Move over Mediterranean—a vegetarian diet is equally good for health

When you think of the Mediterranean these days, the region’s azure waters, rich history, and lively cultures may not come to mind. Instead, you may first think of the Mediterranean diet. This heart- and brain-healthy diet includes olive oil, fruits, vegetables, nuts and fish; occasional red meat; and a moderate amount of cheese and wine. Most doctors and nutrition experts I interview for the Harvard Health Letter tell me that the evidence points to a Mediterranean diet as the very best for our health. But there’s another diet that appears to be equally good: a vegetarian diet.

A study published this week in JAMA Internal Medicine found that people who ate a vegetarian diet were 12% less likely to have died over the course of the five-year study than nonvegetarians. The researchers, from Loma Linda University in California, noted that the benefits of a vegetarian diet were especially good for men, who had a significant reduction in heart disease. Keep in mind that the study couldn’t prove that a vegetarian diet caused good health—it’s possible that it was something else that vegetarians did and nonvegetarians didn’t do that made the difference.

The fact that vegetarian diets are good for you isn’t new. They have long been linked to reduced risk for hypertension, metabolic syndrome, type 2 diabetes, and heart disease. This one underscores the idea that meat consumption influences long-term health. “A diet with meat in it raises the risk of heart disease and cancer, when compared with a vegetarian diet,” says cardiologist Dr. Deepak Bhatt, a Harvard Medical School professor. Red meat and processed meats appear to be the worst offenders as far as boosting the risk of cardiovascular disease or cancer.

Dr. Bhatt told me that he is a vegetarian—meaning that he doesn’t eat meat—and he personally feels that a vegetarian diet is the way to go for environmental and ethical reasons. He also feels it’s a healthy way to eat.

A personal decision

Should you consider forgetting the Mediterranean diet and becoming a vegetarian instead? There isn’t much high-quality data from comparing different types of healthy diets against each other. There is good evidence that following either a Mediterranean diet or a vegetarian diet—which share many common features—can lower cardiovascular risk. “The bottom line is that either type of diet is healthier than the typical American diet,” says Dr. Bhatt. So it’s really a matter of personal choice.

It’s also a matter of determining what kind of vegetarian you want to be. A vegetarian diet can take a number of forms. A vegan diet excludes all animal products (no meat, poultry, fish, eggs, dairy or gelatin). Other more liberal interpretations include a pesco-vegetarian diet, which includes seafood; a lacto-ovo-vegetarian diet, which includes dairy and egg products; a lacto-vegetarian diet, which includes dairy products; and an ovo-vegetarian diet, which includes eggs.

With all of that variety, you’ll need to assess your eating style and determine which fits in best with your lifestyle and personal beliefs.

It’s also important to consider your nutritional needs, warns Dr. Bhatt. Vegetarian diets that include only raw fruits and vegetables can lead to nutrient deficiencies. Without meat or dairy, you may run the risk of not getting enough protein, calcium or vitamin B₁₂. You can get all the protein you need from plant sources, such as peas, beans, lentils, chickpeas, seeds, nuts, soy products, and whole grains such as wheat, oats, barley, and brown rice. You can get calcium from plant sources, such as bok choy, broccoli, Chinese cabbage, collards, and kale. And you can get vitamin B₁₂ from soy and rice drinks, and fortified breakfast cereals.

It’s also important to remember that even with a vegetarian diet, calories still matter and consuming too many—even if they are meat-free—is bad for health.

Becoming a vegetarian will require you to pay more attention to your nutrition, which is a good thing. But it’s also a bit of work, so don’t hesitate to get some advice from your doctor or a dietitian before proceeding. If you want to go with a Mediterranean diet, that’s a good thing, too, and probably easier for many people. Again, it’s a personal choice.

Future research on vegetarian, Mediterranean, and other beneficial diets should examine what is it about these diets that makes them good for us. As Dr. Robert Baron, professor of medicine at the University of California, San Francisco wrote in an editorial accompanying the Loma Linda study, “Our debates about the superiority of one diet over another have not served the public well. It is time to acknowledge the common features of diets associated with good clinical outcomes.”