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Israel's is the country with the healthiest diet in the West, and the nine healthiest diet in the world, according to a new global study published in The Lancet Global Health journal.

Israel's Mediterranean neighbors - especially Turkey, Greece and Italy - received compliments in the research as well.

The Israeli nutrition is considered healthy because it is based on increased consumption of fresh vegetables, olive oil, fruit and grains and on moderate consumption of proteins.

In addition, Israel does have a culture of eating processed food, but not as much as in the United States, Canada and other Western countries. In fact, the study places Israel in the same category as poor African countries like Somalia and Sierra Leon, which have alarming hunger rates, but the research shows that there is no correlation between money and the quality of nutrition: Vegetables and grains, which are considered the healthiest food items, cost very little compared to processed foods which include flavoring and preservatives.

The study was led by Dr. Fumiaki Imamura of the University of Cambridge, who looked into the eating habits in 187 countries with almost 4.5 billion adult residents.
According to the researchers, healthier people eat more grains and legumes, milk, dietary fiber, omega-3s, fish and fruit. The researchers explained that African countries received the highest ranking thanks to their simple and unprocessed menu and the lack of junk food. While these countries' residents suffer from hunger and poverty, they actually have the healthiest food in the world. Chad, one of the poorest countries in the world, was ranked as the country with the healthiest diet overall, followed by Sierra Leon, Mali, Gambia, Uganda, Ghana, Ivory Coast, Senegal, Israel and Somalia. The country with the least healthiest diet overall is Armenia, followed by Hungary, Belgium, the Czech Republic and Kazakhstan. According to British newspaper The Independent, the study shows that high-income nations, such as the US, Canada, Western European nations, Australia and New Zealand, have better diets based on healthy items but substantially poorer diets when unhealthy food was considered. Countries in sub-Saharan Africa and some Asian nations, including China and India, saw no improvement in their diets over the past 20 years.
The study also found that women's eating habits are healthier than men, and that older people eat better than younger adults. The researchers expressed their concern over the increase in the consumption of junk food around the world despite nutrition's critical effect on life expectancy.

Dudi Goldman and Yaron Kelner contributed to this report.

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Study: Israel has the healthiest diet in the West

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Israel's is the country with the healthiest diet in the West, and the nine healthiest diet in the world, according to a new global study published in The Lancet Global Health journal. Israel's Mediterranean neighbors - especially Turkey, Greece and Italy - received compliments in the research as well.

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I love the Machane Yehuda Market in Jerusalem, or the Shuk as it is known. The storekeepers are colorful and the crowds a snapshot of the diversity of Jerusalem residents. Unlike the United States, where fruits are often on sale year-round, Israel does not import its fruits and vegetables.

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I love the Machane Yehuda Market in Jerusalem, or "the Shuk" as it is known. The storekeepers are so colorful and the crowds a snapshot of the diversity of the residents of Jerusalem. Unlike the US where fruits are often on sale year-round, Israel does not import its fruits and vegetables; thus, the availability of fruits is always changing. In the Shuk, a certain excitement can be felt when foods make their seasonal appearance. What I love most about the Shuk, however, is its display of Israel's amazing agricultural productivity and the healthfulness of this bounty.

One day, while walking through the Shuk, I had a thought: why can't the Israeli diet become a model for the rest of the world? Israel is a world leader in so many areas-the high-tech industry, agriculture, missile technology, et cetera. Why can't Israel also be a leader in good nutrition?

The Mediterranean Diet
Since Israel is a Mediterranean country, the Israeli diet is a Mediterranean diet. That is, the type of diet eaten in countries in the Mediterranean region. These diets vary depending on the particular country. All of the Mediterranean diets, however, share certain characteristics. A typical Mediterranean diet consists of plenty of vegetables, grains, nuts, legumes and fruits. Olive oil is the predominant fat. Wine often accompanies meals. Many Mediterranean diets, such as the Italian diet, are low in fat. The Spanish Mediterranean diet has a higher fat content because of its increased use of olive oil. The Israeli Mediterranean diet is somewhat atypical because it not only contains plenty of fruits, grains and vegetables, but it is also Western in its use of eggs, dairy and meat, a consequence of Israel's early agricultural policies.

A dizzying number of diets are promoted in America, each targeted for a specific issue, such as weight loss, cardiovascular disease prevention, improved diabetes control or other health concerns. However, only the Mediterranean diet favorably influences all of these conditions, in addition to other health problems. Studies indicate that the Mediterranean diet has a positive influence on certain forms of cancer and asthma, and helps prevent dementia and depression. ¹ No other diet can make such claims.

No one knows for sure why the Mediterranean diet is so healthy, but many attribute it to its high antioxidant content. During the body's normal functioning, supercharged oxygen and nitrogen molecules are produced, and these can be harmful unless neutralized by the body's antioxidants. High blood glucose and cholesterol levels as well as smoking and eating trans fats increase the production of these supercharged molecules and lead to what is called "oxidative stress." Oxidative stress promotes cardiovascular disease and may influence other conditions such as the neurodegeneration of Alzheimer's disease and the development of cancer.

Fortunately, many of the natural foods we eat are full of antioxidants that can supplement the body's defense against supercharged oxygen molecules. Plants convert solar energy into chemical energy and need to protect themselves against the production of excessive energy, as well as other potentially damaging factors, which is why they contain so many antioxidants. There are literally thousands of antioxidant compounds in fruits, vegetables and whole grains. Removing the bran from flour greatly reduces its antioxidant content-one reason why whole-wheat bread is more healthful than white bread. Health articles often discuss the benefits of including tomatoes, green tea (more healthful than dark tea) and dark chocolate in your diet, all of which have high antioxidant contents.

The Seven Species
The Israeli Mediterranean diet contains foods that are extremely healthful, including the sheva minim, or seven species listed in the Torah as being special products of the Land of Israel. The fruits of the sheva minim have been shown to be loaded with antioxidants. ² The seven species, which are blessed with certain holiness, are wheat, barley, olives, grapes, dates, figs and pomegranates. Depending on the time of year, the fruits of the shivat haminim are ubiquitous in the Shuk.

The seven species are perfectly adapted to Israel's climate. Wheat and barley are sown during the winter months when there is rainfall (the "early" rain mentioned in the second paragraph of Shema) and they ripen under the influence of the "late" rain in the spring. The early rain usually arrives like clockwork shortly after Sukkot. Grape vines and olive, fig and pomegranate trees are able to survive the dry Israeli summer months and the complete absence of rain.

Olive oil is an important component of Mediterranean diets. Extra-virgin or virgin olive oil is rich in antioxidants, although this is not the case for "pure" or "light" olive oil. This is because the "impurities" removed contain the antioxidants. There is considerable evidence that olive oil protects against cardiovascular disease. Interestingly, studies indicate that monounsaturated fat (which is the main fat in olive oil) has no protective properties, while olive oil does-additional evidence for the importance of antioxidants. 3

Moderate wine drinking (but not heavy alcohol consumption) has been shown to prolong longevity and prevent cardiovascular disease and some forms of cancer. This is attributed to its high antioxidant content, although wine may also contain other substances that have beneficial cellular properties. ⁴ Red rather than white wine has the highest antioxidant content.

The Israeli Diet as a Model Diet
The modern Israeli diet has the potential to be a model diet, since it combines the healthiest foods of the Mediterranean together with wholesome foods from the West.

Olive oil rather than corn oil is the country's favored oil. Wines are plentiful. Figs, dates, pomegranates and a multitude of other fruits are readily available (in season). Vegetables, especially tomatoes, cucumbers and peppers, are easily obtainable and used extensively in salads. Nuts such as almonds and walnuts grow naturally in the country and are also high in antioxidants. Restaurant and take-out meals in Israel tend to contain far more vegetables than in the US. Hummus and tahini are popular dips, and are made from natural products.

However, I can already hear the skeptics. Sure, the Israeli diet is Mediterranean-like. But how can a diet containing whole milk, eggs and meat be a model diet?

The reality is that there is considerable turmoil nowadays in the world of nutrition, as it is becoming increasingly evident that many of the "truisms" that were the bedrock of American nutrition for over half a century lack scientific support. Eggs slightly raise cholesterol levels in a percentage of people (hyper-responders), but no scientific study has been able to show that this translates into increased risk of cardiovascular disease, except perhaps in diabetics. Blood cholesterol levels are indeed raised by saturated fat, but recent studies have concluded that saturated fat does not promote heart disease. ⁵ Nor has research been able to show that low-fat milk prevents pediatric obesity. ⁶ It was pointed out recently in an article in the reputed medical journal JAMA Pediatrics that "the recommendations to replace whole milk with reduced-fat milk (in children) lacks any evidence basis for weight management or cardiovascular disease prevention . . . ."

Admittedly, it is possible to eat too much of a good thing. Many Americans eat more than enough red meat and would do well to substitute some of their meat consumption with vegetable protein and fish, but high meat consumption is rarely the case in Israel. The consumption of dairy products has been shown to have many health benefits, including preventing obesity and providing the calcium needed for bone development and bone turnover. Eggs are filling and can be helpful with weight control.

Nevertheless, just because a diet has the potential to be a model diet does not mean that it necessarily is. A bit of realism is in order. Israeli nutrition is far from perfect. Americans are not the only ones who drink soft drinks. Israelis do so too. Soft drinks have the distinction of being the only food proven in scientific studies to be associated with excessive weight gain. Israelis also love pareve desserts, some of which contain too much trans fat-rich margarine. However, the country recently introduced mandatory labeling for packaged goods, which may help to reduce trans fat consumption. Ingestion of even small amounts of trans fat can lead to oxidative stress and promote heart disease. Furthermore, schooling in Israel is not necessarily conducive to good nutrition. Many children do not eat breakfast at home and schools do not provide hot lunch for students. Students are therefore expected to bring sandwiches, snacks and drinks for breaks during the day, some of which are unhealthy.

So what is the upshot of all this? The Israeli diet could potentially be a model diet for much of the world, but Israelis need to put in the effort to make it so.

Dr. Arnold H. Slyper is a pediatric endocrinologist and former professor of pediatrics. His clinical and academic interests are in obesity and preventive nutrition. He made aliyah in 2013 and lives in Ma'ale Adumim. He currently works as a pediatric endocrinologist for Clalit Health Services. He is the author of the book Saving your Family from Obesity (2013).
Notes
1. My web site, eatforhealth.org, discusses the health benefits of the Mediterranean diet. Scientific references are included.

2. Elliot M. Berry et al., "The Middle Eastern and biblical origins of the Mediterranean diet," Public Health Nutrition 14 (2011). This is an excellent summary of the antioxidant status of the sheva minim and other Biblical foods.

3. Lucas Schwingshackl and Georg Hoffmann, "Monounsaturated fatty acids, olive oil and health status: a systematic review and meta-analysis of cohort studies," Lipids in Health and Disease 13 (2014): 154.

4. Alberto AA Bertelli et al., "Grapes, wines, resveratrol, and heart health," Journal of Cardiovascular Pharmacology 54 (2009): 468-476. This is a summary of the health benefits of wine and its constituents.

5. Rajiv Chowdhury et al., "Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis," Annals of Internal Medicine 160 (2014): 398-406. This very recent study has attracted considerable media attention with its demonstration that saturated fat is not associated with cardiovascular risk and that polyunsaturated fat is not associated with cardiovascular protection.

6. Arnold H. Slyper and Wei-Min Huang, "Milk, Dairy Fat and Body Weight in Pediatrics: Time for Reappraisal," Infant, Child & Adolescent Nutrition (1) 2009: 148-159. This article summarizes current knowledge regarding consumption of dairy and dairy fat and body weight.

This article was featured in Jewish Action Spring 2015.

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Why the World's Healthiest Western Diet Is Found in Israel - Jewish Action

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I love the Machane Yehuda Market in Jerusalem, or "the Shuk" as it is known. The storekeepers are so colorful and the crowds a snapshot of the diversity of the residents of Jerusalem. Unlike the US where fruits are often on sale year-round, Israel does not import its fruits and vegetables; thus, the availability of fruits is always changing.

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Hummus, tomato-cucumber salad, extra-virgin olive oil ... these and other staple foods on virtually every Israeli table undoubtedly helped propel the country to #1 on a new ranking of countries with the lowest rate of diet-related deaths worldwide and #10 on the 2019 Bloomberg Healthiest Country Index.

Although many Israelis do have some unhealthy eating habits - too much char-grilled meat, processed foods, sweets and deep-fried foods - the overall picture is rosy compared to most countries' diets and especially the SAD (standard American diet).

And it will likely get even better after the Ministry of Health publishes its newest guidelines for healthful eating emphasizing the traditional "Mediterranean diet" approach that most Israelis already embrace.

That's our first of 13 reasons you should eat like an Israeli.

The healthful foundation of Israel's way of eating is common to all countries bordering the Mediterranean Sea.

"The Mediterranean diet has the most evidence of being the 'super diet,' and it's also sustainable especially if it's local," says Dr. Elliot Berry, professor emeritus of human nutrition and metabolism at Hebrew University Hadassah Medical School, and consultant to the United Nations and the Israeli Health Ministry.

"The ministry's new Mediterranean food pyramid recommends foods for optimal health including whole grains, wine in moderation, pomegranates, figs, walnuts and extra-virgin olive oil - more plant foods and less animal and highly processed foods," Berry tells ISRAEL21c.

The Mediterranean diet encourages moderate amounts of fish and poultry, and low intake of dairy products (mostly yogurt and cheese), red and processed meats, and sweets. It puts a strong focus on the social and cultural aspects of dining, such as communal mealtimes (see #12 below).

Family Friendly Mediterranean-style Cooking: With a Groundbreaking Guide to Weight Loss, Weight Control and Cardiovascular Health, a new book by Israel-based pediatric endocrinologist Dr. Arnold Slyper, promotes what he calls an Israeli Mediterranean diet based on his studies of the metabolism of overweight children in Israel.

Salad with breakfast, lunch and dinner

Freshly chopped salad is the cornerstone of all Israeli meals. The most basic Israeli salad starts with locally grown cucumbers and tomatoes dressed with herbs, sea salt, extra-virgin olive oil (the only kind available here) and squeezed lemon juice.

We really pound back those fruits and veggies: According to the Israeli Central Bureau of Statistics, as of the end of 2018, Israel's 8.9 million residents each have access annually to an average 152 kilograms of fruit and 154 kg of vegetables.

If you've ever enjoyed a traditional Israeli breakfast buffet at a hotel or restaurant, you know what we're talking about.

In addition to a huge variety of raw sliced vegetables and vegetable salads, you'll find shakshuka (eggs poached in pepper-and-onion-studded tomato sauce), freshly baked breads, a large variety of cheeses, porridge and other warm delights to jumpstart your day.

The benefits of a hearty breakfast have been proven in several Israel studies that reveal eating more in the morning and less in the evening suppresses blood-sugar surges, eases weight loss, and helps diabetics avoid insulin resistance. (Just take it easy with the burekas and other high-cal, high-fat goodies on the buffet table.)

If you don't see a plate of homemade hummus at mealtime, you're probably not in Israel.

This delicious and nutritious creamy paste - based on protein-rich chickpeas, sesame tahini, sea salt and lemon juice - is not only for dipping here in Israel.

A large plate of hummus garnished with olive oil and parsley, and often with whole cooked chickpeas, zaatar and extra tahini, is considered a perfectly satisfying meal, scooped up with chunks of warm fluffy pita bread.

You can even find restaurants in Israel that serve nothing but a large variety of hummus and accompaniments. This kind of eatery is called a hummusiya, and we highly recommend checking it out.

Tahini ( tahina to Israelis), simply ground sesame seeds, is not only an essential ingredient in hummus but has pride of place in Israeli cuisine as the basis of an all-purpose dip and dressing (think falafel, sabich or whole-roasted eggplant).

Israelis import 50,000 tons of sesame seeds per year, consumed mainly in the form of tahini and hummus. Sesame seeds are rich in copper, manganese, calcium, phosphorus, magnesium, iron, zinc, molybdenum, vitamin B1, selenium and dietary fiber.

The regal red pomegranate is one of the seven indigenous crops mentioned in the Bible (the others are wheat, barley, grapes, olives, figs and dates) and is a visual symbol of Israel itself.

Pomegranate seeds (the edible part of the fruit) guard against cancer and heart disease, boost immunity and reduce chronic inflammation. Gastric distress, hot flashes, hemorrhoids, conjunctivitis, osteoarthritis, hypertension and high cholesterol are some of the ailments pomegranate seeds are believed to ease.

Because Israeli pomegranates ripen in early fall, they are featured on Rosh Hashana (Jewish New Year) tables for their beauty and their tart flavor. The seeds are used in both vegetable and fruit salads, while pomegranate juice is popular for marinades and beverages.

Israelis don't consider a salad to be a salad if it doesn't have chopped tomatoes in it.

Israel is a powerhouse in breeding better tomatoes and we grow a lot of them: Some 140,000 tons of tomatoes for fresh consumption each year, and twice that amount for processed foods such as tomato sauce and paste. About 2,000 tons of Israeli tomatoes and cherry tomatoes are exported annually.

Along with vitamins and minerals, tomatoes contain lycopene, the carotenoid phytonutrient that makes them red. Lycopene is a powerful antioxidant beneficial for the heart, blood pressure, prostate, bones and skin. Our bodies absorb lycopene best when tomatoes are consumed with something oily like olive oil or cheese.

Unrefined extra-virgin olive oil is the foundation of the Mediterranean diet, and hence in Israeli cooking.

Often considered a fountain of youth, EVOO is a rich source of healthful monounsaturated fat, antioxidants, vitamins and minerals. ("Virgin" means it comes from the first pressing, while "extra" signifies low acidity, both critical factors in a high-quality oil.)

In Israel, Leccino, Coratina, Koroneiki, Souri and other varieties are grown and bottled by both large and boutique brands, many of which regularly win national and international awards. Every year, between 15,000 and 16,000 tons of EVOO is produced in Israel.

We pop 'em like candies, stuff 'em with walnuts and use their silan (nectar) as a low-glycemic honey, straight up and in an endless assortment of stews, sauces, rubs and marinades.

Israelis love locally grown dates and this superfruit loves us back: dates protect against heart attack and stroke by lowering blood triglyceride levels; stabilizing blood pressure; and providing a good dose of antioxidants, vitamins A and B, protein and dietary fiber.

Eaten mainly in dried form, dates are truly "all natural" because, unlike other dried fruit, dates do not need to be preserved with potassium sorbate or sulfur dioxide. Their high sugar content preserves them naturally.

We cannot deny that Bamba, Israel's favorite packaged snack, is a processed food. But it belongs on this list because scientific studies have shown that the peanutty snack plays a key part in keeping Israeli children free of the peanut allergies that plague their peers in the West.

Bamba contains 50% peanuts and is fortified with vitamins and minerals including folic acid and iron. And now you can buy this crunchy treat at major American retailers including Walmart.

In American supermarkets, you can find just about any kind of fruit or vegetable any time of the year because whatever is not in season is imported.

In Israel, much of the produce appears according to the local season - and while that may mean forgoing strawberries in summer and peaches in winter, it's quite exciting when those items come to market ripe and fresh.

"Seasonality is very important," says Berry. "Going to local markets for fruits and vegetables in season is just lovely."

Nutritionists agree that produce retains more nutrients and flavor when it's picked at the peak of freshness and quickly brought to market, rather than picked early and left to ripen on a long truck or boat journey.

Local seasonal produce needs less human intervention (such as pesticides and coatings) and less fuel to get to consumers, and is generally much cheaper.

But don't worry: Israeli markets always have an abundance of year-round staples: onions, garlic, carrots, potatoes, tomatoes, peppers, cucumbers, celery, leafy greens, a variety of fruits and much more.

"The social aspect of eating is very important to health," says Berry. "Communal meals are relaxed and convivial. Adults should involve the children, teaching them to make sensible choices within the Mediterranean framework, and showing them how to cook and cut salads."

The Israeli lifestyle checks all those boxes. Large Shabbat dinners on Friday nights are held sacred even in the least religious of Jewish families, and it goes without saying that Passover seders, Rosh Hashana dinners and Yom Ha'atzmaut barbecues require hosts to borrow extra folding chairs to accommodate all the guests. Arab Israelis, too, are well known for serving bountiful communal meals to family, friends and newcomers alike.

Israel reportedly has the highest number of vegetarians and vegans per capita of any other country, and the latest research indicates this plant-based trend contributes to the country's overall good health.

Consuming more fruits, veggies and whole grains, but less meat, is one of four factors (along with not smoking, staying lean and exercising 30 minutes daily) that "may help prevent - and in some cases even help treat or reverse - every single one of our fifteen leading causes of death, including high blood pressure, heart disease, diabetes, and more," according to the Evidence-Based Eating Guide by American bestselling physician/author/speaker Dr. Michael Greger ( How Not to Die).

Click here for our guide to the best vegan restaurants in Israel.

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13 reasons you should eat like an Israeli - ISRAEL21c

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Hummus, tomato-cucumber salad, extra-virgin olive oil ... these and other staple foods on virtually every Israeli table undoubtedly helped propel the country to #1 on a new ranking of countries with the lowest rate of diet-related deaths worldwide and #10 on the 2019 Bloomberg Healthiest Country Index.