“The oil is the gold of the Mediterranean” – this is an old saying from Southern Europe. There is more behind it than just culinary traditions: It is a philosophy of life that brings heart protection, energy, and longevity to the table. While many are still searching for the one "superfood," the Mediterranean diet shows that the true trick lies in the sum of small, wise decisions – from olive oil to nuts, from fish to whole grains.

The Mediterranean diet is less a diet than a food culture. At its core are plant-based, unprocessed foods, abundant monounsaturated fatty acidsfats primarily found in olive oil that positively influence blood fats, omega-3 fatty acidspolyunsaturated fats from fish that reduce inflammation, and polyphenolsplant-based protective substances with antioxidant and anti-inflammatory effects. Thus, “heart-protective superfoods” are not marketing hype, but functional components: extra virgin olive oil as the primary fat source, nuts like almonds and walnuts, fish and seafood, plenty of vegetables, legumes, and whole grains. The key is the swap: more whole foods, less heavily processed items, less sugar, and refined grains. For high performers, this means more stable energy, less inflammation, better vascular function – the foundation for focus, endurance, and healthy longevity.

Extra virgin olive oil (EVOO) not only provides monounsaturated fats but also polyphenols that protect LDL particles from oxidative damage and thus counteract atherosclerosis – with links to fewer cardiovascular events and a better blood pressure profile ^[1]. A meta-analysis of human RCTs also shows: olive oil polyphenols significantly raise HDL cholesterol and slightly lower LDL – a small lever with long-term effects ^[2]. Daily consumption of nuts provides additional cardioprotective bioactives; particularly, almonds, walnuts, and pistachios demonstrate strong profiles for cardiovascular protection ^[3]. Conversely, industrial trans fats, heavily processed products, and sugar-sweetened beverages increase the risk of type 2 diabetes, ischemic heart disease, and colorectal cancer – even moderate amounts measurably raise risk, supporting recommendations to limit intake ^[4]. Eating fish too infrequently often also means a low omega-3 indexproportion of EPA/DHA in red blood cells; a marker for cardiovascular risk; just two portions of fish per week or an EPA/DHA supplementation significantly raise this index – a preventive advantage for heart health ^[5], embedded in the broader benefits of fish for metabolism, brain, and immune system ^[6]. Whole grains instead of white flour correlate with fewer coronary diseases, while high amounts of refined grains increase risk – a direct, everyday-relevant swap with vascular dividends ^[7].

The evidence on olive oil is extensive and qualitatively diverse. A recent umbrella review summarizes 17 systematic reviews and finds consistent benefits of olive oil consumption for cardiovascular diseases, type 2 diabetes, certain cancers, and even overall mortality – with heterogeneous data on individual biomarkers, necessitating further high-quality RCTs ^[8]. Additionally, clinical studies show that the polyphenol content of olive oil matters: randomized comparisons indicate a significant increase in HDL and a slight decrease in LDL, particularly with polyphenol-rich oil – a plausible mechanism, as polyphenols protect LDL from oxidation and stabilize vascular functions ^[2]. For nuts, a comprehensive overview consolidates the cardioprotective properties of various types and highlights almonds, walnuts, and pistachios as particularly rich in bioactive compounds – a finding that supports the daily moderate nut portion as a simple, effective prevention strategy ^[3]. Simultaneously, a rigorous burden-of-proof approach suggests that processed meats, trans fats, and sugar-sweetened beverages are associated with increased risks for diabetes, ischemic heart disease, and colorectal cancer; although the levels of evidence are sometimes rated as “weak,” the burden of disease warrants clear reduction recommendations ^[4].

- Transition consistently to extra virgin olive oil as the main fat: use 2-3 tablespoons daily, cold over vegetables, legumes, or as a finisher over warm dishes. Pay attention to polyphenol-rich quality (fresh, intensely fruity-bitter) – this supports HDL and protects LDL from oxidation ^{[1] [2]}.
- Eat a small handful of nuts daily (about 30 g), preferably walnuts and almonds. Use them as a snack, topping for yogurt, or salads – this increases the intake of heart-healthy fatty acids and antioxidants without spikes in blood sugar ^[3].
- Reduce heavily processed products, refined grains, and sugary items: swap breakfast cereals for oats/whole grains, white bread for sourdough whole grain, soft drinks for water/infused water. This lowers exposure to trans fats and reduces the risk of diabetes and heart diseases ^[4].
- Incorporate 2-4 fish meals per week, with at least one being fatty fish (e.g., salmon, sardines). If daily life does not allow it, consider EPA/DHA supplements after consultation – both significantly raise the omega-3 index ^[5] and support the heart, brain, and immune system ^[6].
- Consume red wine only if medically appropriate and in moderation (e.g., 1 glass with a meal, do not accumulate) – and only for individuals without contraindications. Keep in mind: alcohol is a Group 1 carcinogen; you can also obtain polyphenols from olive oil, vegetables, fruits, and whole grains – without the risks of alcohol ^[9].

The next few years will clarify which components of olive oil and polyphenol contents deliver the strongest effects and which combinations of nuts, whole grains, and fish provide maximum vascular protection. We expect more large, multicentric RCTs with hard endpoints and biomarker panels – so that high performers can tailor their diets even more precisely for heart protection, energy, and longevity.