For decades, health authorities have claimed that the diet of people living in Mediterranean countries, which emphasizes the use of olive oil, nuts and fresh produce, is a major factor in the consistently low rates of heart disease in this region. However, a group of filmmakers led by a British cardiologist now suggests that the role played by the Mediterranean diet may have been oversimplified. In a new film, they suggest that it’s not just the food that makes people in this region in better health, but a range of lifestyle influences. Some of these factors, they say, have been overlooked in the past. Through the film they hope to show viewers how these factors work together to contribute to the longevity of the region’s population, as well as to clear up some of the misconceptions about the Mediterranean diet itself. The movie, titled Pioppi Protocol, is set in Pioppi, a small town south of Naples, Italy. Several of the filmmakers chose the town because Ancel Keys, the first scientist to recognize the health benefits of the Mediterranean diet in the last 30 years or so, lived here for much of that time. Keys’ past epidemiologic studies linked saturated fats to heart disease. His findings have also inspired the widespread adoption of low-fat diets, although health authorities in many countries no longer strongly recommend the practice. Dr. Aseem Malhotra says he was inspired to travel to the Mediterranean region and spend time learning about the traditional diets there. He is a firm believer in the efficacy of these diets and will prescribe olive oil to his own patients as a prescription. An interventional cardiologist and consultant to the UK’s National Obesity Forum, Malhotra said studies have shown that after quitting smoking people find their risk of heart attacks and strokes drastically reduced in a short period of time. But he says the heart attack patients he treats often don’t see that dietary changes can have that same effect in a short period of time. “There’s this notion among people with heart attacks and heart disease that there’s not much they can do when the body is already so damaged. Some of my patients think that way, too,” Malhotra said. “But by changing your diet, you can quickly and dramatically lower your risk of heart attack, even if you have coronary artery disease. We have data showing that this risk is reduced within a few weeks.” Dr. Malhotra went to the Mediterranean region with documentary filmmaker Donal O’Neill. They found that a number of factors seemed to play a role in the longevity of people in the Pioppi region, and diet was just one of them. The average life expectancy of people there is about 90 years. They were surprised by the fact that the people they encountered there enjoyed their diet so much that they turned almost every meal into an opportunity to meet and socialize with friends and family. They also noticed that people spent a lot of time outdoors, breathing in the fresh air. Instead of jogging or exercising at specific times of the day, they engaged in a lot of leisurely physical activities like walking and biking. And they seem to have lower levels of chronic stress. “We need to redefine the Mediterranean diet,” says Dr. Malhotra. “The fact is, it’s a lifestyle. It’s that whole set of things, including diet, but also socializing, getting the right kind of exercise, going outdoors, and being in the sun. The question, though, is how do we combine what we learn from this village and town with what we know about modern medicine.” What was learned there about food in the Mediterranean region was also quite surprising to Dr. Malhotra and O’Neill. Although olive oil and vegetables are regularly eaten by the locals, some aspects of their traditional diet vary very widely from region to region. They found that the consumption of pork and lamb was quite common in some areas, but sugar was used less in the local traditional diet. They learned that olive oil is not made in the same way, and they also found that one of the grains regularly eaten by the Piopi people is very different from the one consumed by most Americans. Dr. Malhotra said that in the film, he will try to correct some of the misconceptions people have about the diet, while also showing how one can quickly improve their health in just a few weeks by drawing on various elements of the Mediterranean lifestyle. “We want to show people that there are things that are achievable for them,” says Dr. Malhotra. “Making a few simple changes can lead to a huge improvement in health, as well as increase their vitality in a short period of time.”