Such significance is in the eye of the beholder, or rather in the opinion of the patient. There are reasons for liking the Mediterranean diet other than health reasons, namely aesthetic ones; and this is important, because if it were discovered that a diet of raw cabbage and boiled fish without salt produced the same result, would anyone other than a masochist contemplate adhering to it? After all, only hypochondriacs turn their meals into medicines and nothing else.

Even if the study had found much more dramatic results than it did find, it would have been severely limited in its application. It does not follow from the fact that the diet prevents stroke or heart attack in people at relatively high risk of having one in the first place that it would prevent either or both of them in people at much lower risk.

On the other hand, it is also possible that the Mediterranean diet would have prevented the development of the high risk in the first place if taken early enough in life. It is true that Mediterraneans, on the whole, have fewer heart attacks and strokes than people of more northerly climes; what is not so clear is how far Mediterraneans actually consume a Mediterranean diet. The idea that diet is the sovereign way to health is a very old one, but given the fact that nations of the most diverse dietary habits are among those with the highest life expectancy, it might not be correct.

In any case, the Spanish research involved the monitoring and one might almost say the badgering of patients to get them to comply with the diet. What is found in the context of a trial is not necessarily transferable to “real” life.
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