, lingonberries, bilberries, apples, and pears—from Nordic countries. Of note, like olive oil, canola oil is rich in heart-healthy monounsaturated fat and a clutch source of omega-3 fatty acids.

In an interventional study published in the Journal of Nutrition, researchers examined how the Nordic diet impacted fasting plasma lipid levels in 200 adults with metabolic syndrome. Participants were randomized to either the healthy Nordic diet—replete with whole grains, fruits, vegetables, berries, fish, low-fat dairy, low-fat meat, and vegetable oils/margarines—or an “average” Nordic diet inclusive of regular-fat milk products, limited fruits and vegetables, limited berries, low-fiber cereal products, and dairy fat-based spreads.

“A healthy Nordic diet transiently modified the plasma lipidomic profile, specifically by increasing the concentrations of antioxidative plasmalogens and decreasing insulin resistance-inducing ceramides,” the authors concluded.

Japanese diet

We’ve taken a look at some of the healthiest diets from the Mediterrean and Nordic regions, now let’s take a look at, perhaps, one of the most health-conscious Asian diets: the Japanese diet. Broadly speaking, Japanese and other Asian cuisines are low in fat, high in fiber, and rich in plant-derived estrogenic compounds known as phytoestrogens. These compounds protect against hormone-dependent cancers and coronary artery disease. The two main types of phytoestrogens are isoflavonoids (found in soybeans) and lignans (found in sesame and other oilseeds).

So, what does the Japanese diet consist of, exactly? For one, there’s edamame. This legume is similar to snow peas, and is popular in Japanese cuisine. Edamame consists of steamed or boiled soybeans served in the pod, and it is incredibly healthy when served unsalted. It is chock-full of nutrients including magnesium, vitamin C, vitamin B6, calcium, and iron. Other healthy components of the Japanese diet include raw fish, seafood, sea vegetables, and garden vegetables, which are often steamed or stir fried.  

In a study published in Nutrition, researchers examined the overall nutritional quality of the Japanese diet to assess adherence and nutritional intake. The cross-sectional study involved 1,129 elderly Japanese adults who answered a food-frequency questionnaire. Measures reflected better nutrient intake—such as fiber, protein, vitamin A, vitamin C, iron, calcium, and potassium—with the only detractor being high sodium content. 

Indian diet

The cuisine of India is diverse, with eating patterns related to social identity, religion, and more. No “average diet” exists, but one common thread that does run through India’s diverse geography is the prevalence of traditional vegetarian cuisine. Like the Japanese diet, vegetarian-centered Indian diets are low in fat, high in fiber, and rich in phytoestrogens. 

Authors of a systematic review published in the British Journal of Nutrition found that 29 of 41 dietary patterns in India were predominantly vegetarian, consisting of fruits, vegetables, and pulses. Of note, diets in the northern and western regions of India are more similar to each other, as are those in the eastern and southern territories.

“A varied diet high in fruits, vegetables, pulses, and nuts was associated with lower cholesterol, indicating that more traditional diets may have a healthier profile,” wrote the authors.

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