You may have heard of the benefits of the Mediterranean diet, but new research suggests they may be limited to people in certain tax brackets. A study from Italy found that the Mediterranean diet may be beneficial to heart health only for the upper classes - less educated and wealthy individuals that adhere to the same diet plan are not likely to experience the same benefits.

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Even if poorer individuals ate similar foods, had similar regular exercise habits, went to routine check-ups and did not smoke, the effects of a Mediterranean diet were still not as strong as for more wealthy and educated people, Healthday reported. Although the reason for these disparities are not yet clear, the researchers suggest it may be due to differences in the quality of food that wealthy and less wealthy individuals consume.

“Our study has revealed that the socioeconomic position is able to modulate the health advantages linked to Mediterranean diet,” explained study researcher Marialaura Bonaccio in a recent statement. “In other words, a person from low socioeconomic status who struggles to follow a Mediterranean model, is unlikely to get the same advantages of a person with higher income, despite the fact that they both similarly adhere to the same healthy diet."

For the study, researchers looked at the diets, income and education level of nearly 19,000 men and women, taking into account many external factors, including body mass index and marital status. Still, results showed that although the Mediterranean diet could reduce risk of cardiovascular disease and stroke in upper class individuals by as much as 60 percent, the same effects were not seen in lower class individuals.

In addition to food quality, preparation skill may also account for the differences in health benefits. The study noted that less wealthy individuals tended to prepare their vegetables in ways that often drained many of the health benefits. For example, boiling vegetables can drain many of the nutrients, while grilling and even microwaving tends to preserve vitamins, The Globe and Mail reported.

Education may also play a role in these differences, as more educated individuals are more likely to understand the importance that certain foods have to their health and better cater to these nutritional needs, Healthday reported.

Traditionally, the Mediterranean diet is one that has high amounts of fruit, vegetables, whole grains, and fish, and lower amounts of red meat, cheese, and poultry, Harvard Health reported. The diet has been well studied, with research suggesting it’s beneficial to preventing heart attack, stroke, premature death, helps with weight loss, and even reduces the risk for developing Alzheimer’s disease, diabetes, and various types of cancer. However, the point of this study is to add some skepticism to the benefits of this diet, and show that they may not be as universal as past studies suggest.

“We cannot be keeping on say[ing] that the Mediterranean diet is good for health if we are not able to guarantee an equal access to it,” concluded de Gaetano.

Source: Bonaccio M, Di Castelnuovo A, Pounis G, et al. High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study. International Journal of Epidemiology.

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