The PREDIMED study out of Barcelona Spain has shown substantial benefits including reduced risk of stroke for those on a plant-based Mediterranean diet. The data from any ambitious study can be investigated further, and built upon with additional new studies. This has happened, and the additional analyses have shown important additional benefits for our thinking (cognition), as we get older, including reducing dementia and Alzheimer’s disease.

The new follow-up study published in JAMA Network Journals regarding the aforementioned study has shown evidence that improved cognition is associated with supplementing the plant-based Mediterranean diet with extra virgin olive oil or mixed nuts. Although the authors warn that more research is needed, I don’t know any adverse effects from using extra virgin olive oil or mixed nuts in the diet; moreover, most people enjoy both plant-based foods. So if you’re striving to do whatever possible to avoid dementia and Alzheimer’s disease, why not eat a plant-based diet, including olive oil and nuts?

Why do these foods protect the brain? Tufts Health & Nutrition Letter reports an explanation given by Tammy Scott, PhD, at Tufts’ Human Nutrition Research Center on Aging. The center explores the relationship between nutrition, physical activity, and healthy and active aging. Her explanation is that “brain aging is associated with increased inflammation and oxidative stress, and both nuts and olive oil are rich in antioxidants and anti-inflammatory agents, which may help to protect against the damage that is a factor in vascular disease and the development of dementia.”

Last week on July 27, 2015, an article was published in the Washington Post called: Want to lose weight? Eat like the Japanese, by Lenny Bernstein. The article is based upon a completely separate study – a vast 5-year research project led by Azzeddine Azzam, a professor of agricultural economics at the University of Nebraska; Sarah Rehkamp, a graduate research assistant who now works for the U.S. Department of Agriculture, and Christopher Gustafson, an assistant professor of Agricultural Economics, also at the University of Nebraska. They developed a mathematical model to help discern the efficiency of calorie use in a variety of diets around the world. The study is not finished with the peer review and assessment for publication in a journal; but Rehkamp made a presentation on July 28, 2015. It’s such an interesting piece that I thought that I’d not wait for publication (thanks to Lenny Bernstein for bringing it to our attention). These three researchers are agricultural economists; not nutritionist – but they have certainly clarified some interesting outcome numbers. Surely, nutritionists can build upon this work in designing their next studies.

In essence the University of Nebraska researchers found that you could eat the same calories and lose weight by eating the way certain cultures eat. It suggests that it’s not just the number of calories; it’s also what and how a person eats. American health costs, environmental costs and efficacy of calorie intake can be improved by utilizing habits and food choices of other eating styles around the world.

It’s not a news flash that Americans consume more calories than necessary; with the net result of over two-thirds being overweight or obese. But what is news worthy is that their findings show that if Americans continued eating the same number of calories, but ate an diet with more plants they could lower their average body mass index (BMI), save on health care costs and improve the environmental impact of the American meat-based diet. In essence, we would be eating far less red meat and dairy, and far more fish, seafood and vegetables.

I’m not surprised by the fact that eating more fish and vegetables lowers the carbon impact on the environment. Nor am I surprised that possibly eating the same number of calories in plant foods, yields a net weight loss; my point is that more and more research finds factors associated with improved health for both the planet and ourselves by eating a plant-based diet.

Because Italian and Greek US restaurants want you to think their food is the Mediterranean-style of eating that nutritionist, like myself, are extolling, people often get confused and choose foods that don’t really fill the bill for a healthier eating style. When you think of eating Mediterranean, do you picture a big white flour pizza, topped with a mound of cheese and maybe with some sausage? Or do you think of Moussaka, loaded with red meat, mashed potatoes and butter, and of course a load of cheese? (American versions so often replace the eggplant with ground red meat and add plenty of hard cheese.) Don’t let the restaurants or common ideas about food from Mediterranean countries confuse you.

If you want to know the dietary guidelines for the PREDIMED Study, Tufts published them in their August 2015 issue. Besides adding nuts or olive oil they include the following:

• At least two daily servings of vegetables, including a salad
• At least three daily servings of fresh fruit
• At least three weekly servings of legumes, such as beans, lentils, garbanzo beans, soybeans and peas (tofu, falls in this group)
• At least three weekly meals of fish or seafood, especially fatty fish such as salmon, tuna or sardines
• A sauce (“sofrito”) of tomatoes and onion, often including garlic and aromatic herbs, simmered in olive oil, at least twice a week
• Wine with dinner, for those who drink alcohol.
• Participants were told to cut down on fatty red and processed meat, commercially baked goods such as pastries, fat-based spreads (like mayonnaise), and sugared sodas.

Although the Nebraska study suggests that cuisines from diverse countries can also provide many of the benefits of what we commonly call Mediterranean-style of eating, the fact is that eating less red and processed meat; more fruits and vegetables; more legumes and fish; less sugar and processed snack foods, can provide the benefits as the traditional foods of many countries of earth. Whether you flavor your food to taste Asian; Middle Eastern; Nordic; Mediterranean; or African it can still be an important factor in your health and the health of our environment. If you’re looking for a place to start, how about just increasing the frequency and amount of vegetables and fruit – maybe with a sprinkle of nuts and olive oil?