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Table 1 Summary of the Mediterranean and Indian diets

From: Definitions and potential health benefits of the Mediterranean diet: views from experts around the world

Dietary components commonly consumed

Mediterranean diet

Indian diet

Evidence on health benefits of the Indian counterparts

Oils

Olive oil

Ground nut oil Mustard oil

Compared with persons consuming sunflower oil, those using mustard oil for cooking had an RR of 0.44 for IHD in the age-, sex-, and smoking-adjusted analysis. Similarly, persons using mustard oil for frying foods had a 71% lower risk (RR: 0.29; 95% CI: 0.13, 0.64) in multivariate analysis. When compared with all other fats and oils, the inverse association with mustard oil remained [70].

Alcohol

Wine

Beer and whisky

The INTERHEART study found that while alcohol protected people from heart attacks in the large sample population from 52 countries, it appeared to be harmful to Indians [71]. The Sentinel Surveillance cross-sectional study, analyzing data from 10 industrial sites in India, reported an odds ratio of 1.4 (1.0 to 1.9, P = 0.05) for CHD among alcohol users after adjusting for major confounders [72].

Proteins

More fish, sea foods, chicken and legumes. Less red meat

Most from legumes/pulses and less from non-vegetarian foods

Although fish consumption (among non-vegetarians) has been shown to improve lipid fractions among Indians and thus lower CVD risk [73], the consumption varies in different regions. Most Indians consume pulses much more frequently than fish [74–76]. In the Indian context, culture, traditions, customs and taboos influence meat consumption to a great extent, especially in the rural societies. However, there have been studies that show that urbanization has been causing a rise in demand for meat products. The per capita meat consumption in India is only around 44.39 gm/capita/day as compared to world consumption of 116.82 gm/capita/day.

Omega-3 fatty acids

Fish

Mustard oil, flax seeds

Mustard oil is the source of the short chain omega 3 fatty acids in Indian diets [77–79].

Carbohydrates

Whole grains, complex carbohydrates and more fiber

Refined cereals and processed foods

Evidence from some studies shows a positive association between refined carbohydrates and insulin resistance. Experiments with complex whole grains and fiber have yielded a better glycemic profile [80–82]. However, dietary data collection methods which are largely self-reported in these studies need to be standardized further for better quality data.

Dairy

Low consumption

Frequent use of dairy in beverages, desserts

Observational data suggests that dairy consumption in India was inversely associated with obesity. After controlling for potential confounders, the risk of being obese was lower among women (OR = 0.57; 95% CI: 0.43 to 0.76) and men (OR = 0.67; 95% CI: 0.51 to 0.87) who consume ≥1 portion of plain milk daily than those who do not consume any milk [83]. However, interventional studies are warranted to confirm this association.

Fruits and Vegetables

Fresh raw fruits and vegetables

Low consumption of fresh fruits and vegetables

The protective role of fruits and vegetables especially for better cardiovascular health (better lipid profiles, immunity, blood glucose levels and so on) has been ascertained in multiple studies globally but high costs, perishability and lack of awareness in some societies are challenging, especially in India [84–88]. Educational campaigns from school level coupled with policy interventions are needed to enhance consumption and improve heart-health.

  1. CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; IHD, ischemic heart disease; RR; relative risk.