One should be aware that there are a lot of methodological issues/limitations involved in the mediterranean and Okinawan dietary studies.
Attempting to isolate just the diet as a cause in their health/longevity is difficult. Of the many variables known and unknown, there are obviously potential genetic variables(e.g. having Okinawan or Cretan genes) and lifestyle variables(e.g. possible calorie restriction in the Okinawans, living on an idyllic island in the Cretans) that are hard to exclude.
This is completely misguided criticism out of ignorance. Willcox et al. never tried to isolate the diet as the sole or even major cause of the Okinawan longevity. In fact, only roughly one third of their book The Okinawan Way is about diet. The rest is about various lifestyle apects peculiar to the Okinawan elders, their social life and relationships, even spirituality.
Genetics have of course been ruled out as the cause of Okinawan longevity, by comparative studies with emigrant groups from Okinawa. Genetics are a determinant of individual longevity but they certainly don't explain its prevalence in Okinawa.
Then there are varying interpretations/definitions about what constitutes each diet, with experts questioning the accuracy of recording/reporting of diets in the original studies, and with diets in these places having since changed.
There are also well standardised methods to obtain reliable epidemiological data.
Trials of the mediterranean diet(or limited components of it) have been relatively short term, have loose control over *actual* diet, rely on participants to report their own diet (which is kown to result in inaccuracy), give results as just biomarkers instead of actual health outcomes or are limited to elderly and/or unhealthy people who are already at high risk of death and disease.
We must eat. So we sift through the shitty, incomplete science that is nutrition, and then we eat what we think will sustain good health. All food is poison to some degree -- kale, blueberries, salmon... So limit calories, and focus on the bare bones evidence as it emerges, like the PREDIMED work. It's incomplete, but slowly clues develop. What's least harmful? Eat that.
This forum has almost zero science going on. Maybe rats might settle the debate? Since, they don't live long and don't have opinions or beliefs (as far as I know! ).
As far as the proof is in the pudding and tribes. I still believe the only way to proove causation is from a experiment. Therefore, at less yoga instructors, tribes, and really old people grew up in a lab they can't be used other than to hypothesize then test in a experiment.
Every science is incomplete by its very definition. And we actually know a whole lot more about optimum nutrition than the three of you suggest. Nutritional science is not for the die-hard reductionists. It's one of the most sophisticated, integrative fields of science, connecting different categories of evidence spanning an continuum from strictly causal in-vitro studies over animal studies, RCTs, case-control, up to correlational epidemiological studies, each of them having its purpose and justification. PERIMED only confirmed what already was known from epidemiological evidence by another, more causal category of evidence derived from an RCT:
It's principally impossible to gain scientific understanding of nutrition by relying exclusively on reductionist methods. One can't study a forest by examining single trees only. That way you will learn a lot about trees, but still don't understand what constitutes a forest. (Now substitute nutrient for tree and nutrition for forest).
Unfortunately, what evidence there is for benefit of these diets is still relatively weak and unimpressive regarding increased lifespan and healthspan.
This is BS, really. We are talking about at least 30% of all cancer and 60% of all heart desease which could be prevented by dietary means, to name only two leading causes of death. There is no controversy about that, it necessarily derives from the synthesis of all the categories of evidence I mentioned. Diet is at least as important for longevity as physical activity and social relationships.
Edited by timar, 05 December 2013 - 12:10 AM.