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ISSN: 2182-1054
DOI : 10.7455/ijfs/5.1.2016.a10
Manuela Vaz Velho and Rita Pinheiro and Ana Sofia Rodrigues
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The Atlantic Diet – Origin and features
International Journal
of Food Studies
OFFICIAL JOURNAL OF THE ISEKI_FOOD ASSOCIATION
International Journal of Food Studies IJFS April 2016 Volume 5 pages 106–119
The Atlantic Diet – Origin and features
Manuela Vaz Velhoa*, Rita Pinheiroa, and Ana Sofia Rodriguesb
aEscola Superior de Tecnologia e Gest˜ao, Instituto Polit´ecnico de Viana do Castelo, Av. Atlˆantico, 4900-348
Viana do Castelo, Portugal
bEscola Superior Agr´aria, Instituto Polit´ecnico de Viana do Castelo, Ref´oios, 4990-706 Ponte de Lima, Portugal
*Corresponding author
mvazvelho@estg.ipvc.pt
Tel: +351-258819700
Fax: +351-258827636
Received: 6 April 2015; Published online: 18 April 2016
Abstract
Despite globalization there still are food patterns which are clearly differentiated from one region to
another in Europe and elsewhere. In this study the Atlantic Diet is considered as the traditional diet
in Portugal and Galicia, a region in northwest Spain.
This paper aims to contribute to a better understanding of the Atlantic Diet food pattern in order to
fully exploit the potential of this Atlantic gastronomical heritage.
The background of the Atlantic Diet concept, the characterization of Atlantic Diet foods and a compi-
lation of scientific findings related to the consumption of these foods are covered.
A brief description of the Mediterranean Diet, the primitive pattern and the updated Mediterranean
pyramid are also included in order to aid understanding of the globalization of this previously local
health food pattern.
Final remarks and suggestions for further studies are made.
Keywords: Atlantic Diet; Food patterns
1 Introduction
The Atlantic Diet concept originated some years
ago when the Instituto Polit´ecnico de Viana do
Castelo (IPVC), University of Santiago de Com-
postela, Spanish Nutrition Foundation (FEN)
and Galician Association for the study of the At-
lantic Diet (ASGAEDA) joined forces with the
objective of placing the Atlantic Diet as a world-
wide reference for a healthy diet. As a result
of discussions between scientists from the Span-
ish and Portuguese Atlantic regions, the Euro-
pean Center for the Atlantic Diet (CEDA) was
founded in 2003 in Portugal. Subsequently the
“Atlantic Diet Foundation” was created in 2007
in Galicia, Spain by the University of Santiago
de Compostela.
In 2006 these institutions and organizations com-
mitted to the Atlantic Diet signed the “Baione
Declaration on the Atlantic Diet” with the aim
of developing a strategy for the promotion and
maintenance of the Atlantic Diet at different lev-
els, and having the following objectives:
The promotion of the Atlantic Diet as a
source of health and pleasure;
The promotion of research, development and
innovation on the Atlantic Diet, with respect
to health in the area of fisheries, aquacul-
ture, agriculture, livestock, viticulture and
natural resources;
The involvement of the food industry,
tourism and catering sectors to develop and
Copyright 2016 ISEKI-Food Association (IFA) 10.7455/ijfs/5.1.2016.a10
The Atlantic Diet 107
apply the main elements of the Atlantic
Diet within principal and supplementary
foods, through both traditional and inno-
vative cooking preparations and supply for
consumption at home and outside it;
The involvement of the educational sector
at various levels to educate consumers about
the cultural heritage of the Atlantic Diet;
Ensure that public and private institutions
recognize the values of the Atlantic diet,
lifestyle and the accompanying environmen-
tal commitments, and are committed to
their protection and promotion as a func-
tional diet;
Assess the potential environmental impact
in its broadest sense (urbanization, trans-
portation, environmental pollution, etc.) of
maintaining the values of the Atlantic Diet.
For the above purposes, two International con-
gresses, one seminar and three international
meetings, specifically dedicated to the Atlantic
Diet, were organized.
The 1st International Congress on the Atlantic
Diet, organized by CEDA, took place in Viana
do Castelo, Portugal from 17 to 19 July, 2003.
Two years later a seminar entitled: “Atlantic
Diet, Benefits for your Health and Well-Being”
took place in Santiago de Compostela, Spain
from 29 to 30 April, 2004. The 2nd International
Congress on the Atlantic Diet, organized by Uni-
versity of Santiago de Compostela, took place in
Baiona, Spain, from 16 to 18 November, 2006.
Three international meetings, organized by the
Fundaci´on Espa˜nola de la Nutrici´on (2003, 2005
and 2008) were also focused on the Atlantic Diet.
Furthermore, in many other scientific and tech-
nical events, not restricted to the Atlantic Diet,
the subject of the Atlantic Diet was also incor-
porated, for example:
The XVII Congresso de Gastronomia do Minho
and V Congresso Luso-Galaico, with a Session
II “A Dieta Atlˆantica na Euro regi˜ao Galiza-
Norte de Portugal”, took place in Vila Nova de
Cerveira, Portugal, 26-29 April 2007; The 1st In-
ternational Congress of Gastronomy and Wines
Portugal, with a session III “The gastronomy
and wines in Europe – Atlantic Diet”, took place
in Matosinhos, Portugal, 24-26 November 2011;
and the Atlantic Stakeholder Platform Confer-
ence, with its Session A4 “Atlantic Tourism –
Atlantic Diet: Why include food from the sea
in your diet”, took place in Porto, Portugal, 20
January 2015.
2 Atlantic Diet Features
Since 2000 there have been many attempts to
establish the Atlantic Diet features. At the cre-
ation of the European Center for Atlantic Diet
(CEDA), the Instituto Polit´ecnico de Viana do
Castelo ordered a study to compile general fea-
tures of the Atlantic Diet. In this first study
(Leslie, 2000) the author chose countries which
were representative of three regions of Europe,
with different types of climates, geographic envi-
ronments and lifestyles: Atlantic, Mediterranean
and Central European countries. The countries
considered were as follows:
Atlantic region: Portugal, Spain, France,
Ireland, United Kingdom, Belgium, Nether-
lands, Denmark, Norway and Iceland. The
results concerning Spain and France have to
be taken with caution as they also belong to
Mediterranean countries;
Mediterranean countries: Italy and Greece;
Central European countries: Germany,
Czech Republic, Poland, Austria and
Switzerland.
The precise characterization of the Atlantic Diet
was not the objective of this study but rather
to provide an overview of the different dietary
intake patterns found in the European Atlantic
countries. This covered eating habits, the main
ingredients used and the typical dishes found in
each country (Table 1), as well as a compari-
son between diets in Central, Mediterranean and
the Atlantic regions of Europe which allowed the
identification of some general features of the At-
lantic Diet.
The strategic plan for the European Center
for Atlantic Diet (CEDA) was developed by
Sociedade Portuguesa de Inova¸c˜ao, S.A. (SPI,
2001). Based on the 1999 version of the nutri-
tion database of the Food and Agriculture Or-
IJFS April 2016 Volume 5 pages 106–119
108 Vaz Velho et al.
ganization of the United Nations, a few features
were compiled that were still valid in 2011 and
are therefore presented in this chapter.
The consumption of seafood (including fish) is
higher in the Atlantic countries than in the Cen-
tral European countries. Countries close to the
sea consume more sea products than landlocked
countries because of the easy availability of fish.
For the two Mediterranean countries, their con-
sumption of fish is more or less the same as in
Denmark, Netherlands, Belgium, United King-
dom and France. The northern and southern
Atlantic countries differentiate themselves from
all the other countries by their very high con-
sumption of fish, although Iceland has a fish con-
sumption significantly higher than other Atlantic
countries. The limited agricultural production in
Iceland, due to its soil and climate characteris-
tics (J´ohannesson, 2010) together with the easy
availability of fish might justify this high con-
sumption of fish products. After Iceland (annual
per capita fish supply of 90 kg), comes the south-
ern and northern countries of the Atlantic: Por-
tugal, Norway, Spain, France and Denmark with
56.8, 53.4, 42.4 and 34.6 kg, respectively (FAO-
STAT Food balances, 2011). The data refers to
per capita fish supply and not per capita fish con-
sumption as the former includes losses through
distribution and food preparation.
It can be observed that the countries in the center
of Europe have the largest difference in the con-
sumption of meat and fish; they eat much more
meat than fish. Their physical environment is
more favorable to the breeding of livestock than
to access to fish.
A second observation is that the Atlantic coun-
tries in the central region of the Atlantic Cor-
ridor (Spain, France, United Kingdom, Belgium,
Netherlands and Denmark) have more or less the
same meat/fish ratio than the countries repre-
senting the Mediterranean countries. The three
extremities of Atlantic European countries (Por-
tugal, Norway and Iceland) have a different ratio
from the other countries. For Iceland, as men-
tioned before, fish is more important in the diet
than meat. Concerning Portugal and Norway,
fish is almost eaten in the same quantity as meat.
There is a large difference in the consumption of
potatoes and vegetables between Mediterranean
and Atlantic countries. In Atlantic countries,
people eat in general more potatoes and fewer
vegetables than in Mediterranean countries. This
follows the assumption that potatoes are one of
the characteristics of an Atlantic Diet. Compar-
ing the Central region of Europe and the Atlantic
region, the difference is not so marked.
Nevertheless, it can be noticed that southern At-
lantic countries are larger consumers of vegeta-
bles than Central regions. There is a gradient
‘South North’ for the consumption of vegetables:
countries that are located in the South region
eat more vegetables than in the North. The nat-
ural conditions, due to the sunnier climate of the
southern Atlantic countries, favor the cultivation
of vegetables.
There are no major differences in the consump-
tion of milk among the three regions: Atlantic,
Mediterranean and Central region of Europe but
Norway can be distinguished by its higher con-
sumption of milk. This fact is not a surprise upon
considering the nutritional characteristics of this
product and the European Agricultural Policies.
Europe has an excess of milk production and its
consumption has been promoted throughout the
European Union. Types of milk, other than cow
milk, can be more specific to some regions; how-
ever the consumption of other types of milk is
very low when compared with cow milk.
The European Atlantic region includes Portugal,
some regions of Spain, some regions of France,
Ireland, United Kingdom, Belgium, Netherlands,
Denmark, Norway and Iceland, which is not an
EU country. However, geographical location is
not enough to determine a common food pattern
as diet is influenced by many other factors, in-
cluding income, culture, religion and lifestyle. In
the last century, the globalization of diets, some-
times for health reasons, sometimes for its con-
venience, and other factors, such as world wars,
resulted in dramatic changes to the consump-
tion of traditional foods in European Atlantic
regions. There is evidence of the impact of the
First World War on food consumption and nu-
trition in Britain (Gazeley & Newell, 2013). In
Portugal and Galicia, traditional foods, many
of which have a Celtic influence (for example,
broths with meat and cabbage) are still eaten
every week at home and can be found in the ma-
jority of restaurants. Whereas the Irish colcan-
non and the Welsh cawl traditional dishes, with
IJFS April 2016 Volume 5 pages 106–119
The Atlantic Diet 109
meat and cabbage, are only consumed on festive
days or more recently in a few new traditional
restaurants. Scientists from Galicia and Portu-
gal, at the time of formation of CEDA in 2003,
considered that the Atlantic Diet food pattern
is still “alive” in those regions and the Atlantic
Diet was defined as the traditional diet of Portu-
gal and Galicia.
A relevant book entitled “La Dieta Atl´antica, el
pescado y las algas – Su importancia en el neu-
rodesarrollo y la funci´on cerebral”
parenciteTojo2009 was edited by the University
of Santiago de Compostela in 2009. The authors
compiled anthropological and historical informa-
tion about the nutritional characteristics of di-
ets from prehistory to recent days, together with
information about food patterns in the North-
west of Spain and in the Spanish Mediterranean
border regions, which enabled comparisons to be
made. They defended the role of the Atlantic
Diet as a health counterpoint to the recent West-
ern Diet.
The type of foods associated with the traditional
Atlantic Diet of Galicia identified by Tojo and
Leis (2009) are as follows:
High intake of seasonal foods, locally fresh and
minimally processed; High intake of vegetables,
fruits, potatoes, bread and cereals, chestnut,
whole nuts, legumes and honey; Use of olive
oil for seasoning and olive oil and pork lard to
cook; High consumption of fish, mollusks and
crustaceans; Moderate consumption of milk and
cheese; Moderate consumption of meat (cow and
pork); Moderate consumption of eggs; Moderate
consumption of wine usually with meals; Con-
sumption of sauces with a healthy fat profile;
Moderate consumption of simple sugars, desserts
based on cereals, dried fruits and eggs; High
intake of mineral water, with a healthy min-
eral profile; Cooking methods mainly by boiling,
stewing, roasting and grilling. Authors stated
these foods will ensure an abundant intake of
complex sugars and fiber; an abundant intake
of PUFAs (LCPUFAs omega-3 with a good ratio
of omega6/omega3, oleic acid and linoleic CLA;
adequate vitamin and mineral intake; and abun-
dant intake of functional food components (such
as antioxidants, sterols, flavonoids, carotenoids,
lycopene and indols).
The Atlantic Diet pyramid built by Tojo and Leis
(2009) (Figure 1) is placed in all refectories of the
University of Santiago de Compostela. The types
of food and cooking methods used for everyday
student meals at the University of Santiago de
Compostela are based on it (Tojo, 2008).
No major differences were found in Portuguese
and Galician food patterns in 2000 by Leslie
(2000) but a feature of the Portuguese diet
should be emphasized – the daily intake of veg-
etable soup with Brassica species and the pres-
ence of rice in most of the meals already men-
tioned in Table 1. It is important to mention that
under the designation “Vegetables” of FAOSTAT
food balances (2011), tomatoes and onions are
discriminated but the remaining vegetables are
placed together as an item named “Other veg-
etables” of which Portugal presents the higher
supply of 113.9 kg per capita compared to the
other Atlantic countries. However, it can be as-
sumed that Brassica species (cabbage) constitute
a significant proportion of this supply as it is the
second most consumed vegetable after potatoes
in Portugal (Gevers et al., 1998). The consump-
tion of different vegetables in 13 European coun-
tries for 1998 is shown in Table 2.
It is curious, despite the international reknown
of Spanish paella or Italian risotto, that Por-
tugal has a higher rice supply per capita in
Europe- 16.3 kg/year whereas Spain and Italy
have 9.4 and 5.2 kg/per capita/year respectively.
The European average rice supply is only 4.9
kg per capita/year (FAOSTAT food balances,
2011). In Portugal, rice and potatoes are con-
sumed daily within main meals. The most tradi-
tional food dish throughout Portugal is Cozido `a
Portuguesa, similar to Galician Cozido and con-
taining various meats, boiled potatoes and cab-
bage, but is also accompanied with rice. Another
very traditional dish is Feijoada `a Portuguesa, a
pork meat stew with beans, which is also accom-
panied with rice and furthermore, in the north of
Portugal this dish also contains cabbage. Finally,
the best known Portuguese dish that is present
in all Portuguese houses on Christmas Eve, the
Bacalhau Cozido com todos, contains boiled dry
salted cod with potatoes and cabbage, and fresh
garlic and olive oil to season it.
IJFS April 2016 Volume 5 pages 106–119
110 Vaz Velho et al.
Table 1: Comparison of food diets/patterns in European Atlantic countries (adapted from (Leslie, 2000))
Country Breakfast Lunch Dinner Dessert Drinks
Norway Very imp ortant meal, wheat bread with cheese or ham Sandwiches of cheese, ham, caviar, sardines, Boiled potatoes, meat balls with onion, bread Cakes, sweets Beer
accompanied with milk, cereals eggs, milk, fruit and sauce, salted fish, in brine, smoked fish:
salmon, code shrimp, mussel
Denmark Rye bread, milk Sandwiches of scrambled eggs and ham, of Roasted pork, meat balls (pork, sheep, cow), boiled Apple, pear and plum Beer
roasted pork with cabbage, of cod with mustard sauce, rissoles, minced meat,
steak with pickles boiled cabbage, beetroot in brine, cucumber,
pea and carrot salad, boiled potatoes
Netherlands Cereals, bread with sweet or salted, dairy products Sandwiches with different kinds of bread Boiled fish in different ways with vegetables Sweets Beer
and fruits, potatoes salad, cabbage and
sausage, vegetables soup
United Kingdom Eggs, bacon, sausage and tomato, toasted bread with Sandwiches Meat and vegetables soup, fish and French fries, Apple pie with cream, Tea
and Ireland pies, potatoes, cow meat with butter,
tea or coffee, dairy products eggs and onion, roasted meat with pudding
vegetables and sauce
Belgium Bread with jam or fruit in syrup, cheese Meat, seafood (mussel, shrimp, oysters), cod, eel, onion and fish soup, chicken, French fries, cow meat Waffles, chocolate Beer
with beer, onion and carrot, mayonnaise preparations
France Milk with chocolate, cereals, coffee, bread with butter or jam Mussels, oysters, crayfish, crab, ell, cod, tune and sardines, eggs, Cakes, apple, pear, peach, Wine
potatoes, cabbage, mushrooms, salads, butter, garlic, onion, salt cheese, yogurt
Portugal
Milk, coffee, bread with butter, cheese or jam, fruit, yogurt Vegetable soup, usually with Brassica species, dried salted cod, fresh sole, swordfish, squids, sardine, Sponge cake, fresh fruits, Wine
crab, mussels, cow and pork meat with wine sauce, roasted and stew with olive oil, garlic, bay leaf, cream cakes and
parsley, pepper, accompanied with rice and/or boiled or roasted potatoes. almond cakes
Spain
Bread with butter and ham or cheese, biscuits, Grilled fish, salmon, sardines, cod, octopus, tune, seafood: lobster, crab, mussels, Light food: soups, Almond cake Wine,
“churros”, fruit, milk, coffee, chocolate, fruit juice oysters, pork meat with potatoes and vegetables: salads, fish cider
beans, mushrooms, tomato, spinach, green pepper
Iceland Milk, coffee, yogurt, bread and croissants with smoked fish, cereals Dry and fresh fish, crustaceous, sheep, cow, meat sausage, butter Cheese Beer
IJFS April 2016 Volume 5 pages 106–119
112 Vaz Velho et al.
Table 2: Consumption of vegetables in 13 European countries (g.capita-1.day-1) from Gevers et al. (1998)
Vegetable item A B DK GB FIN F D I NL P E S CH Average
Potatoes 133 250 156 126 132 54 198 55 233 372 145 177 118 138.0
Tomato 26 37 44 18 29 20 40 99 15 26 51 21 25 41.5
Lettuce 12 21 7 17 3 6 8 34 8 10 24 8 23 15.7
Onion 18 23 27 - - 4 19 9 10 36 17 15 13 14.0
Cabbage* 16 - 14 - 7 - 10 2 15 114 7 16 13 13.0
Carrots 8 20 31 10 22 13 10 7 16 18 10 18 25 11.7
Beans 6 13 - 3 - 10 6 14 5 27 13 - 5 9.2
Cucumber 14 5 13 - 16 - 12 2 16 2 - 10 5 8.5
Pimento 8 3 - - - - - 8 6 7 11 4 4 7.8
Cauliflower 5 - 9 - 2 6 9 2 14 2 - - 6 6.3
A: Austrian; B: Belgian; DK: Denmark; GB: Great Britain; FIN: Finland; F: France; D: Germany; I: Italy; NL: Netherlands; P: Portugal;
E: Spain; S: Sweden; CH: Switzerland.
*Brassica oleracea
3 Atlantic Diet and Health
The term diet refers to a person’s pattern of eat-
ing and drinking. Diet is influenced by many
factors, including income, culture, religion, geo-
graphic location, and lifestyle.
Most of the so-called western countries have di-
etary guidelines. One of the most reported is the
USA Dietary Guidelines, first published in 1980,
and reviewed, updated and released by U.S. De-
partment of Health and Human Services (HHS)
and the U.S. Department of Agriculture (USDA)
every five years. These Dietary Guidelines con-
tain the latest, science-based nutritional and di-
etary guidance for the general public. They are
the foundation for federal nutrition education
and promotion programs, as well as the basis
for the federal food assistance programs. The
Scientific Report of the 2015 Dietary Guidelines
Advisory Committee (Advisory Report) was sub-
mitted to the Secretaries of the U.S. Depart-
ment of Health and Human Services (HHS) and
the U.S. Department of Agriculture (USDA) in
February 2015 and underwent a Public Consul-
tation Period until May 8 (http://www.health.
gov/dietaryguidelines/2015-scientific-report/ ac-
cessed on 2 April 2015).
A balanced diet contains food from several food
groups and supplies the body with the energy
and essential nutrients it needs (United States
Department of Agriculture (USDA) Center for
Nutrition Policy and Promotion (http://fnic.
nal.usda.gov/dietary-guidance), accessed on 31
March 2015).
The European Food Safety Authority (EFSA)
provides up-to-date and comprehensive scientific
advice to support EU policy makers in their de-
cision making process in the field of nutrition for
the setting of diet-related public health targets
and the development of consumer information
and educational programmes on healthy diets.
In March 2010, EFSA’s Panel on Dietetic Prod-
ucts, Nutrition and Allergies established dietary
reference values for the intake of carbohydrates,
dietary fibre, fats and water (http://www.efsa.
europa.eu/en/topics/topic/drv.htm accessed on
1 April 2015).
Epidemiological, experimental and clinical trial
evidence have demonstrated over the last 50
years a relationship between diet, nutrients and
blood lipid levels (Van Horn et al., 2008).
Nowadays, foods consumed worldwide include
ice cream, candy, pastries, potato chips or other
salted and fatty snacks (Haber, 1997). These fast
food and other processed convenience foods, to-
gether with more meat and other animal prod-
ucts, fewer fresh fruits and vegetables, are con-
sidered to be responsible for burgeoning rates
of heart disease, obesity, diabetes, and other
chronic diseases.
One of the key concerns of nutritionists is to
establish relationships between the type of diet
consumed by the population and the existence of
non-transmissible chronic diseases. Nutritional
interventions that have been applied worldwide
are multiple and involve different aspects that
IJFS April 2016 Volume 5 pages 106–119
The Atlantic Diet 113
contribute to improved food and nutrition pat-
terns worldwide (Rand, Windham, Wyse, &
Young, 1987; Araya, 1997). Arising from a meet-
ing of representatives of the Federation of Euro-
pean Nutrition Foundation no identification of
bad or good food should be indicated to con-
sumers in a regular balanced diet (La Place,
2004). A daily diet is not only food but also
taste and pleasure.
Epidemiological studies point out that about
75% of human cancers are related to extrinsic
factors, the most important smoking and diet
(Fahey & Talalay, 1995). Prevention of cancer
by naturally occurring substances in foods is an
area of growing interest to the scientific commu-
nity.
Several scientific studies have already demon-
strated the health benefits of Atlantic Diet food
components. In particular, fish consumption
and other seafood, vegetables, low alcohol con-
tent beverages, and the Atlantic Diet’s preven-
tive value in heart disease, metabolic and some
cancers. Vitamin B, omega 3 fatty acids and io-
dine are three components of the Atlantic Diet
which may bring health benefit to consumers re-
siding in the Atlantic area.
The association between fish consumption and
risk of cardiovascular disease (CVD) has been
extensively studied. Epidemiological and clini-
cal trial evidence suggests that omega-3 polyun-
saturated fatty acids (PUFAs) might have a sig-
nificant role in the prevention of coronary heart
disease. Dietary sources of omega-3 PUFA in-
clude fish oils rich in eicosapentaenoic acid and
docosahexaenoic acid along with plants rich in
alpha-linolenic acid. Evidence suggests that in-
creased consumption of n-3 FAs from fish or fish-
oil supplements, but not of alpha-linolenic acid,
reduces the rates of all-cause mortality, cardiac
and sudden death, and possibly stroke (Wang et
al., 2006).
Randomized clinical trials (RCTs) with fish
oils (eicosapentaenoic acid and docosahexaenoic
acid) and alpha-linolenic acid have demonstrated
reductions in risk that compare favorably with
those seen in landmark secondary prevention
trials with lipid-lowering drugs. The results
of prospective cohort studies indicate that con-
suming fish or fish oil containing the n-3 fatty
acids eicosapentaenoic acid (EPA) and docosa-
hexaenoic acid (DHA) is associated with de-
creased cardiovascular death, whereas consump-
tion of the vegetable oil-derived n-3 fatty acid
a-linolenic acid is not as effective. RCTs in
the context of secondary prevention also indi-
cate that the consumption of EPA plus DHA
is protective at doses <1 g/d. The therapeu-
tic effect appears to be due to suppression of
fatal arrhythmias rather than stabilization of
atherosclerotic plaques. At doses >3 g/d, EPA
plus DHA can improve cardiovascular disease
risk factors, including decreasing plasma triacyl-
glycerol’s, blood pressure, platelet aggregation,
and inflammation, while improving vascular re-
activity. Mainly on the basis of the results of
RCTs, the American Heart Association recom-
mends that everyone eat oily fish twice per week
and that those with coronary heart disease eat 1
g/d of EPA plus DHA from oily fish or supple-
ments (Breslow, 2006).
There is little doubt that omega-3 long-chain
polyunsaturated fatty acids (n-3 LCPUFAs) in
fish are the key nutrients responsible for the ben-
efits and are important for CVD prevention. Al-
though fish is valued as a source of these fatty
acids, it also provides other nutrients that may
have cardioprotective effects. It is likely that the
beneficial effects of fish consumption on the risk
of CVD are the synergistic effects among nutri-
ents in fish, and the integrative effects of fish con-
sumption may reflect the interactions of nutrients
and contaminants in fish (He, 2009). Shell fish
species such as shrimps are rich in omega-3s and
low in mercury (Smith & Guentzel, 2010).
Regular fish consumption before the age of 1 ap-
pears to be associated with a reduced risk of al-
lergic disease and sensitization to food and in-
halant allergens during the first 4 years of life
(Kull, Bergstrom, Lilja, Pershagen, & Wickman,
2006).
A study using unsaturated fat-enriched diets
with virgin olive, sun-flower and fish oil enhances
hepatic antioxidant defense system; with the vir-
gin olive and fish oil diet providing the best re-
sults (Aguilera, Mesa, Ramirez-Tortosa, Quiles,
& Gil, 2003).
A nationwide case-control study in Norway with
545 cases of childhood-onset type 1 diabetes and
1668 population control subjects concluded that
the use of cod liver oil during the first year of
IJFS April 2016 Volume 5 pages 106–119
114 Vaz Velho et al.
life is associated with lower risk of childhood-
onset type 1 diabetes (Stene, Joner, & Norwe-
gian Childhood Diabet Study G., 2003).
Data compiled on the relationship between diet
and incidence of certain diseases concluded that a
diet rich in fruit and vegetables is strongly associ-
ated with a lower risk of contracting degenerative
diseases, including cardiovascular disease, brain
dysfunction and cataracts, and proliferative dis-
eases such as neoplasms (cancer) (Negri, La Vec-
chia, Franceschi, D’ Avanzo, & Parazzini, 1991;
Steinmetz & Potter, 1991; Block, Patterson, &
Subar, 1992; Verhoeven, Godbohm, van Poppel,
Verhagen, & van den Brandt, 1996; Gold, T.H.,
& Ames, 1997; Ames & Gold, 1998).
The health benefits of onion intake, a major
food component of the Atlantic Diet, were re-
ported by several authors (Kumari, Mathew, &
Augusti, 1995; Goldman, Kopelberg, Debaene,
& Schwartz, 1996; Teyssier et al., 2001; Grif-
fiths, Trueman, Crowther, Thomas, & Smith,
2002). The annual consumption of onions in
Portugal was estimated at 13.8 kg per capita in
2011 (FAOSTAT food balances, 2011) and it is
the third most consumed vegetable after pota-
toes and Brassica species.
Regional varieties of onion from the Northwest of
Portugal were studied. Results indicate that the
red variety has higher nutritional value (minerals
and protein) and higher potential health benefits
related to the presence of antioxidant compounds
(Rodrigues et al., 2003).
A broad array of healthy properties have been at-
tributed to Brassica species in recent years such
as anticarcinogenic, protective actions against
cardiovascular diseases and ageing processes,
prenatal pathologies and cataracts. These
benefits have been related to their high con-
tent in health-promoting phytochemicals namely
glucosinolates (and their hydrolysis products,
isothiocianates), phenolic compounds (hydrox-
ycinamic acids and flavonoids), carotenoids, vi-
tamins (ascorbic acid (AA), tocopherol, and folic
acid) and minerals (Dominguez-Perles, Mena,
Garcia-Viguera, & Moreno, 2014).
The low incidence of coronary heart disease as-
sociated with moderate consumption of red wine
and other alcoholic drinks have been reported
(Renaud & Delorgeril, 1992). In a review study,
Bertelli (2007) reported that white wine is given
less importance than red wine as it contains
lower quantities of polyphenols. However, the
same study underlined several other epidemio-
logical surveys showing that wine “colour” was
not found to have different effects with respect
to coronary artery diseases, modulation of the
release of plasma interleukin-6 and platelet func-
tion. Furthermore, both white and red wine
improved the LDL/HDL cholesterol ratio and
enhanced the LDL clearance rate from blood.
Wine, red or white, is drunk at meals in the At-
lantic Diet region.
Based on a case control study (n=820) of pa-
tients hospitalized with acute myocardial infarc-
tion (AMI), adherence to the Southern Euro-
pean Atlantic Diet (SEAD) was associated with
lower odds of nonfatal AMI (Oliveira, Lopes,
& Rodriguez-Artalejo, 2010). The authors con-
cluded that some but not all food components
of the SEAD may contribute to the very low
coronary mortality in northern Portugal and
Galicia. As far as we know this was the
first epidemiological study examining the asso-
ciation between adherence to the Atlantic Diet
and the occurrence of non-fatal acute myocar-
dial infarction in Portugal. A cross-sectional
study from the same authors and Spanish au-
thors (Guallar-Castillon, Oliveira, Lopes, Lopez-
Garcia, & Rodriguez-Artalejo, 2013) was con-
ducted in 2008-2010 among 10,231 individuals
representative of the population aged 18 years
and older in Spain. Diet was assessed with a
validated computerized diet history. SEAD ad-
herence was measured with an index including
9 food components (fresh fish, cod, red meat
and pork products, dairy products, legumes and
vegetables, vegetable soup, potatoes, whole-grain
bread, and wine), which ranged from 0 (low-
est adherence) to 9 (highest adherence). This
study identified possible mediators of the effect of
SEAD on myocardial infarction, because SEAD
was found to be associated with a lower con-
centration of markers of inflammation and with
reduced triglycerides, insulin, insulin resistance
and systolic blood pressure.
Several other studies have pointed out the ben-
efits of food components typical of the Atlantic
Diet but not grouped as a meal nor aggregated
under the concept of an Atlantic Diet Food pat-
tern.
IJFS April 2016 Volume 5 pages 106–119
The Atlantic Diet 115
There is a continuous move from dietary tradi-
tions which are local, low in technological input
and based on empiricism to diets that are global,
high in technological input and science based.
Over the last century societies have the ability
to improve their diet based on a better scientific
understanding of the health benefits of such di-
ets but innovations are often not achieved due
to commercial considerations. This will require
that all sectors of the food industry to work to-
wards healthy and economically affordable diets.
In addition, there is a continuing demand by con-
sumers to ascertain that traditional foods are not
only healthy but also convenient and easy to pre-
pare (Heinrich & Prieto, 2008).
On current evidence the concept of the ‘Atlantic
Diet’ appears to be as well founded as the con-
cept of the ‘Mediterranean Diet’, but the major
challenge is to define whether there is a tradi-
tional Atlantic Diet as healthy as the Mediter-
ranean Diet when consumed as part of a healthy
lifestyle (Lindsay, 2003). This will require urgent
action given the rapid changes that are occurring
in European dietary habits (Lindsay, 2003).
4 An overview of the
Mediterranean Diet
The Mediterranean Diet has become a popular
area of study due to observations made in
1960 of low incidences of chronic diseases and
high life-expectancy rates attributed to the
Crete population who consumed a traditional
Mediterranean diet. Despite the high daily in-
takes of fat, epidemiological studies showed low
prevalence of heart and other vascular diseases.
(Seven countries study- a 25 year follow-up).
Prevalence of cardiovascular disease varied from
2-10% in Southern European countries and from
10 to 18% in Northern European countries.
Mortality rates varied greatly from East Finland
(262/1000) to Crete (25/1000). Differences in
mortality rates were attributed to nutritional
habits, in particular to the intake of saturated
fatty acids and flavonoids. Differences in types
of fat emerged and the benefit of olive oil
was evidenced by those studies (Tyrovolas &
Panagiotakos, 2010).
The original Mediterranean Diet was the diet
of poor people where meat was a luxury and
meals were based on raw vegetables, goat
cheese, chicken rarely and red meat on festive
days. The ”Mediterranean Diet” gained much
recognition and worldwide interest in the 1990s
as a model for healthy eating habits. The diet
is based on the traditional dietary patterns of
Crete, a Greek island, and other parts of Greece
and southern Italy. The diet is closely tied
geographically to areas of olive oil cultivation in
the Mediterranean Basin.
This diet was successfully resistant to the last
50 years of “modernizing” foods and drinks in
industrialized countries. The “poor” diet of the
people of the southern Mediterranean countries,
consisting mainly of fruits and vegetables, beans
and nuts, healthy grains, fish, olive oil, small
amounts of dairy, and red wine, proved to be
much more likely to lead to lifelong good health.
The healthfulness of this pattern is corroborated
by more than 50 years of epidemiological and
experimental nutrition research.
Oldways, a USA non-profit organization, the
Harvard School of Public Health, and the Eu-
ropean Office of the World Health Organization
(WHO) introduced the classic Mediterranean
Diet in 1993 at a conference in Cambridge,
USA, along with a Mediterranean Diet Pyra-
mid graphic to represent it visually (http:
//oldwayspt.org/resources/heritage-pyramids/
mediterranean-pyramid/overview, accessed on
31 March 2015).
In 1996 the Mediterranean Diet Foundation
was created, with its headquarters in Catalo-
nia, Spain and a scientific committee of 25
scientists from 11 Mediterranean and non-
Mediterranean countries (one from Netherlands)
(http://dietamediterranea.com/en/foundation/
scientific-committee/, accessed on 31 March
2015).
During the 15 th Anniversary Mediterranean
Diet Conference in November 2008, several major
updates were made to the Classic Mediterranean
Diet Pyramid by the Scientific Advisory Board.
These changes focused on gathering plant
foods (fruits, vegetables, grains, nuts, legumes,
seeds, olives and olive oil) in a single group to
visually emphasize their health benefits (http:
//oldwayspt.org/resources/heritage-pyramids/
mediterranean-pyramid/overview, accessed
IJFS April 2016 Volume 5 pages 106–119
116 Vaz Velho et al.
on 31 March 2015). A new feature on the
Mediterranean Diet Pyramid was the addition
of herbs and spices, for reasons of both health
and taste. Also, herbs and spices contribute to
the national identities of various Mediterranean
cuisines. The committee changed the placement
of fish and shellfish on the pyramid, recognizing
the benefits of eating fish and shellfish at least
two times per week. Enjoy meals with others is
now in the base of the Mediterranean Pyramid
of 2008 launched in January 2009.
5 Concluding remarks and further
suggestions
The objective of this paper was not to compare
the Atlantic Diet with the Mediterranean Diet.
More than 50 years of studies separate both con-
cepts. As mentioned previously a wide variety of
fish and shell fish is now placed in the updated
Mediterranean Diet Pyramid with advice to eat
fish and shellfish at least twice a week. There
are no doubts that the residents of the Atlantic
Diet region have traditionally a higher intake of
fish and shellfish than the Mediterranean coun-
tries. Enjoy meals with others, recently placed
in the base of the Mediterranean Diet Pyramid,
is a common practice in Portugal and Galicia,
where mealtimes are regarded as leisurely affairs
to share with family and friends.
Diversity is also a key word. It is not only the
type of food but also the frequency of their intake
which makes a food component healthy or un-
healthy. As mentioned before, no identification
of bad or good food should be indicated to con-
sumers in a regular balanced diet. A daily diet is
not only food but also taste and pleasure. A com-
bined balance of those elements, food and taste,
is characteristic of the Atlantic Diet. Also, it is
well known that food components interact, thus
it is important to analyze a whole meal rather
than the separate food components.
The Atlantic Diet is considered strategic by the
Food-cluster Portugal Foods which has as major
objectives: the surveillance and characterization
of Atlantic Diet by identification, systematiza-
tion and validation of products and recipes under
the concept “Atlantic Diet - a Portuguese way of
being”. The continuing move from dietary tra-
ditions which are local to diets that are global,
as the Mediterranean Diet now is, requires high
technological input and a science base, therefore
companies and public and private R & D insti-
tutions must join together in efforts to validate
and make global another regional healthy diet -
the Southern European Atlantic Diet or Atlantic
Diet.
The previously reported epidemiological studies,
showing higher adherence to the Atlantic Diet
(Southern European Atlantic Diet) and its in-
verse association with the occurrence of non-fatal
AMI and its association with a lower concentra-
tion of coronary disease markers, are a beginning
for consolidation of the healthfulness of the At-
lantic Diet pattern but more epidemiological and
experimental nutrition research is needed to cor-
roborate these findings.
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